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印度南部一家三级护理教学医院抗高血压药物的使用情况研究及对标准治疗指南的依从性

Utilization Study of Antihypertensives in a South Indian Tertiary Care Teaching Hospital and Adherence to Standard Treatment Guidelines.

作者信息

Datta Supratim

机构信息

Department of Pharmacology, Sikkim Manipal Institute of Medical Sciences, East Sikkim, Sikkim, India.

出版信息

J Basic Clin Pharm. 2016 Dec;8(1):33-37. doi: 10.4103/0976-0105.195100.

Abstract

AIM

Hypertension represents a major health problem primarily because of its role in contributing to the initiation and progression of major cardiovascular diseases. Concerns pertaining to hypertension and its sequelae can be substantially addressed and consequent burden of disease reduced by early detection and appropriate therapy of elevated blood pressure. This cross-sectional observational study aims at analyzing the utilization pattern of antihypertensives used for the treatment of hypertension at a tertiary care hospital in perspective of standard treatment guidelines.

MATERIALS AND METHODS

Prescriptions were screened for antihypertensives at the medicine outpatient department of a tertiary care teaching hospital. Medical records of the patients were scrutinized after which 286 prescriptions of patients suffering from hypertension were included. The collected data were sorted and analyzed on the basis of demographic characteristics and comorbidities.

RESULTS

The calcium channel blockers were the most frequently used antihypertensive class of drugs (72.3%). Amlodipine (55.6%) was the single most frequently prescribed antihypertensive agent. The utilization of thiazide diuretics was 9%. Adherence to the National List of Essential Medicines (NLEMs) was 65%. The combination therapy was used more frequently (51.5%) than monotherapy (48.8%). The use of angiotensin-converting enzyme inhibitors/angiotensin 2 receptor blockers (ACE-I/ARB) was 41.4% in diabetes.

CONCLUSIONS

The treatment pattern, in general, conformed to standard treatment guidelines. Few areas, however, need to be addressed such as the underutilization of thiazide diuretics, need for more awareness of drugs from the NLEMs and enhanced use of ACE-I/ARB in diabetic hypertensives.

摘要

目的

高血压是一个主要的健康问题,主要是因为它在引发和促进主要心血管疾病方面所起的作用。通过早期发现和适当治疗高血压,可以大幅解决与高血压及其后遗症相关的问题,并减轻随之而来的疾病负担。这项横断面观察性研究旨在从标准治疗指南的角度分析一家三级护理医院用于治疗高血压的抗高血压药物的使用模式。

材料与方法

在一家三级护理教学医院的内科门诊筛选抗高血压药物的处方。仔细检查患者的病历,之后纳入286例高血压患者的处方。收集的数据根据人口统计学特征和合并症进行分类和分析。

结果

钙通道阻滞剂是最常用的抗高血压药物类别(72.3%)。氨氯地平(55.6%)是最常处方的单一抗高血压药物。噻嗪类利尿剂的使用率为9%。对国家基本药物清单(NLEMs)的依从率为65%。联合治疗的使用频率(51.5%)高于单一治疗(48.8%)。在糖尿病患者中,血管紧张素转换酶抑制剂/血管紧张素2受体阻滞剂(ACE-I/ARB)的使用率为41.4%。

结论

总体而言,治疗模式符合标准治疗指南。然而,仍有一些方面需要解决,如噻嗪类利尿剂的使用不足、需要提高对国家基本药物清单中药物的认识,以及在糖尿病高血压患者中增加ACE-I/ARB的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8eb5/5201061/47d7bfe22310/JBCP-8-33-g003.jpg

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