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韩国初治患者抗高血压药物的处方模式:来自韩国国家健康保险服务索赔数据

Prescribing Patterns of Antihypertensives for Treatment-Naïve Patients in South Korea: From Korean NHISS Claim Data.

作者信息

Kim Sang Hyuck, Shin Dong Wook, Kim Shinhye, Han Kyungdo, Park Sang-Hyun, Kim Yul-Hee, Jeon Shin-Ae, Kwon Yong-Chol

机构信息

Department of Family Medicine, Bumin Hospital, Seoul, Republic of Korea.

Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

出版信息

Int J Hypertens. 2019 Aug 25;2019:4735876. doi: 10.1155/2019/4735876. eCollection 2019.

Abstract

BACKGROUND

Several factors influence the choice of antihypertensive drugs. To facilitate the rational use of drugs it is important to assess their prescription patterns over time. This study aims to evaluate doctors' prescribing patterns of antihypertensive drugs for drug-naïve patients in South Korea.

METHODS

The claims data of the Korean National Health Insurance Research Database from 1 January 2011 to 31 December 2015 were analyzed. The data virtually cover the entire South Korean population. Antihypertensive drugs were further subdivided into angiotensin receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEis), calcium channel blockers (CCBs), beta-blockers (BBs), and thiazide diuretics. The prescription pattern of antihypertensive drugs and associated factors were assessed according to the patients' characteristics, including associated comorbidities.

RESULTS

A total of 2,919,162 subjects had started taking antihypertension medications during the study period. ARB was the most frequently prescribed drug (51.6%) followed by CCB (45.0%), BB (18.5%), diuretics (17.0%), and ACEi (11.7%). Most patients were prescribed with monotherapy (66.7%) rather than combination therapy (33.3%), and CCB was the most frequently prescribed monotherapy drug (25.7%). For combination therapy, ARB + CCB was the most frequently prescribed combination, and the prescription frequency was found to be increasing. In patients prescribed with combination therapy, most had been prescribed single-pill fixed-dose combination.

CONCLUSION

We identified the physicians' prescription patterns of antihypertensive drugs for treatment-naïve patients. The findings of this study can lead to a rational, evidence-based, and cost-effective improvement of prescription patterns in newly diagnosed hypertensive patients.

摘要

背景

多种因素影响抗高血压药物的选择。为促进药物的合理使用,评估其随时间的处方模式很重要。本研究旨在评估韩国初治患者抗高血压药物的医生处方模式。

方法

分析了韩国国民健康保险研究数据库2011年1月1日至2015年12月31日的理赔数据。这些数据几乎覆盖了整个韩国人口。抗高血压药物进一步细分为血管紧张素受体阻滞剂(ARB)、血管紧张素转换酶抑制剂(ACEI)、钙通道阻滞剂(CCB)、β受体阻滞剂(BB)和噻嗪类利尿剂。根据患者特征(包括合并症)评估抗高血压药物的处方模式及相关因素。

结果

在研究期间,共有2919162名受试者开始服用抗高血压药物。ARB是最常处方的药物(51.6%),其次是CCB(45.0%)、BB(18.5%)、利尿剂(17.0%)和ACEI(11.7%)。大多数患者接受单药治疗(66.7%)而非联合治疗(33.3%),CCB是最常处方的单药(25.7%)。对于联合治疗,ARB+CCB是最常处方的组合,且处方频率呈上升趋势。在接受联合治疗的患者中,大多数使用的是单片固定剂量组合。

结论

我们确定了初治患者抗高血压药物的医生处方模式。本研究结果可导致新诊断高血压患者的处方模式在合理性、循证性和成本效益方面得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f06c/6732595/5e2c8ff77273/IJHY2019-4735876.001.jpg

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