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在埃塞俄比亚南部选定医院的降压药物处方模式、医生对ISH 2020 指南的遵守情况,以及门诊药物价格对血压控制的影响。

Antihypertensive prescribing pattern, prescriber adherence to ISH 2020 guidelines, and implication of outpatient drug price on blood pressure control at selected hospitals in Southern Ethiopia.

机构信息

Tehran University of Medical Sciences, Tehran, Iran.

College of Medicine and Health Sciences, Department of Pharmacy, Arba Minch University, Arba Minch, Ethiopia.

出版信息

Eur J Clin Pharmacol. 2022 Sep;78(9):1487-1502. doi: 10.1007/s00228-022-03352-9. Epub 2022 Jun 16.

Abstract

PURPOSE

To determine the impact of drug prescribing pattern, outpatient drug price of medicines, and level of adherence to evidence-based international guidelines on blood pressure (BP) control at selected hospitals in Southern Ethiopia.

METHODS

Hospital-based cross-sectional study was conducted. The data entry and analysis were done by using SPSS version 21.0.

RESULTS

A mean age of participants was 55.87 ± 11.02 years. The rate of BP control was 17.5% based on International Society of Hypertension (ISH) guidelines 2020. In about two-thirds of patients, 270 (66.5%) were taking combination therapy. Mean annual cost of drugs for hypertension was 11.39 ± 3.98 US dollar (USD). Treatment was affordable for only 91 (22.4%) of patients. There was considerable variation on prescriber's adherence to evidence-based guidelines. Body mass index (BMI) of 18-24.9 kg/m, adjusted odds ratio (AOR) = 3.63 (95% confidence interval (C.I), 1.169-11.251, p = 0.026), physically activity, AOR = 12.69 (95% C.I, 1.424-113.17, p = 0.023), presence of no comorbidity, AOR = 12.82 (95% C.I, 4.128-39.816, p = 0.000), and taking affordable antihypertensive regimen, AOR = 3.493 (95% C.I, 1.4242-9.826, p = 0.018), were positively associated BP control.

CONCLUSION

The level of BP control, affordability of drugs for the management of hypertension and related comorbidities, and the prescriber's adherence to evidence-based guidelines were inadequate. Therefore, addressing factors associated with good BP control including affordability and clinician adherence to evidence-based guidelines by responsible stakeholders could improve BP control and reduce associated complications.

摘要

目的

在埃塞俄比亚南部的选定医院,确定药物处方模式、药品门诊价格和对基于证据的国际指南的遵循程度对血压(BP)控制的影响。

方法

进行了基于医院的横断面研究。数据输入和分析均使用 SPSS 版本 21.0 完成。

结果

参与者的平均年龄为 55.87±11.02 岁。根据国际高血压学会(ISH)2020 年指南,BP 控制率为 17.5%。在大约三分之二的患者中,270 名(66.5%)患者接受了联合治疗。高血压药物的年平均费用为 11.39±3.98 美元(USD)。只有 91 名(22.4%)患者的治疗费用可负担得起。开处方者对基于证据的指南的遵循程度存在相当大的差异。体重指数(BMI)为 18-24.9kg/m,调整后的优势比(AOR)=3.63(95%置信区间(CI),1.169-11.251,p=0.026),体力活动,AOR=12.69(95%CI,1.424-113.17,p=0.023),无合并症,AOR=12.82(95%CI,4.128-39.816,p=0.000),服用负担得起的降压方案,AOR=3.493(95%CI,1.4242-9.826,p=0.018),与 BP 控制呈正相关。

结论

BP 控制水平、高血压管理和相关合并症药物的可负担性以及开处方者对基于证据的指南的遵循程度不足。因此,相关利益相关者解决与良好 BP 控制相关的因素,包括可负担性和临床医生对基于证据的指南的遵循,可能会改善 BP 控制并降低相关并发症。

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