School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, QLD, 4102, Australia.
Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
BMC Cardiovasc Disord. 2022 Aug 10;22(1):368. doi: 10.1186/s12872-022-02799-z.
Non-communicable diseases are a growing burden in many African countries; cardiovascular disease is the main disease. Antihypertensive medicines (AHM) are a common treatment option but we know little about community use in most low- and medium-income countries (LMIC). We aimed to describe the use of antihypertensive medicines (AHM) in Ghana and Nigeria using a novel data source.
We used data from mPharma-a health and pharmaceutical company which distributes pharmaceuticals to hospital and retail pharmacies. We extracted data using the anatomical therapeutic chemical (ATC) classification codes and calculated use in defined daily doses and explored patterns by class, medicines, dose, and originator or generic product.
AHM use differed between Ghana and Nigeria. The most used classes in Ghana were angiotensin receptor blockers (ARB) followed by calcium channel blockers (CCB) and angiotensin-converting-enzyme inhibitors (ACEi). The five most used products were 16 mg candesartan, 30 mg nifedipine, 10 mg lisinopril, 5 mg amlodipine and 50 mg losartan. In Nigeria ARB, CCB and diuretics were widely used; the top five products were 50 mg losartan, 10 mg lisinopril, 30 mg nifedipine, 40 mg furosemide, and 5 mg amlodipine. More originator products were used in Ghana than Nigeria.
The differences between Ghana and Nigeria may result from a combination of medical, contextual and policy evidence and reflect factors related to clinical guidance (e.g. standard treatment guidelines), accessibility to prescribers and the role of community pharmacies, and structure of the health system and universal health coverage including funding for medicines. We show the feasibility of using novel data sources to gain insights on medicines use in the community.
在许多非洲国家，非传染性疾病的负担日益加重；心血管疾病是主要疾病。抗高血压药物（AHM）是一种常见的治疗选择，但我们对大多数中低收入国家（LMIC）的社区使用情况知之甚少。我们旨在使用一种新的数据来源描述加纳和尼日利亚的抗高血压药物（AHM）的使用情况。
我们使用了 mPharma 的数据，这是一家向医院和零售药店分销药品的医疗和制药公司。我们使用解剖治疗化学（ATC）分类代码提取数据，并计算出每日剂量的使用情况，并通过类别、药物、剂量以及原研药或仿制药产品探索使用模式。
加纳和尼日利亚的 AHM 使用情况不同。加纳最常用的类别是血管紧张素受体阻滞剂（ARB），其次是钙通道阻滞剂（CCB）和血管紧张素转换酶抑制剂（ACEi）。使用最多的五种产品分别是 16mg 坎地沙坦、30mg 硝苯地平、10mg 赖诺普利、5mg 氨氯地平和 50mg 氯沙坦。在尼日利亚，ARB、CCB 和利尿剂广泛使用；使用最多的五种产品分别是 50mg 氯沙坦、10mg 赖诺普利、30mg 硝苯地平、40mg 呋塞米和 5mg 氨氯地平。加纳使用的原研产品多于尼日利亚。
加纳和尼日利亚之间的差异可能是由于医疗、背景和政策证据的综合作用造成的，反映了与临床指导（如标准治疗指南）、开处方者的可及性和社区药房的作用以及卫生系统的结构和全民健康覆盖相关的因素，包括药品的供资。我们展示了使用新型数据源了解社区药物使用情况的可行性。
