Zhou Tiantian, Liao Xing, Zuo Jiaxin, Han Fang, Meng Ruogu, Zhuo Lin, Liu Guozhen, Hu Jing
Beijing Evidence-based Chinese Medicine Center , Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Chinese Medicine, Beijing, China.
Center for Evidence-based Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
Front Pharmacol. 2025 Apr 28;16:1580787. doi: 10.3389/fphar.2025.1580787. eCollection 2025.
Internet hospitals have emerged as a vital approach for patients seeking treatment for hypertension, with a significant increase in antihypertensive medication prescriptions through these innovative models. However, prescribing characteristics and guideline concordance of these prescriptions remain unclear. This study aim to analyze the prescribing characteristics of Western medicine (WM) and Chinese patent medicine (CPM) for hypertension and assess their concordance with hypertension guidelines in Internet hospitals in China, providing insights for optimizing antihypertensive CPM management.
A cross-sectional analysis was conducted using data from the Yinchuan Internet Medical Regulatory Platform (YIMRP) covering 87 enterprise-led Internet hospitals in China from 1 January 2018, to 31 March 2021. Visits diagnosed with hypertension and prescribed at least one oral antihypertensive medication (either WM or CPM) were included. Guideline concordance was evaluated by comparing prescribed individual antihypertensive WM and CPM in Internet hospitals with international and Chinese hypertension guidelines recommendations. Statistical analyses included descriptive statistics, association rule analysis, and guideline concordance assessment.
Among the 787,209 visits, 93.75% were prescribed WM alone, 4.72% CPM alone, and 1.52% a combination of CPM and WM. Calcium channel blockers (CCBs) (38.50%) was the most prescribed WM class, with nifedipine (19.67%) being the most common individual medication. Most prescriptions of antihypertensive WM were guideline-concordant. Among CPM prescriptions, only 181 (0.37%) included traditional Chinese medicine (TCM) syndrome diagnoses. Of the 38 prescribed antihypertensive CPM, only 7 were guideline-recommended. The most frequently prescribed CPM were Jiuqiang Naoliqing (17.67%), and Zhenju Jiangya tablet (14.74%), neither of which was recommended by the guidelines. The combinations of two CPM were frequently prescribed, but none of these combinations were recommended by guidelines. The most common dual CPM combination was Jiuqiang Naoliqing + Qiangli Dingxuan tablet/capsule ( 8.65%, 0.44%).
The prescribing characteristics of antihypertensive WM in Internet hospitals closely align with those in offline hospitals with relatively satisfactory guideline concordance. However, some issues persist in antihypertensive CPM prescriptions, including the lack of TCM syndrome differentiation, frequent prescription of non-recommended CPM, and duplicate therapies. Strengthening CPM management in Internet hospitals is essential for optimizing hypertension care.
互联网医院已成为高血压患者寻求治疗的重要途径，通过这些创新模式开具的降压药物处方显著增加。然而，这些处方的用药特征和与指南的一致性仍不明确。本研究旨在分析中国互联网医院中高血压的西药（WM）和中成药（CPM）用药特征，并评估其与高血压指南的一致性，为优化降压中成药管理提供见解。
采用横断面分析方法，使用来自银川互联网医疗监管平台（YIMRP）的数据，该数据涵盖了2018年1月1日至2021年3月31日期间中国87家企业主导的互联网医院。纳入诊断为高血压并开具至少一种口服降压药物（西药或中成药）的就诊病例。通过将互联网医院开具的个体降压西药和中成药与国际和中国高血压指南建议进行比较，评估指南一致性。统计分析包括描述性统计、关联规则分析和指南一致性评估。
在787,209例就诊病例中，93.75%仅开具西药，4.72%仅开具中成药，1.52%同时开具中成药和西药。钙通道阻滞剂（CCB）（38.50%）是开具最多的西药类别，硝苯地平（19.67%）是最常见的个体药物。大多数降压西药处方符合指南。在中成药处方中，仅181例（0.37%）包括中医证候诊断。在38种开具的降压中成药中，只有7种是指南推荐的。最常开具的中成药是久强脑立清（17.67%）和珍菊降压片（14.74%），两者均未被指南推荐。两种中成药的联合用药很常见，但这些联合用药均未被指南推荐。最常见的中成药双联组合是久强脑立清+强力定眩片/胶囊（8.65%，0.44%）。
互联网医院中降压西药的用药特征与线下医院密切一致，指南一致性相对令人满意。然而，降压中成药处方仍存在一些问题，包括缺乏中医证候辨证、频繁开具非推荐的中成药以及重复用药。加强互联网医院的中成药管理对于优化高血压治疗至关重要。
