Comparison of primary care prescriptions for old and very old hypertensive patients
| Autor: | SELCAN TÜLÜ ÇOLAK, CANER VIZDIKLAR, MERT KAŞKAL, VOLKAN AYDIN, ÖMER ATAÇ, AHMET AKICI |
|---|---|
| Přispěvatelé: | Tülü Çolak S., Vizdiklar C., KAŞKAL M., AYDIN V., ATAÇ Ö., AKICI A. |
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
Klinik Tıp
BETA-BLOCKERS Temel Tıp Bilimleri Irrational Prescribing ADULTS General Medicine CLINICAL MEDICINE Sağlık Bilimleri Genel Tıp Fundamental Medical Sciences Clinical Medicine (MED) Tıp TIP GENEL & DAHİLİ Elderly Family Physician Health Sciences Hypertension MANAGEMENT Medicine Klinik Tıp (MED) MEDICINE GENERAL & INTERNAL |
| Popis: | Background/aim: Elderly and very elderly individuals might be subject to different approaches for the treatment of hypertension. We aimed to compare drug utilization in hypertensive old patients and very old patients in primary care, along with the evaluation of potentially inappropriate drug prescribing. Materials and methods: In this cross-sectional study, we compared prescriptions of 65–79-year-old (old patient prescriptions [OPP], n = 433,988) vs. ≥80-year-old (very old patient prescriptions [VOPP], n = 134,079) with \"essential hypertension\" diagnosis, issued by 3:1 systematically-sampled primary care physicians (n = 1431) in İstanbul throughout 2016. Drug utilization patterns and distribution of antihypertensives based on drug class and combination status were evaluated. Frequency of potentially inappropriate drugs per Beers Criteria were identified and compared. Results: Antihypertensive monotherapy practice was less common in OPP than VOPP (43.3% vs. 45.3%; p < 0.001). In both groups, the most commonly prescribed drugs were beta-blockers for monotherapy (37.4% vs. 33.1%, p < 0.001) and thiazide diuretics for combined therapy (69.8% vs. 67.4%, p < 0.001). Metoprolol was the most commonly prescribed antihypertensive both in OPP and VOPP (15.3% vs. 14.8%). Furosemide was ranked 10th in OPP and 3rd in VOPP (2.7% vs. 5.5%). Cardiovascular system drugs were the most commonly encountered potentially inappropriate medications in both groups (263.9 vs. 283.4 per 10,000 prescriptions, p = 0.004). Regarding antihypertensive drugs, 2.2% of those in OPP and 2.4% of those in VOPP were identified as potentially inappropriate (p = 0.002). Conclusion: Prescribing preferences to old and very old patients mostly showed slight differences. Almost half of prescriptions comprising antihypertensive monotherapy might imply hesitancy to prescribe combinations. Overuse of risky drugs such as furosemide in both groups, especially in the very elderly, requires more attention. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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