Medicaid Prescriber Compliance with Joint National Committee VI Hypertension Treatment Guidelines
| Autor: | Steven L. Clause, Robert A. Hamilton |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_specialty Attitude of Health Personnel Sodium Chloride Symporter Inhibitors Thiazide diuretic Adrenergic beta-Antagonists New York Alternative medicine Angiotensin-Converting Enzyme Inhibitors 030204 cardiovascular system & hematology Benzothiadiazines 030226 pharmacology & pharmacy 03 medical and health sciences Drug Utilization Review 0302 clinical medicine Electronic records Epidemiology medicine Humans Pharmacology (medical) Practice Patterns Physicians' Diuretics Antihypertensive Agents Aged Retrospective Studies Antihypertensive medication Hypertension treatment Medicaid business.industry Middle Aged Calcium Channel Blockers Surgery Drug Combinations Blood pressure Hypertension Practice Guidelines as Topic Emergency medicine Female Guideline Adherence business |
| Zdroj: | Annals of Pharmacotherapy. 36:1505-1511 |
| ISSN: | 1542-6270 1060-0280 |
| DOI: | 10.1345/aph.1a451 |
| Popis: | BACKGROUND: Since the early 1970s, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) has been tasked with the formulation of national guidelines for the management of hypertension. These were significantly changed in 1993 with publication of JNC-5. JNC-6 kept many basic treatment recommendations (i.e., initiation of therapy with a thiazide diuretic or β-blocker), partly in response to the low adoption rate of the treatment recommendations of JNC-5. OBJECTIVE: To describe single-drug outpatient therapy of hypertension and temporally correlate these therapies with the publication of JNC-5 and JNC-6. METHODS: The electronic records of randomly selected New York State Medicaid recipients without hospitalization who had a diagnosis of hypertension and who were receiving only 1 antihypertensive medication were analyzed for 1994, 1997, and 1999. This analysis identified the medications selected for monotherapy of hypertension and compared these therapies with JNC recommendations. The analysis was correlated to patient comorbidities to further account for provider selection of a non—first-line agent. RESULTS: In 1994, angiotensin-converting enzyme (ACE) inhibitors and calcium-channel blockers accounted for 69% of therapies, with 67.5% of these patients having no JNC-recognized individualizing consideration for their use. In 1999, the combined use of ACE inhibitors and calcium-channel blockers accounted for over 65% of all single-drug therapy; 60% of these patients had no individualizing considerations. Also, in 1999, 47.7% of all patients appeared to be receiving antihypertensive therapies that are not compliant with JNC recommendations. CONCLUSIONS: Single-drug therapy of hypertension in a nonhospitalized New York state Medicaid population from 1994 through 1999 did not closely follow JNC recommendations for the single-agent treatment of hypertension. |
| Databáze: | OpenAIRE |
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