Prescribing pattern of antihypertensive drugs in two European cohorts: a population-based database study

ABSTRACT

Background: Antihypertensive drugs play a crucial role in reducing cardiovascular morbidity and mortality. Variability in prescribing patterns constitutes a major challenge for current healthcare systems. This study aimed to compare patterns of use of antihypertensives in general practice in two southern European populations.

Methods: Observational study. Data on antihypertensive drugs consumption in primary care setting (2016) were obtained from pharmacy refill records in Campania (Italy) and Aragon (Spain). Prescribing rates and the number of defined daily doses [DDD/1,000 inhabitants/day (DID)] were calculated, and the Drug Utilization 90% (DU90%) approach used to reveal differences in prescribing patterns in both regions.

Results: Antihypertensive prescribing rates in Campania and Aragon were 250.8 (95%CI: 250.2–251.3) and 201.7 (95%CI: 200.9–202.5) users/1,000 inhabitants/year. Overall consumption was of 310.1 and 256.8 DID, respectively. Spanish users, especially women and the elderly, consumed a greater volume of diuretics. Conversely, other therapeutic subgroups were more consumed in Campania. However, the most prescribed subgroups accounted for comparable proportions of the total consumption in each region.

Conclusions: Both prescribing rates and intensity of antihypertensive use were higher in Campania. Pharmacy refill records in cross-country comparisons allow to know the factors influencing variability in prescribing habits with a view to improving prescribing quality.

KEYWORDS:

• Drug utilization study
• hypertension
• international comparison
• pharmacoepidemiology

Acknowledgments

The authors thank to O. Howard for English-language editing of the manuscript.

Author contributions

SM, MJR and EM were involved in the conception and design, analysis and interpretation of the data; SM was involved in drafting of the paper; MJR, VO, GL, CF, IA, MJL, VR y EM revised it critically for intellectual content; all authors gave the final approval of the version to be published; and all authors agree to be accountable for all aspects of the work.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by the Grupo de Investigacion en Servicios Sanitarios de Aragon (GRISSA) [B09-17R], from the Instituto de Investigación Sanitaria de Aragon (IISAragon), and funded by the regional Government in Aragon, Spain.