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An evaluation of antihypertensive prescribing practices
D A Knapp1, R J Michocki, J P Richardson
1Center on Drugs and Public Policy, and Schools of Pharmacy and Medicine, University of Maryland, Baltimore.
Pharmacoeconomics
|April 8, 1994
Summary
US physicians generally follow hypertension management guidelines. Continuing education should focus on optimal use of alpha 2-agonists and cost-effective once-daily dosing of antihypertensives.
Area of Science:
- Cardiology
- Pharmacoeconomics
- Internal Medicine
Background:
- Hypertension management requires adherence to guidelines and cost-effective prescribing.
- Physician prescribing patterns for hypertension need evaluation against established standards.
- Pharmacoeconomic considerations are crucial for long-term patient management.
Purpose of the Study:
- To assess US physicians' management of hypertension, including drug prescribing practices.
- To compare physician prescribing patterns with National Institutes of Health (NIH) guidelines.
- To analyze the pharmacoeconomics of prescribed antihypertensive medications.
Main Methods:
- Utilized a 1991 national US database derived from physician-patient encounter forms.
- Evaluated diagnostic/screening services, patient counseling, drug prescribing, and follow-up care.
- Compared prescribed antihypertensive drugs based on NIH guidelines and cost-effectiveness.
Main Results:
- Physicians largely adhered to NIH guidelines for hypertension care.
- A need for continuing medical education was identified regarding alpha 2-agonists' optimal use.
- Specific once-daily formulations of hydrochlorothiazide, chlorthalidone, and atenolol were found to be more cost-effective.
Conclusions:
- US physicians demonstrate general compliance with hypertension management guidelines.
- Targeted education is needed for appropriate use of centrally acting alpha 2-agonists.
- Cost-effective once-daily antihypertensive options exist, particularly hydrochlorothiazide, chlorthalidone, and atenolol.
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