[Quality of conventional release verapamil prescription in patients with arterial hypertension]
J E Machado-Alba1, C Giraldo-Giraldo2, M E Machado-Duque2
1Médico, Magister en Farmacoepidemiología, Magister en Farmacología, PhD en Farmacología, Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira, Colombia.
Insights
Educational interventions reduced conventional release verapamil (CRV) use in hypertension patients. This study highlights moderate adherence and the need for targeted programs to minimize cardiovascular risks associated with CRV.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Hypertension management requires careful drug selection.
- Conventional release verapamil (CRV) poses cardiovascular risks.
- Identifying and reducing inappropriate CRV use is crucial.
Purpose of the Study:
- To identify patients on CRV for hypertension.
- To inform healthcare providers about cardiovascular risks.
- To reduce the number of patients treated with CRV.
Main Methods:
- Quasi-experimental, prospective, before-and-after study.
- 7289 hypertensive patients on CRV in 8 Colombian cities (Oct-Dec 2012).
- 108 educational interventions followed by 3-month evaluation of CRV prescription suspension.
Main Results:
- Treatment withdrawal with CRV achieved in 26.3% (1922/7289) of patients.
- Higher CRV withdrawal rates were associated with treatment in Medellin (OR: 17.6).
- Mean patient age was 67.9 years, with 70.6% males.
Conclusions:
- Moderate adherence to recommendations for CRV use in hypertensive patients.
- Intervention programs are necessary to reduce inappropriate CRV prescribing.
- Targeted interventions are needed in areas with low CRV reduction rates.
Objective:
To identify patients who were being treated for hypertension with conventional release verapamil (CRV), and to notify the professional responsible for their health care on cardiovascular risk to which they are exposed and achieve a reduction in the number of patients who are treated with this drug.
Methods:
A quasi-experimental prospective before and after study without a control group was conducted on 7289 patients diagnosed with hypertension who were on treatment with CRV, between October 1, 2012 and December 31, 2012 in 8 Colombian cities, collected from a database for dispensing medicines. Socio-demographic and pharmacological variables were evaluated. A total of 108 educational interventions were performed on those responsible for their health care, and evaluated within three months with the proportion of suspension of the prescriptions of CRV being evaluated. Multivariate analysis was performed using SPSS 22.0.
Results:
The mean age of patients was 67.9±11.8 years (range: 26-96 years), of which 70.6% were men. Withdrawal of treatment with CRV was achieved in a total of 1922 patients (26.3% of users), distributed as follows: 1160 (60.4%) were the presentation of 120mg, while 762 (39.6%) the 80mg. The variable being treated in the city of Medellin (OR: 17.6; 95% CI: 11.949 to 25.924; P<.01) was statistically significantly associated with the replacement of CRV for another antihypertensive.
Conclusions:
A relatively moderate adherence to recommendations about the proper use of CRV in hypertensive patients, was found. Intervention programs that reduce inappropriate prescribing of potential risks to patients of insurance companies and cities where the change was not achieved, must be enforced.
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