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Therapeutic traditions in Northern Ireland, Norway and Sweden: II. Hypertension. WHO Drug Utilization Research Group
Insights
Physicians in Northern Ireland are more likely to initiate antihypertensive drug treatment than those in Norway and Sweden. However, overall drug utilization is highest in Sweden, possibly due to differences in morbidity.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Antihypertensive drug utilization varies significantly across European countries.
- Understanding prescribing patterns is crucial for optimizing hypertension management.
- Therapeutic traditions influence physician decision-making in hypertension treatment.
Purpose of the Study:
- To compare the propensity to initiate antihypertensive drug treatment among physicians in Northern Ireland, Norway, and Sweden.
- To investigate the preferred first-choice antihypertensive medications in these countries.
- To explore potential reasons for observed differences in drug utilization.
Main Methods:
- A questionnaire survey was conducted among 400 general practitioners and hospital doctors.
- The survey focused on hypertension case histories and treatment initiation.
- Data on drug preferences (beta-blockers vs. thiazides) were collected and analyzed.
Main Results:
- Physicians in Northern Ireland showed a greater propensity to initiate antihypertensive treatment compared to Norway and Sweden.
- Despite higher initiation rates, overall antihypertensive drug utilization was highest in Sweden.
- Swedish physicians favored beta-blockers, while Northern Irish and Norwegian physicians more frequently selected thiazides as first-line therapy.
Conclusions:
- Prescribing patterns for antihypertensive drugs align with national sales and utilization data.
- Differences in prescribing habits may reflect distinct therapeutic traditions.
- Lower antihypertensive drug prescribing in Northern Ireland and Norway, relative to Sweden, could be attributed to variations in true or apparent morbidity.
Abstract:
A questionnaire survey based on hypertension case histories was performed among a representative sample of 400 GP's and hospital doctors in Northern Ireland, Norway and Sweden, countries having markedly different utilization of antihypertensive drugs. We found a greater propensity to start antihypertensive drug treatment in Northern Ireland than in Norway and Sweden. This was true both in mild diastolic and isolated systolic hypertension. Yet the utilization of antihypertensive drugs in Sweden is about 60% higher than in Northern Ireland and 30% higher than in Norway. Swedish physicians preferred beta-blockers as their first choice to a greater extent than physicians in Northern Ireland and Norway who selected thiazides more often. In general, the choice of drugs agreed with the sales and prescribing patterns in the three countries. Besides providing more insight in therapeutic traditions the study indicates that the lower prescribing of antihypertensive drugs in Northern Ireland, and to some extent in Norway, compared to Sweden, might be due to differences in true or apparent morbidity.