Related Experiment Videos
Prescribing pattern of antihypertensive drugs in the community
H H Rotmensch1, L Mendelevitch, D S Silverberg
1Maccabi Health Fund, Tel-Aviv, Israel.
Insights
This study examined hypertension medication use in 200 Israeli patients. Angiotensin-converting enzyme (ACE) inhibitors were most common, while diuretics and beta-blockers were underutilized compared to international standards.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Public Health
Background:
- Hypertension therapy selection is debated.
- Limited data exists on antihypertensive prescribing patterns in Israeli primary care.
Purpose of the Study:
- To investigate antihypertensive drug utilization in a primary care setting in Israel.
- To compare prescribing patterns with international trends.
Main Methods:
- Retrospective analysis of antihypertensive prescriptions for 200 patients.
- Data collected from the Maccabi Health Fund between April and June 1994.
Main Results:
- Monotherapy was used in 64% of patients, combination therapy in 36%.
- Angiotensin-converting enzyme (ACE) inhibitors were the most frequent monotherapy (33.6%).
- Overall, diuretics (21.5%) and beta-blockers (39.5%) showed lower utilization compared to calcium channel blockers (46%) and ACE inhibitors (40%).
Conclusions:
- Diuretic and beta-blocker utilization in Israel is lower than expected, despite evidence of their benefits.
- Factors like lack of national guidelines and absence of utilization reviews may influence prescribing habits.
Abstract:
The selection of the most appropriate therapy for hypertension remains a controversial issue. Little information is available regarding the prescribing patterns of antihypertensives in the primary care setting in Israel. The use of antihypertensives in 200 patients of the Maccabi Health Fund was, therefore, examined from April to June 1994. Sixty-four per cent of patients received monotherapy and 36% combination therapy. The most commonly prescribed medication for monotherapy were angiotensin-converting enzyme (ACE) inhibitors (33.6%), followed by beta-blockers (28.1%) and calcium channel antagonists (26.6%). Diuretics were prescribed to 7.0% of the patients. Analysis of overall drug utilization showed that diuretics were used in 21.5% of patients, beta-blockers in 39.5%, calcium channel blockers in 46% and ACE inhibitors in 40% of patients. Despite the growing evidence of the benefits of diuretics and beta-blockers, our results show a low utilization of these agents in comparison to other countries. It may be speculated that the lack of national guidelines, the absence of utilization reviews by third party providers as well as differences in patient population and climate conditions may all contribute to the current prescribing habits of physicians in the Israeli community.