Initial therapeutic choices for hypertension in the Portuguese Sentinel Practice Network

Daniel Pinto, Ana Paula Rodrigues, Baltazar Nunes

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

INTRODUCTION AND OBJECTIVES: Finding out which drugs are chosen to treat incident cases of hypertension may help in interpreting prevalent use of antihypertensive agents. We aimed to determine the proportion of patients who begin treatment with each antihypertensive drug class, which physicians initiate treatment and whether family physicians alter prescriptions initiated by others, and to compare the prescribing patterns of family physicians and other specialists.

METHODS: In this cohort-nested cross-sectional study between 2014 and 2015 within the Portuguese Sentinel Practice Network, family physicians notified incident cases of hypertension, reporting treatment, who issued the initial prescription and whether treatments initiated by other physicians were changed.

RESULTS: A total of 681 incident cases were notified. The initial prescription was issued by the patient's family physician in 86.9% of cases (95% CI: 84.2-89.3%). The most frequently used agents were angiotensin-converting enzyme inhibitors (51.3% of patients, 95% CI: 47.5-55.0%), thiazide and thiazide-like diuretics (32.2%, 95% CI: 28.8-35.8%), and angiotensin receptor blockers (21.4%, 95% CI: 18.5-24.7%). Compared to other specialists, family physicians used less beta-blockers (20.4 vs. 5.9%, p<0.001) and loop diuretics (8.2 vs. 0.8%, p=0.003). Prescriptions initiated by other specialists were changed by family physicians in 11.6% of cases (95% CI: 6.0-19.6%).

CONCLUSION: Angiotensin-converting enzyme inhibitors were the most frequently prescribed antihypertensive class. Most diagnoses were made by the patient's own family physician. Prescriptions initiated by other specialists were usually continued by family physicians. Prescribing patterns were similar between family physicians and other specialists, except for lower use of beta-blockers and loop diuretics.

Original languageEnglish
Pages (from-to)657-663
Number of pages7
JournalRevista Portuguesa de Cardiologia
Volume37
Issue number8
Early online date17 Jul 2018
DOIs
Publication statusPublished - Aug 2018

Fingerprint

Family Physicians
Hypertension
Prescriptions
Antihypertensive Agents
Sodium Potassium Chloride Symporter Inhibitors
Therapeutics
Angiotensin-Converting Enzyme Inhibitors
Thiazides
Physicians
Sodium Chloride Symporter Inhibitors
cyhalothrin
Angiotensin Receptor Antagonists
Cross-Sectional Studies

Keywords

  • Hypertension
  • Antihypertensive agents
  • Drug utilization
  • Primary care
  • Sentinel surveillance

Cite this

@article{a998c4c109fd4b8d8f9284695446f2e7,
title = "Initial therapeutic choices for hypertension in the Portuguese Sentinel Practice Network",
abstract = "INTRODUCTION AND OBJECTIVES: Finding out which drugs are chosen to treat incident cases of hypertension may help in interpreting prevalent use of antihypertensive agents. We aimed to determine the proportion of patients who begin treatment with each antihypertensive drug class, which physicians initiate treatment and whether family physicians alter prescriptions initiated by others, and to compare the prescribing patterns of family physicians and other specialists.METHODS: In this cohort-nested cross-sectional study between 2014 and 2015 within the Portuguese Sentinel Practice Network, family physicians notified incident cases of hypertension, reporting treatment, who issued the initial prescription and whether treatments initiated by other physicians were changed.RESULTS: A total of 681 incident cases were notified. The initial prescription was issued by the patient's family physician in 86.9{\%} of cases (95{\%} CI: 84.2-89.3{\%}). The most frequently used agents were angiotensin-converting enzyme inhibitors (51.3{\%} of patients, 95{\%} CI: 47.5-55.0{\%}), thiazide and thiazide-like diuretics (32.2{\%}, 95{\%} CI: 28.8-35.8{\%}), and angiotensin receptor blockers (21.4{\%}, 95{\%} CI: 18.5-24.7{\%}). Compared to other specialists, family physicians used less beta-blockers (20.4 vs. 5.9{\%}, p<0.001) and loop diuretics (8.2 vs. 0.8{\%}, p=0.003). Prescriptions initiated by other specialists were changed by family physicians in 11.6{\%} of cases (95{\%} CI: 6.0-19.6{\%}).CONCLUSION: Angiotensin-converting enzyme inhibitors were the most frequently prescribed antihypertensive class. Most diagnoses were made by the patient's own family physician. Prescriptions initiated by other specialists were usually continued by family physicians. Prescribing patterns were similar between family physicians and other specialists, except for lower use of beta-blockers and loop diuretics.",
keywords = "Hypertension, Antihypertensive agents, Drug utilization, Primary care, Sentinel surveillance",
author = "Daniel Pinto and Rodrigues, {Ana Paula} and Baltazar Nunes",
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Initial therapeutic choices for hypertension in the Portuguese Sentinel Practice Network. / Pinto, Daniel; Rodrigues, Ana Paula; Nunes, Baltazar.

In: Revista Portuguesa de Cardiologia, Vol. 37, No. 8, 08.2018, p. 657-663.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Initial therapeutic choices for hypertension in the Portuguese Sentinel Practice Network

AU - Pinto, Daniel

AU - Rodrigues, Ana Paula

AU - Nunes, Baltazar

N1 - Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

PY - 2018/8

Y1 - 2018/8

N2 - INTRODUCTION AND OBJECTIVES: Finding out which drugs are chosen to treat incident cases of hypertension may help in interpreting prevalent use of antihypertensive agents. We aimed to determine the proportion of patients who begin treatment with each antihypertensive drug class, which physicians initiate treatment and whether family physicians alter prescriptions initiated by others, and to compare the prescribing patterns of family physicians and other specialists.METHODS: In this cohort-nested cross-sectional study between 2014 and 2015 within the Portuguese Sentinel Practice Network, family physicians notified incident cases of hypertension, reporting treatment, who issued the initial prescription and whether treatments initiated by other physicians were changed.RESULTS: A total of 681 incident cases were notified. The initial prescription was issued by the patient's family physician in 86.9% of cases (95% CI: 84.2-89.3%). The most frequently used agents were angiotensin-converting enzyme inhibitors (51.3% of patients, 95% CI: 47.5-55.0%), thiazide and thiazide-like diuretics (32.2%, 95% CI: 28.8-35.8%), and angiotensin receptor blockers (21.4%, 95% CI: 18.5-24.7%). Compared to other specialists, family physicians used less beta-blockers (20.4 vs. 5.9%, p<0.001) and loop diuretics (8.2 vs. 0.8%, p=0.003). Prescriptions initiated by other specialists were changed by family physicians in 11.6% of cases (95% CI: 6.0-19.6%).CONCLUSION: Angiotensin-converting enzyme inhibitors were the most frequently prescribed antihypertensive class. Most diagnoses were made by the patient's own family physician. Prescriptions initiated by other specialists were usually continued by family physicians. Prescribing patterns were similar between family physicians and other specialists, except for lower use of beta-blockers and loop diuretics.

AB - INTRODUCTION AND OBJECTIVES: Finding out which drugs are chosen to treat incident cases of hypertension may help in interpreting prevalent use of antihypertensive agents. We aimed to determine the proportion of patients who begin treatment with each antihypertensive drug class, which physicians initiate treatment and whether family physicians alter prescriptions initiated by others, and to compare the prescribing patterns of family physicians and other specialists.METHODS: In this cohort-nested cross-sectional study between 2014 and 2015 within the Portuguese Sentinel Practice Network, family physicians notified incident cases of hypertension, reporting treatment, who issued the initial prescription and whether treatments initiated by other physicians were changed.RESULTS: A total of 681 incident cases were notified. The initial prescription was issued by the patient's family physician in 86.9% of cases (95% CI: 84.2-89.3%). The most frequently used agents were angiotensin-converting enzyme inhibitors (51.3% of patients, 95% CI: 47.5-55.0%), thiazide and thiazide-like diuretics (32.2%, 95% CI: 28.8-35.8%), and angiotensin receptor blockers (21.4%, 95% CI: 18.5-24.7%). Compared to other specialists, family physicians used less beta-blockers (20.4 vs. 5.9%, p<0.001) and loop diuretics (8.2 vs. 0.8%, p=0.003). Prescriptions initiated by other specialists were changed by family physicians in 11.6% of cases (95% CI: 6.0-19.6%).CONCLUSION: Angiotensin-converting enzyme inhibitors were the most frequently prescribed antihypertensive class. Most diagnoses were made by the patient's own family physician. Prescriptions initiated by other specialists were usually continued by family physicians. Prescribing patterns were similar between family physicians and other specialists, except for lower use of beta-blockers and loop diuretics.

KW - Hypertension

KW - Antihypertensive agents

KW - Drug utilization

KW - Primary care

KW - Sentinel surveillance

U2 - 10.1016/j.repc.2017.10.016

DO - 10.1016/j.repc.2017.10.016

M3 - Article

VL - 37

SP - 657

EP - 663

JO - Revista Portuguesa de Cardiologia

JF - Revista Portuguesa de Cardiologia

SN - 0870-2551

IS - 8

ER -