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Adherence to Available Clinical Practice Guidelines for Initiation of Antihypertensive Medication in Patients With or Without Diabetes Mellitus and Other Comorbidities in Taiwan
Author(s) -
Chou ChihChieh,
Lin WeiShiang,
Kao TungWei,
Chang YawWen,
Chen WeiLiang
Publication year - 2012
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/0091270011398658
Subject(s) - medicine , diabetes mellitus , medical prescription , kidney disease , heart failure , comorbidity , coronary artery disease , population , antihypertensive drug , intensive care medicine , disease , angiotensin receptor blockers , emergency medicine , angiotensin converting enzyme , blood pressure , pharmacology , environmental health , endocrinology
The aim of the study is to explore the prescribing trends for antihypertensive medications in newly diagnosed hypertensive subjects with different comorbidities with or without diabetes in Taiwan. Factors for prescribing angiotensin receptor blockers (ARBs) are also investigated. The study design is a secondary data analysis of Taiwanese population from the National Health Insurance, from 1997, to 2004. A total of 3218187 patients were included in the statistical analysis; there were 2963861 cases without diabetes and 254326 with diabetes. From 1998 to 2004, in both arms, there were significant trends for increasing ARB use (ρ = 0.964, P < .001). Patients with preexisting diabetes were more likely to be prescribed ARBs than those without preexisting diabetes (OR = 1.68; 95% CI, 1.65–1.70). A similar situation was noted for patients with the comorbidities of cerebrovascular accident (OR = 1.61), congestive heart failure (OR = 2.20), coronary artery disease (OR = 1.63), and chronic kidney disease (OR = 2.23). Although diuretics were not the most commonly prescribed antihypertensive for nondiabetics during the study period, physicians' prescribing practices were within the range of published clinical practice guidelines for hypertension management. Further comprehensive studies are needed to explore the impact of prescription patterns, especially ARBs, on the allocation of health care resources and therapeutic efficacy in Taiwan.