TRENDS IN ANTIHYPERTENSIVE PRESCRIBING

Aim. To identify trends in the prescribing of antihypertensive medicat ions and measure the changes in government and patient expenditure res ulting from any identified change. Methods. The computerised records o f 16 069 patients from six Otago practices from 1991-3 were examined. Those patients prescribed any antihypertensive medication in all 3 yea rs were selected for investigation. The antihypertensives prescribed w ere assigned to one of seven classes. The cohort was then divided into two groups; those remaining on the same class of medication for the t hree years and those changing medication class at any stage. Reasons f or any change were identified. The direct costs of the prescribing dec isions taken were evaluated. Results. 914 patients were prescribed ant ihypertensives in all 3 years. Of these 579 (63.3%) remained on the sa me class of medication, while 335 (36.7%) changed class. A clinical re ason was identified for medication change in 98% of cases available fo r examination. There was no significant shift in expenditure for those remaining on the same medication, while costs increased by 20.6% for those changing. Conclusion. For this cohort increased expenditure on a ntihypertensives was driven by those changing medication. Although the se changes were prompted by clinical reasons, better health outcomes f or patients cannot be assumed due to lack of objective indicators.