A PRESCRIPTION SURVEY IN A HOSPITAL HYPERTENSION OUTPATIENT-CLINIC

Aims The objective of this study was to investigate drug utilization i n the management of hypertension in Hong Kong. Methods We conducted a prescription survey to examine the use of antihypertensive drugs in a hypertension clinic in a regional hospital and the resulting expenditu re incurred. The use of concurrent medications such as antidiabetic dr ugs and lipid-lowering agents was also Examined. Results During a 7-we ek study period, 530 prescriptions were collected. All except 14 patie nts received antihypertensive drugs with 262 (50.8%) on monotherapy an d 254 (49.2%) on combination therapy. Calcium channel blocking agents and p-adrenoceptor blocking agents were the two most popular antihyper tensive drugs used in both monotherapy (38% and 31%, respectively) and combination therapy (27% and 33%, respectively). forty-nine patients (19%) received three antihypertensive drugs or more. The number of ant ihypertensive drugs showed a significant positive correlation with the duration of attendance at the clinic (r=0.88, P<0.001). Of the total 530 prescriptions, 5.6% and 10% contained antidiabetic drugs and lipid -lowering agents, respectively. Calcium channel blocking agents, angio tensin converting enzyme (ACE) inhibitors and lipid lowering agents, a ccounted for 82% (HK$211 654; pound 1 approximate to HK$12) of the tot al drug expenditure (HK$258 115). Seventy-nine percent of the lipid lo wering agents prescribed were hydroxymethylglutaryl coenzyme A (HMG Co n) reductase inhibitors. Amlodipine accounted for 26% of usage but con tributed to 41% of the overall costs of calcium channel blocking agent s. alpha(1)-adrenoceptor blocking agents were only used infrequently a nd were the most expensive class of drugs, due to the preferred use of doxazosin rather than prazosin which is far cheaper than the former. Conclusions In view of the use of these often costly drugs for long-te rm therapy, monitoring of their use and its correlation with clinical outcomes and quality of life is essential to ensure the optimal use of health care resources.