Pharmacoutilization of antihypertensive drugs: a model of analysis

Obiectives: To identify clinical and economic indicators of pharmacoutiliza tion of antihypertensive drugs. patients and methods: 4614 subjects receivi ng a first prescription for amlodipine, atenolol, fosinopril, indapamide, o r losartan were included in the study. All prescriptions filled during the study period from January 1, 1997 to December 31, 1998 were considered. A r etrospective analysis was carried out on information recorded in the drug d atabase. The percentage of patients continuing, discontinuing, and switchin g the initial treatment, duration of treatment, and doses used were calcula ted together with total costs. Results: A large proportion of patients (65. 1%) discontinued the treatment. From the analysis of the mean daily dose ta ken by patients who continued the treatment, it was found that many subject s took a drug dosage which was below the therapeutic dose range, whereas th e administration of doses above the therapeutic range occurred only occasio nally. Continuation of treatment accounted for 48.1% of total costs, switch ing accounted for 20.8%, and discontinuation represented 31.1% of total exp enditures. Conclusions: With adequate markers, helpful data can be collecte d for monitoring the quality of antihypertensive drug prescriptions and the rational usage of resources in the general practice setting.