V.M. Kornatsky, A.P. Dorogoi, Zh.H. Adaricheva. Clinical pharmacoeconomic analysis in the cardiology practice

The aim – to study features of drug prescriptions for the treatment of arterial hypertension (AH) in outpatient and inpatient settings using integrated AVS-, VEN (Vital, Essential, Non-essential) and frequency analysis.

Materials and methods. Physician recommendations in outpatient cards and in discharge notes after hospital treatment were retrospectively analyzed using peer review method according to the designed protocol. The study included 213 records of patients (101 males) with AH stage I and II who had blood pressure of 140/90 mm Hg and above. Patients with stage III AH, concomitant tumors or any other serious diseases requiring pathogenetic treatment were not included in the study. VEN-analysis was performed to study compliance with clinical protocols or guidelines. Classes of recommendations, level of evidence, results of randomized clinical trials and relevant meta-analyses were taken into account. If a drug recommended by doctor was based on guidelines, it attributed to the category of «V» – vital: diuretics (thiazide or loop), angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers and β-blockers.

Results. Every patient with AH in general clinical practice is recommended to take up to 4 drugs (4.3 for women, 3.6 for men). Original and generic foreign drugs are prescribed more often even in the presence of Ukrainian analogues in the pharmaceutical market. The fixed combinations of antihypertensives are prescribed less than the same drugs separately, affecting adherence and cost of treatment.

Conclusions. Polypragmasy is noted in the outpatient treatment of patients with AH; drugs of foreign manufacturers, insufficient use of fixed drug combinations dominate in prescriptions that adversely affects both adherence and cost of treatment.

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