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Expert Rev Pharmacoecon Outcomes Res. 2019 Aug;19(4):463-471. doi: 10.1080/14737167.2019.1567338. Epub 2019 Jan 29.

Prescribing pattern of antihypertensive drugs in two European cohorts: a population-based database study.

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a Departament of Microbiology, Preventive Medicine and Public Health , University of Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón) , Zaragoza , Spain.
b Center of Pharmacoeconomics (CIRFF) , University of Naples Federico II , Naples , Italy.
c Dipartimento di Scienze Mediche Traslazionali , University of Campania "Luigi Vanvitelli" , Napoli , Italy.
d Institute of Cardiovascular Sciences , University College of London , London , UK.
e Aragon Healthcare Service , Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón) , Zaragoza , Spain.


Background: Antihypertensive drugs play a crucial role in reducing cardiovascular morbidity and mortality. Variability in prescribing patterns constitutes a major challenge for current healthcare systems. This study aimed to compare patterns of use of antihypertensives in general practice in two southern European populations. Methods: Observational study. Data on antihypertensive drugs consumption in primary care setting (2016) were obtained from pharmacy refill records in Campania (Italy) and Aragon (Spain). Prescribing rates and the number of defined daily doses [DDD/1,000 inhabitants/day (DID)] were calculated, and the Drug Utilization 90% (DU90%) approach used to reveal differences in prescribing patterns in both regions. Results: Antihypertensive prescribing rates in Campania and Aragon were 250.8 (95%CI: 250.2-251.3) and 201.7 (95%CI: 200.9-202.5) users/1,000 inhabitants/year. Overall consumption was of 310.1 and 256.8 DID, respectively. Spanish users, especially women and the elderly, consumed a greater volume of diuretics. Conversely, other therapeutic subgroups were more consumed in Campania. However, the most prescribed subgroups accounted for comparable proportions of the total consumption in each region. Conclusions: Both prescribing rates and intensity of antihypertensive use were higher in Campania. Pharmacy refill records in cross-country comparisons allow to know the factors influencing variability in prescribing habits with a view to improving prescribing quality.


Drug utilization study; hypertension; international comparison; pharmacoepidemiology

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