Pharmacoepidemiology of the administration of antihypertensive drugs by doctors in the Voronezh region in comparison with the results of the PYTHAGOR IV study

Abstract

Background: To examine the pharmacoepidemiology of treatment for arterial hypertension (AH) in Russia, the PYTHAGOR study has been conducted since 2001, including PYTHAGOR III (20012002), PYTHAGOR III (2008), and PYTHAGOR IV (2013). Increasing the role of doctors of outpatient care in the pharmacotherapy of patients with AH creates prerequisites for conducting new pharmacoepidemiological studies. Aim: To investigate the structure of prescriptions of antihypertensive drugs (AHD) by outpatient doctors at the regional level in comparison with the results of PYTHAGOR IV pharmacoepidemiological study. Materials and methods: In 2018, a survey was conducted in the Voronezh region among 104 doctors, including 58 general practitioners (55.8%), 37 therapists (35.6%), and four cardiologists (3.8%). The average age of the doctors was 45.7 13.5 years, the accumulated period of work was 21.0 13.7 years, and the period of work in an outpatient clinic was 16.6 12.4 years. Results: In the structure of doctors pREFERENCES in selecting free combinations of AHD, doctors preferred angiotensin-converting enzyme inhibitors (iACE; 90.3%), but they were prescribed more rarely than that in PYTHAGOR IV study (93.8%). The remaining AHD groups were used by doctors of the VR more often than in the PYTHAGOR IV study: beta-adrenoblockers, 89.4% (PYTHAGOR IV, 73.1%); diuretics, 88.4% (73.2%); calcium antagonists (CА), 86.5% (67.3%); angiotensin II receptor blockers (ARB), 81.7% (62.1%); imidazoline receptor agonists, 57.6% (13.3%). In the selection of fixed combinations of AHD: iACE or ARB with a diuretic was used in 71.9% and 36.4%, respectively, and iACE with CA in 46.2%. In the PYTHAGOR IV study, these combinations were used more rarely, i.e., in 33.3%, 28.0%, and 24.1%, respectively. Conclusion: The data obtained indicate adherence of doctors to modern clinical guidelines for the pharmacotherapy of AH.