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

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Background: To examine the pharmacoepidemiology of treatment for arterial hypertension (AH) in Russia, the PYTHAGOR study has been conducted since 2001, including PYTHAGOR I–II (2001–2002), 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.

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作者简介

Elvira Kartashova

Voronezh State Medical University named after N.N. Burdenko

Email: elvira.imanova@mail.ru
ORCID iD: 0000-0002-8595-9805
SPIN 代码: 3601-9077
Researcher ID: ABH-2241-2020

Postgraduate student of the Department of Clinical Pharmacology

俄罗斯联邦, 10 Studentskaya str., Voronezh, 394036

Galina Batischeva

Voronezh State Medical University named after N.N. Burdenko

Email: bat13@mail.ru
ORCID iD: 0000-0003-4771-7466
SPIN 代码: 2285-1917
Researcher ID: AAD-8203-2019

Doctor of Medical Sciences, Full Pprofessor, Head of Department of Clinical Pharmacology 

俄罗斯联邦, 10 Studentskaya str., Voronezh, 394036

Olga Zhdanova

Voronezh State Medical University named after N.N. Burdenko

Email: olga.vr9@yandex.ru
ORCID iD: 0000-0002-3917-0395
SPIN 代码: 1235-9770
Researcher ID: А-9510-2018

Doctor of Medical Sciences, Associated Professor of the Department of Clinical Pharmacology

俄罗斯联邦, 10 Studentskaya str., Voronezh, 394036

Yulia Sharapova

Voronezh State Medical University named after N.N. Burdenko

编辑信件的主要联系方式.
Email: Shajulia2007@yandex.ru
ORCID iD: 0000-0002-4269-2143
SPIN 代码: 6545-5778
Researcher ID: AAB-5935-2020

Candidate of Medical Sciences, Associated Professor

俄罗斯联邦, 10 Studentskaya str., Voronezh, 394036

参考

  1. Kobalava ZD, Konradi AO, Nedogoda SV, et al. Arterial hypertension in adults. Clinical guidelines 2020. Russian Journal of Cardiology. 2020; 25(3):149–217. (In Russ). doi: 10.15829/1560-4071-2020-3-3786
  2. Leonova MV, Steinberg LL, Belousov YuB, et al. Results of pharmacoepidemiologic study of arterial hypertension PIFAGOR IV: physicians compliance. Russian Journal of Cardiology. 2015;(1):59–66. (In Russ). doi: 10.15829/1560-4071-2015-1-59-66
  3. Martsevich SY, Lukina YV, Zagrebelnyy AV, et al. on Behalf of the Working Groups of the Registries PROFILE and REСVASA. Combined Antihypertensive Therapy in Real Clinical Practice. Focus on Fixed Combinations of Antihypertensive Drugs (According to the Data of Outpatient Registries RECVASA and PROFILE). Rational Pharmacotherapy in Cardiology. 2017;13(3):323–9. (In Russ). doi: 10.20996/1819-6446-2017-13-3-323-329
  4. Levashova OV. Analiz struktury naznacheniya gipotenzivnykh preparatov v usloviyakh g. Kurska v sravnenii s rezul’tatami farmakoepidemiologicheskogo issledovaniya PIFAGOR IV. In: Lazarenko VA, Mal GS, Boldina NV, editors. Farmakologiya serdtsa: materialy Vserossiyskoy nauchno-prakticheskoy konferentsii s mezhdunarodnym uchastiyem, posvyashchennoy 80-letiyu kafedry farmakologii (Kursk, 29 sentyabrya 2021). Kursk: MedTestInfo; 2017. P. 7–8. (In Russ).
  5. Efanov AYu, Efanova SA, Pochinok EM, et al. Pharmacoepidemiological aspects of arterial hypertension treatment in Tyumen region. Medical Alphabet. 2018;1(3):51–5. (In Russ).
  6. Perepech NB, Shurygina VD, Tregubov AV. Doctors’ Adherence to the Guidelines on the Diagnostics and Treatment of Arterial Hypertension. Rational Pharmacotherapy in Cardiology. 2019;15(4):502–9. (In Russ.) doi: 10.20996/1819-6446-2019-15-4-502-509

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2. Fig. 1. Frequency of administration of the main groups of antihypertensive drugs by outpatient doctors of the Voronezh region compared with PYTHAGOR IV.

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3. Fig. 2. Frequency of beta-adrenoblockers administration by doctors of the Voronezh region compared with PYTHAGOR IV study.

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4. Fig. 3. Frequency of administration of preparations of the group of diuretics by doctors of the Voronezh region compared with PYTHAGOR IV.

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5. Fig. 4. Frequency of administration of CA group preparations by doctors of the Voronezh region compared with PYTHAGOR IV.

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6. Fig. 5. Frequency of administration of fixed combinations of antihypertensive drugs by doctors of the Voronezh region compared with PYTHAGOR IV.

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版权所有 © Kartashova E., Batischeva G., Zhdanova O., Sharapova Y., 2021


Media Registry Entry of the Federal Service for Supervision of Communications, Information Technology and Mass Communications (Roskomnadzor) PI No. FS77-76803 dated September 24, 2019.



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