Analysis Of Out-patient Prescriptions For Hypertensive Patients And A Cross-sectional Study On Knowledge Of Physicians In Different Hospitals Of Tianjin

Objective: Through investigating the application of antihypertensive drugs in different hospitals in Tianjin, comparing Hypertension Guideline, analyzing the use of antihypertensive drugs in order to provide the scientific basis for the rational use and management of antihypertensive drugs. To survey the clinical ability of Hypertension treatment among the physicians in different hospitals in Tianjin, and provide a reference for better treatment.Methods:The retrospective investigation in respect of the prescriptions of out-patients with hypertension in2012were written out, in one West Hospital, one Chinese Medical Hospital and two Community Hospitals in Tianjin were statically analyzed. To take account of each prescription’s factors, including the patient code, age, gender, dates, drug name, the combination drug use of antihypertensive drugs and the total number of precriptions.Some physicians worked in the Class3-A hospitals, and the others worked in Community Hospitals, they were all investigated by questionnaires, and then analysed the data from the survey.The data were investigated with Microsoft Excel2010and analyzed by SPSS18.0, the utilization characteristics and development trend of antihypertensive drugs were discussed.Results:Of the outpatient prescriptions reviewed, three hospitals(the West Hospital, the Chinese Medical Hospital and the Community Hospital) involved use of antihypertensive drugs, of whom, antihypertensive drugs were mostly used in patients aged between36to79years, percentages were83.18%,87.97%and91.05%. The differences between different age groups in respect of incidences of hypertension were significant(P＜0.001)in same hospital.In the West Hospital, among these single antihypertensive drug prescriptions, the usage frequency listed the first calcium channel blockers(CCB),followed by angiotensin receptor blockers(ARB), beta blockers (β-RB), angiotensin converting enzyme inhibitors(ACEI) and single-pill combination(SPC). In the Chinese Medical Hospital, the most frequently prescribed antihypertensive drugs were CCB, ARB,ACEI, β-RB, and SPC of these singl antihypertensive drug prescriptions. In the Community Hospital, among these single antihypertensive drug prescriptions, the usage frequency listed the first CCB, followed by ARB, Chinese patent drugs, ACEI, and β-RB. The most of combination of two drugs was CCB+ARB program, there were significant difference(P<0.001) between the good recommendations and the bad recommendations in different hospitals. The surveies were adjusted to take account of risk factors for hypertension, the percentages of usage in the hospitals were38.1%、36.0%and24.8%, there was no significant difference(P>0.05) between the hospitals. The usage of the anti-platelet therapy was common, antilipemics therapy, and the reducing hyperhomocysteinemia therapy were followed. The three kind of drugs were widely used by hypertensive patients of60-79years old, though the other age groups used lacked, the differences between different age groups in respect of therapies were significant (P＜0.001).About the knowledge on non-pharmacologic treatments, the accuracy of low-salt diet was85.9%, weight control was69.1%, and the physicians in different class hospitals showed significant differences (P＜0.001) about non-pharmacologic treatments; There were remarkable differences (P<0.05) on the accuracy of special indications in the three antitypertensive drugs(such as diuretics, beta-blockers, ACE inhibitors), but Hypertensor No0showed no significant differences (P=0.796); The treatments or the common complications of hypertension between different departments were standard, but the overall level was still insufficient.Conclusions:The utilization of antihypertensive drugs were basically reasonable in the West Hospital, the Chinese Medical Hospital and the Community Hospital in Tianjin, Which CCB and ARB accounted for over50%of the total, diuretic’s usage was inadequate. The physicians should follow the drug treatment guidelines, pay attention to their mechanism, safety and adverse reations when using these drugs. As well, the related risk factors for cardiovascular diseases should be intervenced, if necessary, use drug therapy, attain the best clinical benefit.The physicians in the Class3-A hospitals in Tianjin showed better control over the knowledge about hypertension than the primary care physicians, so should be strengthen communications and coordination, reeducated with the knowledge of hypertension, in order to improve their ability of clinical treatment of hypertension.