Analyses On The Prevalence Of Hypertension And Rational Drug Use Of Community Residents In Shanxi Province

Objective:To understand the inpatient distribution and medication status of hypertension patients in Shanxi Province,analyze the sex,age,resource utilization status and medication status of hypertension inpatients,make clear the focus of hypertension prevention and control,and provide reference for the health management of hypertension patients.Method:Multi-stage random sampling was used to collect the information of discharged patients with hypertension from sample institutions in 2015-2017.The diagnosis information was coded according to the international classification of diseases(ICD-10).The database of discharged patients was established by using stata12.0.The basic information of hospitalized patients with hypertension was statistically described,mainly including the composition ratio and chi-square test.The residents' drug use information survey was conducted by multi-stage random sampling in five counties or districts of the province.The health status,drug use,family doctor management and behavior lifestyle of residents with hypertension were collected.The risk factors of hypertension were analyzed by composition ratio,chi-square test,single factor analysis and logistic regression.Result:1.Basic information of discharged patients with hypertension:The proportion of hypertension inpatients in primary medical institutions was the highest(47.41%);80.03% of the patients were hospitalized for less than 10 days,and the most patients were hospitalized for 6-10 days;In terms of gender and age distribution,the proportion of elderly patients over 60 years old is the highest(63.42%),and the number of hospitalized women after 50 years old is higher than that of men,and the number of hospitalized men and women first increases and then decreases with the increase of age,forming a peak at 60-64 years old.The total hospitalization expenses of hypertension patients were mainly composed of drugexpenses(41.76%),examination expenses(13.8%),laboratory examination expenses(13.8%),the third level hospitals had the highest hospitalization expenses,and the basic medical institutions had the lowest self payment proportion(16.42%).2.Medication of hypertension patients: the average prescription cost of hypertension patients in grass-roots institutions is 40.9 yuan,and the proportion of prescriptions more than 50 yuan is 19.05%;the low-risk hypertension patients are given more drugs alone(53.15%),and the medium and high-risk hypertension patients are mainly two kinds of combined drugs,mostly Calcium Channel Blocker(CCB)and other drugs.The six anti-hypertensive drugs that took more frequently were nifedipine sustained release tablets,L-amlodipine besylate,indapamide tablets,compound reserpine tablets,lacidipine and nitrendipine tablets.3.Signing of family doctor: the proportion of hypertension patients who perform the contracted services of family doctors in the basic level of health records,physical examination and treatment was 91.43%,82.14% and 60%,all of them were higher than those of the patients without contract(16%,44%,28%)(P <0.001).4.The type of anti-hypertensive drugs,drug compliance,risk level of hypertension,whether the blood lipid is normal or not and physical exercise have influence on the effect of blood pressure control(P < 0.05).Conclusion:1.Hypertension patients make more use of basic medical institutions;prevention and control of hypertension should pay attention to the health management of patients with hypertension and the tendency of low age in the study of rational drug use;drug cost accounts for the largest proportion of inpatient cost,and hospital level has a greater impact on inpatient cost.2.The common diseases and chronic diseases are the main ones in the village clinics.High blood pressure population has a higher proportion of risk factors such as less exercise,less fruits and vegetables,obesity,family history and so on;under the intervention of family doctors,the health management of high blood pressure patients is more standardized.3.Hypertension patients are mainly treated with drugs,and non drug treatment should run through drug treatment all the time.The principle of anti-hypertensivedrug selection is to protect the heart,be effective and convenient,have little side effects and have little impact on the quality of life.