Cristin-resultat-ID: 363711
Sist endret: 30. oktober 2017 10:54
Resultat
Vitenskapelig artikkel
2007

The Effects of Mandatory Prescribing of Thiazides for Newly Treated, Uncomplicated Hypertension: Interrupted Time-Series Analysis

Bidragsytere:
  • Atle Fretheim
  • Kari Håvelsrud
  • Signe Flottorp
  • Graeme MacLennan
  • Doris Tove Kristoffersen
  • Jan Odgaard-Jensen
  • mfl.

Tidsskrift

PLoS Medicine
ISSN 1549-1277
e-ISSN 1549-1676
NVI-nivå 2

Om resultatet

Vitenskapelig artikkel
Publiseringsår: 2007
Volum: 4
Hefte: 7
Sider: 1178 - 1186
Open Access

Importkilder

Isi-ID: 000252135100002

Klassifisering

Vitenskapsdisipliner

Klinisk medisinske fag

Beskrivelse Beskrivelse

Tittel

The Effects of Mandatory Prescribing of Thiazides for Newly Treated, Uncomplicated Hypertension: Interrupted Time-Series Analysis

Sammendrag

Background The purpose of our study was to evaluate the effects of a new reimbursement rule for antihypertensive medication that made thiazides mandatory first-line drugs for newly treated, uncomplicated hypertension. The objective of the new regulation was to reduce drug expenditures. Methods and Findings We conducted an interrupted time-series analysis on prescribing data before and after the new reimbursement rule for antihypertensive medication was put into effect. All patients started on antihypertensive medication in 61 general practices in Norway were included in the analysis. The new rule was put forward by the Ministry of Health and was approved by parliament. Adherence to the rule was monitored only minimally, and there were no penalties for non-adherence. Our primary outcome was the proportion of thiazide prescriptions among all prescriptions made for persons started on antihypertensive medication. Secondary outcomes included the proportion of patients who, within 4 mo, reached recommended blood-pressure goals and the proportion of patients who, within 4 mo, were not started on a second antihypertensive drug. We also compared drug costs before and after the intervention. During the baseline period, 10% of patients started on antihypertensive medication were given a thiazide prescription. This proportion rose steadily during the transition period, after which it remained stable at 25%. For other outcomes, no statistically significant differences were demonstrated. Achievement of treatment goals was slightly higher (56.6% versus 58.4%) after the new rule was introduced, and the prescribing of a second drug was slightly lower (24.0% versus 21.8%). Drug costs were reduced by an estimated Norwegian kroner 4.8 million (E0.58 million, US$0.72 million) in the first year, which is equivalent to Norwegian kroner 1.06 per inhabitant (E0.13, US$0.16). Conclusions Prescribing of thiazides in Norway for uncomplicated hypertension more than doubled after a reimbursement rule requiring the use of thiazides as the first-choice therapy was put into effect. However, the resulting savings on drug expenditures were modest. There were no significant changes in the achievement of treatment goals or in the prescribing of a second antihypertensive drug.

Bidragsytere

Aktiv cristin-person

Atle Fretheim

  • Tilknyttet:
    Forfatter
    ved Helsetjenester ved Folkehelseinstituttet

Kari Håvelsrud

  • Tilknyttet:
    Forfatter
    ved Helsetjenester ved Folkehelseinstituttet

Signe Agnes Flottorp

Bidragsyterens navn vises på dette resultatet som Signe Flottorp
  • Tilknyttet:
    Forfatter
    ved Avdeling for vurdering av tiltak ved Folkehelseinstituttet

Graeme MacLennan

  • Tilknyttet:
    Forfatter
    ved University of Aberdeen

Doris Tove Kristoffersen

  • Tilknyttet:
    Forfatter
    ved Avdeling for forskning og analyse av helsetjenesten ved Folkehelseinstituttet
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