An evaluation of antihypertensive prescribing practices.
We evaluated the management of patients with hypertension (including drug prescribing) by US physicians, compared their prescribing to National Institutes of Health (NIH) guidelines, and compared the pharmacoeconomics of the prescribed antihypertensive drugs.  A 1991 national US database, using physician-patient encounter forms, was our data source.  Results showed that physicians generally met the NIH guidelines regarding diagnostic/screening services, patient counselling/education, antihypertensive drug prescribing and follow-up. Two areas should be the foci of continuing medical education for US physicians.  Firstly, physicians need to be reminded that centrally acting alpha 2-agonists are optimally used as supplemental antihypertensive drugs rather than as initial agents, which is how some physicians utilised them.  Secondly, if once-daily administration is used to promote patient compliance, physicians should be aware that, of the frequently prescribed first-line antihypertensive drugs, hydrochlorothiazide, chlorthalidone and atenolol presently have substantially less expensive once-daily dosage forms than other diuretics or beta-blockers, calcium antagonists or ACE inhibitors.
Knapp
D A
DA
Center on Drugs and Public Policy, and Schools of Pharmacy and Medicine, University of Maryland, Baltimore.
Michocki
R J
RJ
Richardson
J P
JP
Knapp
D A
DA
D000959:Antihypertensive Agents / Q000191:economics; D016208:Databases, Factual; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends