Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000.
OBJECTIVE
The aim of this study is to explore trends in primary care prescribing for chronic heart failure (CHF) over a 5-year period (1996-2000).


METHODS
This study consisted of repeated cross-sectional surveys in a dynamic cohort from the Integrated Primary Care Information (IPCI) primary care database. The cohort comprised all patients aged > or = 55 years with a CHF diagnosis and prescribed a cardiovascular medication during the study period. The point prevalence per calendar year was determined for each of the main drug groups used to treat CHF.


RESULTS
The study population consisted of 3121 CHF patients. Small increases were seen in the percentage of CHF patients prescribed spironolactone (4.6%, 95% CI: 2.3-6.9%), beta-blockers (6.1%, 95% CI: 2.6-9.5%) and angiotensin II antagonists (6.8%, 95% CI: 5.1-8.6%) during the study period, while the prescribing of digoxin decreased (-4.4%, 95% CI: -8.2 to -0.7). Prescribing of diuretics (difference: -0.7% 95% CI: -2.7-4.2) and ACE inhibitors (difference: 4.0% 95% CI: -0.1-8.2%) remained unchanged.


CONCLUSIONS
Prescription of some drug groups for CHF increased. However, given the new scientific evidence that has emerged in past 15 years regarding CHF pharmacotherapy, the changes observed were less than expected.
Pont
Lisa G
LG
Drug Utilisation Studies, Department of Clinical Pharmacology, University of Groningen, The Netherlands.
Sturkenboom
Miriam C
MC
van Gilst
Wiek H
WH
Denig
Petra
P
Haaijer-Ruskamp
Flora M
FM
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017891:Pharmacoepidemiology; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers