Drug therapy of cardiovascular risk factors: guidelines versus reality in primary health care service.
OBJECTIVE
To determine the monthly costs of prescription drugs for the treatment of hypertension, hypercholesterolemia, and diabetes mellitus and their share in the total prescription drugs expenditures allowed by the Croatian Institute for Health Insurance.


METHODS
Hypertension, hypercholesterolemia, and diabetes mellitus were diagnosed in 4,916 patients in three general practitioner (GP) offices in the Zagreb area in January 2005. The monthly cost of medications prescribed by the GPs for the treatment of these three diseases was obtained by summarizing the prices of all antihypertensive, lipid-lowering, and antidiabetic drugs prescribed in one month. The monthly medication costs for each disease separately and all three diseases together were compared with the total prescription drug expenditures approved by the Croatian Institute for Health Insurance.


RESULTS
Hypertension was diagnosed in 1,112 (22.6%), hypercholesterolemia in 324 (6.5%), and diabetes mellitus in 359 (7.3%) patients. Monthly cost of all medications prescribed for these three diseases accounted for 81.2% of the total amount approved for medications by the Croatian Institute for Health Insurance. Antihypertensive drugs accounted for 51.1%, antidiabetic drugs for 11.7% for, and lipid-lowering treatment for 18.4%. The medications were prescribed most often to patients older than 65 years (93.6%).


CONCLUSIONS
GPs are strongly obligated by the annual contract with the Croatian Institute for Health Insurance to keep the medication expenses within the approved amount. However, the approved amount is spent mostly on the drug treatment of hypertension, hypercholesterolemia, and diabetes mellitus as the main cardiovascular risk factors.
Marković
Biserka Bergman
BB
Biserka Bergman Markovic, General Practice Office, Albaharijeva 4, 10000 Zagreb, Croatia, bbmarkovic@yahoo.co.uk.
Kranjcević
Ksenija
K
Reiner
Zeljko
Z
Blazeković
Sanja Milaković
SM
Spehar
Stanka Stojanović
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000191:economics* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017523:Croatia; D003920:Diabetes Mellitus / Q000188:drug therapy*; D016527:Drug Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000145:classification / Q000191:economics*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D006973:Hypertension / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000191:economics* / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D011320:Primary Health Care / Q000191:economics* / Q000592:standards; D012307:Risk Factors
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents