Trends in the use of antihypertensive drugs by outpatients with diabetes in Taiwan, 1997-2003.
OBJECTIVE
To analyze trends in AHD-use by diabetic outpatients in Taiwan over a 7-year period (1997-2003) and to see whether the trends are consistent with clinical trial outcomes and published guidelines.


METHODS
A cross-sectional survey was implemented using National Health Insurance Research Database between January 1997 and December 2003. Adult outpatients who had diagnoses of diabetes and hypertension and who had concurrent antidiabetic and antihypertensive drug claim were identified. The prescribing trends were described in terms of the prescribing rates and patterns of AHDs in each study year.


RESULTS
Of the AHDs, CCBs were the most widely prescribed class throughout the study period but the prescribing rates declined considerably over the study period. A significant downward trend was also observed for beta-blockers and other classes. Drugs acting on the RAS were the only one class showing a significant increase in prescribing rates with time. The prescribing patterns for monotherapy regimen decreased over time while those for two-, three-, and four or more drug regimens increased over time. Monotherapies maintained with CCBs, beta-blockers, diuretics, and other classes steadily declined but those maintained with drugs acting on the RAS markedly increased.


CONCLUSIONS
The use of drugs acting on the RAS showed a marked increasing trend over the course of the study. Physicians' prescribing patterns for AHD are increasingly involving multi-drug regimens. These findings may imply that management of hypertension in patients with diabetes had a positive trend toward to new clinical trial outcomes and guideline's recommendation.
Chiang
Chi-Wen
CW
Graduate Institute of Pharmaceutical Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chen
Chi-Yu
CY
Chiu
Hui-Fen
HF
Wu
Hsin-Lung
HL
Yang
Chun-Yuh
CY
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D019992:Databases as Topic; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007356:Insurance, Pharmaceutical Services / Q000639:trends; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
D000959:Antihypertensive Agents; D007004:Hypoglycemic Agents