Analysis of preferences in the use of fixed-doses combinations antihypertensive drugs in the regions of far-eastern federal district

Abstract

Background: Diseases characterized by elevated blood pressure are the most frequently diagnosed pathology among socially significant diseases in the Russian Federation. According to clinical recommendations of the Russian Medical Society for Arterial Hypertension 2010–2019, the use of two and more component drugs improves the compliance of patients to treatment. The purpose of this study was a comparative analysis of preferences in the usage of combined antihypertensive drugs in ten regions of the Far Eastern Federal District (FSD). Materials and Methods: Intra-group analysis of data on the sale of antihypertensive drugs in pharmacy organizations (162 drugstores) for the period 2018 was carried out in the 10 regions of the FSD. The sample is uneven due to the difference in total number of drugstores in the regions. The sample was random. Pharmacies were in urban and rural areas. The total purchase of all defined daily doses of all antihypertensive drugs was taken as 100%. Then, fixed-dose combinations were selected. The share of each drug in the sales structure was then calculated. Kruskal–Wallis criterion was used for determining the differences in the structure of acquisition of drugs between the regions. The Spearman’s rank correlation and factor analysis were used for determining the correlation between the drug’s acquisition structure and the FSD region. Results: Two-component drugs are most in demand in the Amur region – 15.2% and Zabaykalsky Krai – 12.3%, and the lowest demand in the Sakhalin region – 5.25% and Magadan region – 6.5%. The largest sales indicators of three-component drugs were observed in the Zabaykalsky Krai – 1.2% and the Republic of Buryatia – 1.0%. The most acquired combinations were atenolol+chlorthalidone, valsartan+amlodipine, losartan+hydro-chlorothiazide, perindopril/lisinopril/ramipril+amlodipine, perindopril+indapamide. Conclusion: Group leaders may vary depending on the region, which is due to the preferences of medical specialists. However, the differences are not significant, which proves the unity of approaches to combined drug therapy of arterial hypertension.