PCV151 ASSESSMENT OF MEDICATION UTILIZATION PATTERN OF PATIENTS WITH SYSTOLIC HYPERTENSION AND COMPELLING INDICATIONS IN A PRIMARY CARE PRACTICE

Abstract

OBJECTIVES: The study evaluated medication utilization pattern of patients aged 50 years and older with systolic hypertension (SH) in a primary care setting. Specific objectives were: 1) to assess the prevalence of comorbid conditions by patient demographics, and 2) to study the utilization of antihypertensive classes based on compelling indications. METHODS: Retrospective analysis was conducted using GE Centricity electronic medical records (EMR) from a large primary care physician group. Patients with SH (ICD-9-CM 401.xx) with systolic blood pressure (SBP) >140 mmHg, diastolic blood pressure (DBP) <90 mmHg, 50 years and older, continuously enrolled in the database and having 12 months pre- and post-index date observations were identified. Patients on dialysis were excluded from the study. Demographics, office visits, clinical measures, compelling indications for antihypertensive treatment and comorbidities, drug regimens over a 2-year period were collected. Descriptive analysis was performed using SPSS version 17. RESULTS: A total of 22,074 patients had hypertension out of which 1,616 met the inclusion/exclusion criteria for SH. Mean age was 68.88+/-11.38 years; 59.03% females, and 78.4% had one or more compelling indications/comorbidities. Hyperlipidemia was the most prevalent comorbid condition (70.9%, n = 1,145), followed by diabetes (24.7%, n = 399) and coronary artery disease (15.6%, n = 252). A total of 16.4% of SH patients were on statins, followed by CCBs (16.2%) and ACEIs (15.3%). By compelling indications (top medication class), 18.8% patients with diabetes were taking CCBs, 16.9% patients with hyperlipidemia were taking CCBs, and 15.8% patients with CAD were taking ACEIs. CONCLUSIONS: Evidence from large clinical trials demonstrate that appropriate use of antihypertensive therapy in patients with SH and compelling indications reduces the incidences of stroke, myocardial infarction, and heart failure. Thus, it is important for physicians to follow the Seventh Joint National Committee (JNC 7) guidelines to improve quality of care and health outcomes in patients with SH.