Abstract
Studies describe differences between recommendations for hypertension treatment and actual drug use. Antihypertensive use data from the Department of Veterans Affairs (VA) for 1995 to 1999 showed a downward trend for calcium antagonist (CA) use and increased use of β-blockers (BB) and thiazide diuretics (TD). This study evaluates national VA antihypertensive treatment for 2000 to 2002 and compares these data to treatment data for 1995 to 1999. National VA pharmacy data were used to determine use of BB, TD, CA, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and combinations of antihypertensive drugs for 2000 to 2002. Dispensing data were converted to treatment days. In addition to national trends, data were analyzed regionally to examine geographic differences. Pharmacoeconomic analysis estimated the financial impact of medication changes. Antihypertensive drug use in the VA represented more than 1 billion days in 2002. The ACEI were most commonly used, representing 33.4% and 33.5% of treatment days in 2000 and 2002, respectively. Changes from 2000 to 2002 were 21.9% to 24.2% for BB, 29.3% to 24.4% for CA, and 13.2% to 14.2% for TD. Use of ARB increased from 2.1% to 3.7% of treatment days. Analysis of the 21 VA regions showed geographic variation. For example, the proportion of BB treatment days is highest in a northeast VA region (28.6%) and lowest in a southeast region (19.9%). In 2002 the VA has saved an estimated $8.5 million because of changes in medication use. As a proportion of antihypertensive agent use, CA continues to fall in the VA, whereas BB, TD, and ARB use have increased. However, TD use remains low, despite national guidelines that promote use of this class of agent.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1095-1099 |
| Number of pages | 5 |
| Journal | American Journal of Hypertension |
| Volume | 17 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2004 |
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Keywords
- guidelines
- health care costs
- Hypertension
- medication use
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Antihypertensive medication use in the department of veterans affairs : A national analysis of prescribing patterns from 2000 to 2002. / Lopez, Julio; Meier, Joy; Cunningham, Fran; Siegel, David.
In: American Journal of Hypertension, Vol. 17, No. 12, 12.2004, p. 1095-1099.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Antihypertensive medication use in the department of veterans affairs
T2 - A national analysis of prescribing patterns from 2000 to 2002
AU - Lopez, Julio
AU - Meier, Joy
AU - Cunningham, Fran
AU - Siegel, David
PY - 2004/12
Y1 - 2004/12
N2 - Studies describe differences between recommendations for hypertension treatment and actual drug use. Antihypertensive use data from the Department of Veterans Affairs (VA) for 1995 to 1999 showed a downward trend for calcium antagonist (CA) use and increased use of β-blockers (BB) and thiazide diuretics (TD). This study evaluates national VA antihypertensive treatment for 2000 to 2002 and compares these data to treatment data for 1995 to 1999. National VA pharmacy data were used to determine use of BB, TD, CA, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and combinations of antihypertensive drugs for 2000 to 2002. Dispensing data were converted to treatment days. In addition to national trends, data were analyzed regionally to examine geographic differences. Pharmacoeconomic analysis estimated the financial impact of medication changes. Antihypertensive drug use in the VA represented more than 1 billion days in 2002. The ACEI were most commonly used, representing 33.4% and 33.5% of treatment days in 2000 and 2002, respectively. Changes from 2000 to 2002 were 21.9% to 24.2% for BB, 29.3% to 24.4% for CA, and 13.2% to 14.2% for TD. Use of ARB increased from 2.1% to 3.7% of treatment days. Analysis of the 21 VA regions showed geographic variation. For example, the proportion of BB treatment days is highest in a northeast VA region (28.6%) and lowest in a southeast region (19.9%). In 2002 the VA has saved an estimated $8.5 million because of changes in medication use. As a proportion of antihypertensive agent use, CA continues to fall in the VA, whereas BB, TD, and ARB use have increased. However, TD use remains low, despite national guidelines that promote use of this class of agent.
AB - Studies describe differences between recommendations for hypertension treatment and actual drug use. Antihypertensive use data from the Department of Veterans Affairs (VA) for 1995 to 1999 showed a downward trend for calcium antagonist (CA) use and increased use of β-blockers (BB) and thiazide diuretics (TD). This study evaluates national VA antihypertensive treatment for 2000 to 2002 and compares these data to treatment data for 1995 to 1999. National VA pharmacy data were used to determine use of BB, TD, CA, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and combinations of antihypertensive drugs for 2000 to 2002. Dispensing data were converted to treatment days. In addition to national trends, data were analyzed regionally to examine geographic differences. Pharmacoeconomic analysis estimated the financial impact of medication changes. Antihypertensive drug use in the VA represented more than 1 billion days in 2002. The ACEI were most commonly used, representing 33.4% and 33.5% of treatment days in 2000 and 2002, respectively. Changes from 2000 to 2002 were 21.9% to 24.2% for BB, 29.3% to 24.4% for CA, and 13.2% to 14.2% for TD. Use of ARB increased from 2.1% to 3.7% of treatment days. Analysis of the 21 VA regions showed geographic variation. For example, the proportion of BB treatment days is highest in a northeast VA region (28.6%) and lowest in a southeast region (19.9%). In 2002 the VA has saved an estimated $8.5 million because of changes in medication use. As a proportion of antihypertensive agent use, CA continues to fall in the VA, whereas BB, TD, and ARB use have increased. However, TD use remains low, despite national guidelines that promote use of this class of agent.
KW - guidelines
KW - health care costs
KW - Hypertension
KW - medication use
UR - http://www.scopus.com/inward/record.url?scp=11144252276&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=11144252276&partnerID=8YFLogxK
U2 - 10.1016/j.amjhyper.2004.07.015
DO - 10.1016/j.amjhyper.2004.07.015
M3 - Article
C2 - 15607614
AN - SCOPUS:11144252276
VL - 17
SP - 1095
EP - 1099
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 12
ER -