Improving cost-effectiveness of hypertension management at a community health centre.
To describe the pattern of prescribing for hypertension at a community health centre (CHC) and to evaluate the impact of introducing treatment guidelines and restricting availability of less cost-effective antihypertensive drugs on prescribing patterns, costs of drug treatment and blood pressure (BP) control.
Before/after intervention study.
Medium-sized CHC in the Cape Flats area of Cape Town.
1 084 hypertensive patients attending the CHC, who had at least two prescriptions for antihypertensive drugs during a 1-year period starting on 1 January 1992.
1. Implementation of stepped-care guidelines for hypertension, specifying treatment with more cost-effective drugs and minimising drug treatment. 2. Reducing availability for routine prescribing by CHC doctors of 10 less cost-effective antihypertensive drugs or drug combinations.
1. Mean number of drugs prescribed per patient. 2. Proportion of prescriptions for :
each major class of antihypertensive drug ;
restricted availability and freely prescribable drugs ;
and more and less cost-effective drugs. 3. Mean monthly cost of drugs prescribed per patient. 4. Mean blood pressure and proportion of BP readings controlled (<160/95 mmHg) or uncontrolled (= 160/95 mmHg).
A mean of 1.7 active drugs was prescribed per patient per visit.
The most frequently prescribed drugs were thiazide-like diuretics (44.8%), centrally acting agents (28. (...)
Mots-clés Pascal : Hypertension artérielle, Optimisation, Coût, Antihypertenseur, Economie santé, République Sud Africaine, Afrique, Homme, Appareil circulatoire pathologie, Traitement, Chimiothérapie
Mots-clés Pascal anglais : Hypertension, Optimization, Costs, Antihypertensive agent, Health economy, South Africa, Africa, Human, Cardiovascular disease, Treatment, Chemotherapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0307830
Code Inist : 002B12B05B. Création : 27/11/1998.