Trends in co-prescribing of angiotensin converting enzyme inhibitors and angiotensin receptor blockers in Ireland.
Affiliation
Department of Renal Medicine, Adelaide & Meath Hospital Incorporating National Children Hospital (AMNCH), Dublin 24, Ireland. wahafiz@um.edu.myIssue Date
2011-03MeSH
AdolescentAdult
Aged
Aged, 80 and over
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Clinical Trials as Topic
Diabetes Mellitus
Drug Therapy, Combination
Female
Heart Failure
Humans
Hypertension
Ireland
Male
Middle Aged
Myocardial Ischemia
Physician's Practice Patterns
Regression Analysis
Young Adult
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Trends in co-prescribing of angiotensin converting enzyme inhibitors and angiotensin receptor blockers in Ireland. 2011, 71 (3):458-66 Br J Clin PharmacolJournal
British journal of clinical pharmacologyDOI
10.1111/j.1365-2125.2010.03835.xPubMed ID
21284706Abstract
(i) To examine the trends in co-prescribing of angiotensin converting enzyme inhibitor (ACEI) and angiotensin-II receptor blocker (ARB) therapy and (ii) to examine the influence of major clinical trials (CALM, COOPERATE, VALIANT and ONTARGET) on co-prescribing.The Irish HSE-Primary Care Reimbursement Services database was used to identify patients ≥16 years old co-prescribed ACEIs and ARBs between January 2000 and April 2009 (n= 266 554 prescriptions). The rate of prescribing per 1000 general medical services (GMS) scheme population was calculated for each month. Patients with diabetes, hypertension, heart failure and ischaemic heart disease were also identified by prescribing of certain medications. A linear trend test was used to examine prescribing trends. Logistic regression was used to examine prescribing according to patient characteristics. The effects of the major trials on prescribing were examined using segmented regression analysis for 12 months pre- and post-trials.
There was a significant linear trend in overall ACEI and ARB co-prescribing over the study period (P < 0.001). Rate of co-prescribing in January 2000 and April 2009 was 0.16 and 5.72, per 1000 eligible population, respectively. Those 45-64 years old (OR = 2.88, 95% confidence interval (CI) 2.71, 3.06) and ≥65 years (OR = 2.52, 95% CI 2.36, 2.68) were more likely to receive dual therapy compared with those <45 years old. Those with hypertension (OR = 8.85, 95% CI 8.45, 9.27), diabetes (OR = 4.10, 95% CI 3.97, 4.23) and heart failure (OR = 1.78, 95% CI 1.72, 1.84) were more likely to receive dual therapy compared with the general population. Significant increases in prescribing were observed only after the CALM (P= 0.03) and VALIANT (P= 0.007) trials.
Increased co-prescribing of ACEIs and ARBs was observed in Ireland during 2000-09. Prescribing patterns did not appear to be affected by results from major trials.
Item Type
ArticleLanguage
enISSN
1365-2125ae974a485f413a2113503eed53cd6c53
10.1111/j.1365-2125.2010.03835.x
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