Comparison of primary care prescriptions for old and very old hypertensive patients

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dc.authorid0000-0002-8511-6349
dc.authorid0000-0001-8984-9673
dc.contributor.authorTülü Çolak, Selcan
dc.contributor.authorVızdıklar, Caner
dc.contributor.authorKaşkal, Mert
dc.contributor.authorAydın, Volkan
dc.contributor.authorAtaç, Ömer
dc.contributor.authorAkıcı, Ahmet
dc.date.accessioned2023-05-29T12:56:14Z
dc.date.available2023-05-29T12:56:14Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Tıbbi Farmakoloji Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Aile Hekimliği Ana Bilim Dalı
dc.description.abstractBackground/aim: Elderly and very elderly individuals might be subject to different approaches for the treatment of hypertension. We aimed to compare drug utilization in hypertensive old patients and very old patients in primary care, along with the evaluation of potentially inappropriate drug prescribing. Materials and methods: In this cross-sectional study, we compared prescriptions of 65-79-year-old (old patient prescriptions [OPP], n = 433,988) vs. >= 80-year-old (very old patient prescriptions [VOPP], n = 134,079) with "essential hypertension" diagnosis, issued by 3:1 systematically-sampled primary care physicians (n = 1431) in Istanbul throughout 2016. Drug utilization patterns and distribution of antihypertensives based on drug class and combination status were evaluated. Frequency of potentially inappropriate drugs per Beers Criteria were identified and compared. Results: Antihypertensive monotherapy practice was less common in OPP than VOPP (43.3% vs. 45.3%; p < 0.001). In both groups, the most commonly prescribed drugs were beta-blockers for monotherapy (37.4% vs. 33.1%, p < 0.001) and thiazide diuretics for combined therapy (69.8% vs. 67.4%, p < 0.001). Metoprolol was the most commonly prescribed antihypertensive both in OPP and VOPP (15.3% vs. 14.8%). Furosemide was ranked 10th in OPP and 3rd in VOPP (2.7% vs. 5.5%). Cardiovascular system drugs were the most commonly encountered potentially inappropriate medications in both groups (263.9 vs. 283.4 per 10,000 prescriptions, p = 0.004). Regarding antihypertensive drugs, 2.2% of those in OPP and 2.4% of those in VOPP were identified as potentially inappropriate (p = 0.002). Conclusion: Prescribing preferences to old and very old patients mostly showed slight differences. Almost half of prescriptions comprising antihypertensive monotherapy might imply hesitancy to prescribe combinations. Overuse of risky drugs such as furosemide in both groups, especially in the very elderly, requires more attention.
dc.identifier.citationTülü Çolak, S., Vızdıklar, C., Kaşkal, M., Aydın, V., Ataç, Ö. ve Akıcı, A. (2023). Comparison of primary care prescriptions for old and very old hypertensive patients. Turkish Journal of Medical Sciences, 53(2), 572-585. https://doi.org/10.55730/1300-0144.5618
dc.identifier.doi10.55730/1300-0144.5618
dc.identifier.endpage585
dc.identifier.issn1300-0144
dc.identifier.issn1303-6165
dc.identifier.issue2
dc.identifier.scopus2-s2.0-85159210096
dc.identifier.scopusqualityQ3
dc.identifier.startpage572
dc.identifier.urihttps://doi.org/10.55730/1300-0144.5618
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10989
dc.identifier.volume53
dc.identifier.wos000981607700016en_US
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.institutionauthorAydın, Volkan
dc.institutionauthorAtaç, Ömer
dc.language.isoen
dc.publisherTÜBİTAK (Scientific and Technological Research Council of Türkiye)
dc.relation.ispartofTurkish Journal of Medical Sciencesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectElderly
dc.subjectFamily Physician
dc.subjectIrrational Prescribing
dc.subjectHypertension
dc.titleComparison of primary care prescriptions for old and very old hypertensive patients
dc.typeArticle

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