AIMS: (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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
AIMS: (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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Ian Graham; Dan Atar; Knut Borch-Johnsen; Gudrun Boysen; Gunilla Burell; Renata Cifkova; Jean Dallongeville; Guy De Backer; Shah Ebrahim; Bjørn Gjelsvik; Christoph Herrmann-Lingen; Arno Hoes; Steve Humphries; Mike Knapton; Joep Perk; Silvia G Priori; Kalevi Pyorala; Zeljko Reiner; Luis Ruilope; Susana Sans-Menendez; Wilma Scholte Op Reimer; Peter Weissberg; David Wood; John Yarnell; Jose Luis Zamorano; Edmond Walma; Tony Fitzgerald; Marie Therese Cooney; Alexandra Dudina; Alec Vahanian; John Camm; Raffaele De Caterina; Veronica Dean; Kenneth Dickstein; Christian Funck-Brentano; Gerasimos Filippatos; Irene Hellemans; Steen Dalby Kristensen; Keith McGregor; Udo Sechtem; Sigmund Silber; Michal Tendera; Petr Widimsky; Jóse Luis Zamorano; Attila Altiner; Enzo Bonora; Paul N Durrington; Robert Fagard; Simona Giampaoli; Harry Hemingway; Jan Hakansson; Sverre Erik Kjeldsen; mogens Lytken Larsen; Giuseppe Mancia; Athanasios J Manolis; Kristina Orth-Gomer; Terje Pedersen; Mike Rayner; Lars Ryden; Mario Sammut; Neil Schneiderman; Anton F Stalenhoef; Lale Tokgözoglu; Olov Wiklund; Antonis Zampelas Journal: Eur J Cardiovasc Prev Rehabil Date: 2007-09
Authors: Katharina Wolf-Maier; Richard S Cooper; José R Banegas; Simona Giampaoli; Hans-Werner Hense; Michel Joffres; Mika Kastarinen; Neil Poulter; Paola Primatesta; Fernando Rodríguez-Artalejo; Birgitta Stegmayr; Michael Thamm; Jaakko Tuomilehto; Diego Vanuzzo; Fenicia Vescio Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: Marc A Pfeffer; John J V McMurray; Eric J Velazquez; Jean-Lucien Rouleau; Lars Køber; Aldo P Maggioni; Scott D Solomon; Karl Swedberg; Frans Van de Werf; Harvey White; Jeffrey D Leimberger; Marc Henis; Susan Edwards; Steven Zelenkofske; Mary Ann Sellers; Robert M Califf Journal: N Engl J Med Date: 2003-11-10 Impact factor: 91.245