engleski

Quality of cardiovascular drug prescribing in Croatia, 2001-2005.

Background: Cardiovascular diseases are the leading cause of morbidity and mortality in Croatia. These indicators pointed to the need of assessing the utilization of cardiovascular agents and the quality of their prescribing. Objective: The purpose was to investigate the outpatient utilisation of cardiovascular drugs in Croatia, during the 2001-2005 period using the ATC/DDDs methodology and to investigate the relationship between the utilisation of particular drug groups and the number of hospital admissions. Method: Data on outpatient drug utilization were obtained from Zagreb Municipal Pharmacy to calculate the number of DDD, and DDD per 1000 inhabitants per day (DDD/TID). Drug Utilization 90%(DU90%) method was used on the drug prescribing quality assessment . Data on hospital admissions were collected from the inpatient base kept at Zagreb Institute of Public Health. Results: Total utilisation of cardiovascular drugs (group C), was between 402.9 DDDs/TID and 362.9 DDDs/TID) in Croatia during the 2001-2005 period. Agents acting on the renin-angiotensin system (C09) (104.2 DDDs/TID) and calcium channel blockers (C08) (80.5 DDDs/TID) accounted for more than 50% of drugs used for the treatment of hypertension in 2005. The great increase in the utilization was observed for statins (78.3%). A markedly increasing utilization was recorded for ACE inhibitors in combination with hydrochlorothiazide (HCTZ) (40.5%) and angiotensin II antagonists (278%). Comparison of DU90% segment between 2001 and 2005 revealed pentoxifylline and amiodarone to be absent, whereas cilazapril and ramipril in combination with HCTZ, bisoprolol, valsartan and losartan alone or in combination with HCTZ were added in 2004 and 2005.. On the other hand, DU90% segment still contained doxazosin and propafenone, which had no grounds in therapeutic guidelines. During the period of observation, total rate of hospital admissions for major cardiovascular events decreased by 17.2%.

Quality; cardiovascular; drugs

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