Iomedcentral.com/1472-6963/8/Figure three Time tendencies for single-drug antihypertensive cure Time
Iomedcentral.com/1472-6963/8/Figure three Time traits for single-drug antihypertensive procedure Time trends for single-drug antihypertensive procedure. Notice: * implies p-value <0.0083 under the Cochran-Armitage trend test, being significant with Bonferroni adjustment for multiple comparisons (p < 0.05/6 = 0.0083).One of the limitations of this study is the potential confounding by severity of disease for different levels of clinical facilities. Because the NHI reimbursement database has no link to details on patients' blood pressure levels or laboratory data, we were unable to directly compare the severity of hypertension among various groups of patients. Nonetheless, we have limited our study subjects to newly diagnosed cases of uncomplicated hypertension with mono-therapies, and for them there is no restriction on selection of doctors under the NHI in Taiwan. In such a way, hypertensive patients initially treated at different clinical facilities might not be so much different in severity. Moreover, Table 4 indicated that medical centers used more ARBs and less ACE inhibitors after adjustment for other determinants. As the efficacy of these two types of antihypertensive medication is similar , it seems that ARBs might be prescribed to substitute for some ACE inhibitors in medical centers or regional hospitals and this trend probably was unrelated to the different severity of hypertension. The NHI database provides a 200,000-person sample representing almost 1 of the overall population of 22.9 million people in Taiwan; thus, we estimate that there mayhave been up to 0.75 million newly-diagnosed cases of uncomplicated hypertension in Taiwan during the sevenyear period of this study. If the daily drug costs for PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/12777835 uncomplicated hypertension may be reduced by a mean of US 0.three?.six, this would bring about yearly price savings of up to US 82?sixty three million in all round pharmaceutical expenditure within just Taiwan’s NHI. If these kinds of motion ended up prolonged to include all prevalent cases of hypertension throughout Taiwan, the total number of yearly cost savings on expenditures for antihypertensive medication could even operate to US 0.2 billion. Less than the current confined WRW4 assets, this could evidently make the NHI way more sustainable .ConclusionThe preliminary prescription designs for antihypertensive therapies for uncomplicated hypertension in Taiwan seem to be inconsistent together with the recent global clinical tips. Even though diuretics are classified as the minimum pricey class of antihypertensive drugs, they are really even so being used to be a second- or third-line method of treatment, that has a notably small prescription fee. There has been a developing pattern inside the prescribing of ARBs since the original option of treatment for uncomplicated hypertension, significantly in medical facilities and regional hospitals. ThesePage nine of(website page amount not for quotation applications)BMC Health Providers Research 2008, 8:http://www.biomedcentral.com/1472-6963/8/Table four: Several logistic regression estimates of ARB and ACE inhibitor mono-therapy prescription characteristics for newlydiagnosed uncomplicated hypertension patients, 1998?004*Variables OR Affected person gender Female (reference) Male Individual age (a long time) thirty?4 (reference) fifty five Geographical region Northwest (reference) Midwest Southwest Eastern Offshore islands Form of medical facility Main treatment clinics (reference) Nearby hospitals Regional hospitals Healthcare facilities Time elapsed because preliminary treatment PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/17845596 one year or considerably less (reference) two? decades four? many years Comorbidity immediately after h.