Analysis Of The Application Of Antihypertensive Drugs In Inpatients In The Department Of Cadiology And Geriatic In Our Hospital

Objective:1. To investigate the frequency, money sort and DUI of the oral antihypertensive drugs in hospitalized patients with hypertension in the Department of Cardiology and Geriatric in a hospital of Shanghai in 2014, and to evaluate the rationality of drug use in the patients with hypertension.2.To investigate the coincidence situation of antihypertensive drugs for the patients with hypertension in the Department of Cardiology and Geriatric with Guidelines For Rational Drug Use In Hypertension, summarize the relationship between drug regimens and hypertension with other diseases or complications, and analyze the rationality of drug regimens, to provide reference for rational use of antihypertensive agents.Methods:1. The retrospective survey was performed by collecting cases of inpatients with essential hypertension in the Department of Cardiology and Geriatric in a hospital in Shanghai in 2014. Cases should meet with the standard of Hypertension Prevention Guide in diagnostic criteria and where 100 cases were chosen. EXCEL form was used to count the selected cases. The collected data includes the patient’s hospitalization number, sex, ages, admission time, diagnosis, blood pressure at admission and discharge, the using antihypertensive drugs’name, unit price, specifications, usage and dosages, medication time, etc.2. The statistical analysis were made on antihypertensive drugs used in the selected cases by taking frequency analysis (DDDs), ranking of amount of money and statistical description.3. According to the patient’s age, investigate the situation of drugs used for the patients with hypertension at different ages in the Department of Cardiology and Geriatric.4. Drugs and the regimens of antihypertensive therapy for the selected cases were classified according to the hypertension with with different clinical symptoms and target organ damage. Drug therapy and regimens was analyzed to summary the characteristic of drug regimens.5. According to the Guideline for Prevention and Treatment of Hypertension in China recommended by the combination drug therapy, compare the coherence degree of drug regimens of the patients with hypertension in the department of Cardiology and Geriatric and guideline.Results:1. From the DUR analysis of the overall trend of medicine, the majority of the patients with the use of antihypertensive drugs in the Cardiology department and Geriatric department was basically rational, and the rationality in the Department of Cardiology is better than that the Department of Geriatric.2. The Department of Cardiology:the patients with hypertension of 40-59 years old mainly use monotherapy and triple-drug therapy while the patients with hypertension of in 60-69,80-89 and 90-99 years old were mainly use simple drug therapy and two-drug therapy. The patients with hypertension of 70-79 years old mainly use two-drug therapy and triple-drug therapy. The Department of Geriatric:The patients with hypertension of 70-79,80-89 and 90-99 years old mainly use simple drug therapy and two-drug therapy.3. The antihypertensive drug use of hypertensive patients with different clinical symptoms and target organ damage in patients with drug use:The medication of the patients with uncomplicated hypertension primarily monotherapy mainly based on CCB, two-drug therapy mainly based on CCB+β -RB/ARB and three-drug therapy mainly based on CCB+β -RB+a third antihypertensive drug based in Cardiology Department; The medication of the patients with uncomplicated hypertension primarily monotherapy for the CCB and ARB, two-drug therapy based mainly on CCB+ARB/ β -RB and three-drug therapy for the ARB+β -RB+CCB based in Geriatric Department.The medication of the hypertensive patients with cardiovascular disease primarily monotherapy mainly based on ARB and CCB, two-drug therapy based mainly on ARB+CCB, three-drug therapy mainly based on ACEI+ β -RB+DA/CCB and four-drug therapy for the CCB+β -RB+DA+ACEI/ARB in Cardiology Department; The medication of the hypertensive patients with cardiovascular disease primarily monotherapy mainly based on CCB and ARB, two-drug therapy based mainly on ARB+CCB/DA, three-drug therapy mainly based on CCB+β-RB+DA/ARB and four-drug therapy for the CCB+β-RB+DA+ARB/CP in Geriatric Department.The medication of the hypertensive patients with cerebrovascular disease primarily two-drug therapy based mainly on CCB+ARB/β-RB, three-drug therapy mainly based on CCB+DA+ARB/ACEI and CCB+β-RB+ACEI/CP and four-drug therapy for the CCB+β -RB+DA+ARB in Cardiology Department; The medication of the hypertensive patients with cerebrovascular disease primarily monotherapy mainly based on ARB and CCB, two-drug therapy based mainly on ARB+CCB/DA/β -RB, three-drug therapy mainly based on ARB+CCB+a third antihypertensive drug and four-drug therapy for the CCB+β -RB+DA+CP in Geriatric Department.The medication of the hypertensive patients with diabetes disease primarily monotherapy mainly for the ACEI、β -RB and CCB, two-drug therapy based mainly on ARB+CCB/β -RB, three-drug therapy mainly based on CCB+ β -RB+ARB/CP/ACEI in Cardiology Department; The medication of the hypertensive patients with diabetes disease primarily monotherapy mainly based on ARB and CP, two-drug therapy based mainly on ARB+CCB/β -RB and three-drug therapy mainly based on ARB+CCB+DA/β -RB in Geriatric Department.The medication of the hypertensive patients with kidney disease primarily two-drug therapy based mainly on β -RB+CCB/ARB/DA and ARB+DA, three-drug therapy mainly based on ARB+CCB+β -RB and four-drug therapy for the ARB+CCB+β -RB+DA in Cardiology Department;The medication of the hypertensive patients with kidney disease primarily monotherapy mainly based on CCB,two-drug therapy based mainly on ARB+CCB/ β-RB, three-drug therapy mainly based on β -RB+DA+CCB/ARB in Geriatric Department.4. According to our country’s guidelines the therapy recommend and not recommended, and the conformity of the patients with hypertension and guidelines in Geriatric department is higher than that of Cardiology department.Conclusion:There is still a certain gap between the clinical use of antihypertensive drugs in the Department of Cardiology and Geriatric and the guide. In order to improve the quality of pharmaceutical care, hospital should strengthen the implement of guideline and take effective measures to reduce irrational drug use. The treatment of hypertension should be based on the combination of specific circumstances of different risk factors, and choice of different antihypertensive drugs and dosage regimes. It is the basis of achieving the best curative effect to realize individualized patient medication therapy ladder.