Prescribing Patterns of Antihypertensive Drugs in Uncomplicated Hypertension

Association Between GP Characteristics and Prescription Patterns for Antihypertensive Drugs: A Cross-sectional Study in Normandy, France

Hypertension incurs substantial cardiovascular morbidity and mortality, particularly in primary prevention settings. General practitioners (GPs) play a pivotal role in the management of hypertension in primary care, yet variations exist among GPs. The determinants shaping GPs' antihypertensive medication (AD) prescription patterns in the setting of hypertension remain ambiguous. This investigation sought to elucidate how GPs' characteristics and professional activities influence AD prescriptions. A cross-sectional study utilizing a sample of 2,165 GPs was conducted in Normandy, France, in 2019. The ratio of AD prescriptions to overall prescription volume was computed for each practitioner. GPs were classified as 'low' or 'high' AD prescribers based on the median of this ratio. The ratio was examined in relation to GPs' demographic and professional variables such as age, gender, practice setting, years of experience, consultation frequency, the demographics and socioeconomic status of their patient panels, and prevalence of chronic conditions in patients. These associations were explored using both univariate and multivariate analyses.

Study Overview

• Status: Completed
• Conditions: Cardiovascular Diseases; Hypertension,Essential
• Intervention / Treatment: Drug: Antihypertensive Agents

• Study Type: Observational
• Enrollment (Actual): 3325032

Contacts and Locations

Study Locations

• France
  • Caen, France, 14200
    • Xavier Humbert

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The participant pool for this study comprised GP characteristics and prescription practices within the Normandy region in northwestern France during the course of 2019. With a resident population of 3,325,032 as of January 1, 2019, and a total of 2,165 registered GPs, the study was well-situated to offer a representative analysis.

In order to focus on conventional full-time primary GP care, practitioners whose primary professional focus included specialties such as osteopathy, acupuncture, homeopathy, or nutrition were excluded. Furthermore, GPs with fewer than 300 annual consultations/visits (less than one per day), fewer than 2,000 annual drug prescriptions, no patients with any of the 30 chronic diseases that qualify for no-charge treatment under French law, or solely very low-income patients (eligible for no-charge GP visits as defined by French legislation) were also excluded.

Description

Inclusion Criteria:

• All patients who had at least one visit to their GP in 2019 were included, but minors were omitted.

Exclusion Criteria:

• minors

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
hypertensive subjects	Drug: Antihypertensive Agents; use of antihypertensive drugs
non-hypertensive subjects

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
GP demographics	age and gender of GPs, the urban or rural classification of the practice location (based on the GP's clinic postal code and DATASANTE tables from the French National Institute for Statistics and Economic Studies, INSEE), and the number of years in practice.	1 year
medical practice activities	frequency of home visits and consultations, the total number of registered patients, the average number of visits or consultations per patient, the average patient age, the number of very low-income patients, and the prevalence of registered chronic diseases (notably diabetes mellitus and cardiovascular diseases).	1 year

Collaborators and Investigators

• Sponsor: University Hospital, Caen

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2019
• Primary Completion (Actual): August 12, 2022
• Study Completion (Actual): June 5, 2024

Study Registration Dates

• First Submitted: July 19, 2024
• First Submitted That Met QC Criteria: July 19, 2024
• First Posted (Actual): July 24, 2024

Study Record Updates

• Last Update Posted (Actual): July 25, 2024
• Last Update Submitted That Met QC Criteria: July 24, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: hypertension; primary care; prescriptions
• Additional Relevant MeSH Terms: Vascular Diseases; Hypertension; Cardiovascular Diseases; Essential Hypertension; Antihypertensive Agents
• Other Study ID Numbers: 24-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No