Volume 64, Number 12, 1223-1229, DOI: 10.1007/s00228-008-0495-5

Utilisation of angiotensin receptor blockers in Sweden: combining survey and register data to study adherence to prescribing guidelines

Pia Frisk, Tor-Olov Mellgren, Niklas Hedberg, Anita Berlin, Fredrik Granath and Björn Wettermark

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Abstract

Purpose  

Angiotensin receptor blockers (ARBs) offer a new treatment alternative for patients with hypertension and heart failure. Due to comparatively high prices, most guidelines suggest ARBs be restricted to patients intolerant to angiotensin-converting enzyme inhibitors (ACEi). We analysed the prescribing patterns of ARBs in Sweden by combining prescription register data with patient self-reported data.

Methods  

Survey data from 517 patients dispensed ARBs in 55 pharmacies and data on dispensed prescriptions from the Swedish Prescribed Drug Register were used to study indication, comorbidity and whether ARBs were initiated as first-line treatment.

Results  

In 2006, ARBs were dispensed to 3.6% of the Swedish population. The survey showed that 92% used them for hypertension. Register data showed that 23% of all patients initiated on an ARB had not been prescribed any other antihypertensive drugs 1 year prior to the initiation.

Conclusions  

ARBs are commonly used in Sweden, mainly to treat hypertension. Adherence to prescribing guidelines may be improved.

Keywords  Angiotensin receptor blockers - Drug utilisation - Guidelines - Prescribing - ACE inhibitors - Patient survey

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