Pharmacoepidemiological study of recommendations of diuretics for the treatment of hypertension in the outpatient setting

The aim of the study is pharmacoepidemiologicalanalysis of the structureandreasonability of diuretic therapy in patients with hypertensive disease (HD)in ‘real-life’ clinical practicesettings.Materialandmethods:we underwentthe retrospectivepharmacoepidemiologicalcomparative analysisof the structureofdiuretic therapyreviewingoutpatient cardsfrom 2011 to 2014.We extracted data from outpatientcardsin outpatient department of Krasnodar Territoryusingcontinuous sampling method(421 patients)with the subsequent assessmentin accordance withmodern guidance materials. Results. In comparison with the regional study historic resultsthe administrationoftorsemidehad significantly increasedin patients withHD andnoncomplicatedchronic cardiac failure(12%).The priority drugs for the administrationamong diuretics werehydrochlorothiazide (24%)and indapamide (20%),spironolactone (20%).The ACE inhibitoror sartanusing in fixed combination with diuretic was recommended in 20% of out- patient cards.Structure ofdiuretic distribution in group of patients with HD, associated withCHF(II-IVfunctional class)had showedthe efficiencyof spironolactonein26%,of hydrochlorothiazide - 15%,torsemide - 13%,indapamide - 7%;the combination of spironolactoneandtorsemidewas receivedby 14% of patients,the combination of spironolactoneandhydrochlorothiazide - 6%,spironolactoneand furosemide - 1%,in 4% of outpatient cardswe noticed the triple combination of monocomponentdiuretic.Conclusion. We did not find unreasonable administration of diuretic therapy combination out ofindication and in the presence of contradictions.The prescription of modern long-termdiuretics associated with lower risk of side-effects developing will improve efficiencyand safetyof pharmacotherapy.It is very important to use fixed drugs combinationin case of administration the diuretic and agentsofrenin angiotensin system inhibitors.The volume and prescription reasonability analysis ofdiuretic therapy in patients withHDin ‘real-life’ clinical practicesettingshas shown compliance with modernnational guidance materials for the HD and CHF treatment.