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2010 | 5 | 5 | 627-635

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Antihypertensive drugs utilisation and educational activities


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The mortality rate from cardiovascular diseases is high in Serbia. Analysis of antihypertensive drugs utilization is the basis for assessment of cardiovascular pharmacotherapy appropriateness. The aim of this study was to analyze the trend in antihypertensive drugs utilization among outpatients in Niš region, South Serbia compared to some Nordic countries (Norvay, Sweden) and Australia as well as to analyze trends in educational and drug promotion activities directed to primary healthcare workers within the same region. Using the ATC/DDD methodology, we analyzed the utilization of antihypertensive drugs dispensed on prescription in the Nis region over the 2003–2007 period. The study was retrospective, based on data obtained from Central City Pharmacy Nis. Educational and drug promotion activities were noted from the records of Medical Faculty, University of Nis, and from the records of local branches of pharmaceutical companies active in Serbia. Wilcoxon’s test was used in order to calculate the statistical significance of difference. A significant increase of 79.8% (153.8/ 276.6 DDD/inhabitants/day) in antihypertensive drug consumption was observed in the same period. This analysis showed there were substantial increases in the use of diuretics (134.7%), ACE inhibitors (79.5%) and calcium channel blockers (116.1%), especially amlodipin (241.2%). During the observed period, annual numbers of educational activities and of pharmaceutical sales representatives employed within the region increased for almost one fourth. This analysis pointed to a significant increase in the use of antihypertensive drugs in the Nis region, which was matched with increase in educational and drug promotion activities within the region, so that in 2006–2007 total consumption was approximate to some referential countries (Norvay, Sweden).










Physical description


1 - 10 - 2010
20 - 8 - 2010


  • Unit of Clinical Pharmacology, Clinical Centre Nis, 18000, Nis, Serbia
  • Pharmaceutical Institution Nis, 18000, Nis, Serbia
  • Faculty of Medicine Kragujevac, 18000, Nis, Serbia


  • [1] The world health report (accesed 30, april 2009) Avalaible from: www.who.int/medicines/areas/Wawatch.htm
  • [2] Miljkovic M., Djukic Lj., Analysis of Drug Utilization in Serbia during the Years 1996 and 1997, Pharmacother Drug Saf, 2000, 59–64
  • [3] Jankovic SM, The clinical pharmacology departments should develop their services according to the local health care needs. Eur J Clin Pharmacol, 2004, 60, 381–382 http://dx.doi.org/10.1007/s00228-004-0791-7[Crossref]
  • [4] World Health Organization. ATC index with DDDs, (World Health Organization: World Health Organization Collaborating Centre for Drug Statistics Methodology, 2003–2005, Available from:http://www.whocc.no/atcddd/2009/juned/Wawatch.htm
  • [5] Horn F., Mandryk J., Mackson J., Wutzke S., Weekes L., Hyndman R., Measurement of changes in antihypertensive drug utilization following primary care educational interventions, Pharmacoepidemiol Drug Saf, 2007, 16, 297–308 http://dx.doi.org/10.1002/pds.1243[WoS][Crossref]
  • [6] Semark B., Fredlund K., Astrand B., Brudin L., Reimbursement for drugs - a register study comparing economic outcome for five healthcare centres in areas with different socioeconomic conditions, Scand J Public Health, 2009, 37, 647–653 http://dx.doi.org/10.1177/1403494809106544[Crossref][WoS]
  • [7] Stojakovic N., Skrbic R., Stoisavljevic-Satara S., Babic-Duric D., Nezic L., Sabo A., Prescription-only drugs in Banja Luka region: utilization analyses, Med Pregl, 2004, 57, 72–76, (in Serbian) http://dx.doi.org/10.2298/MPNS0402072S[Crossref]
  • [8] Vukusic I., Culig J., Data sources on drug utilization in Croatia and Europe, Acta Medica Croatica, 2005, 59, 277–282, (in Croatian)
  • [9] Vitry A. and Lai HY. Advertising of antihypertensive medicines and prescription sales in Australia, Int Med J 2009, 39, 728–732 http://dx.doi.org/10.1111/j.1445-5994.2009.01909.x[Crossref]
  • [10] Wei L., Ebrahim S., Bartlett C., Davey PP., Sullivan FM., Mac Donald TM., Statin use in the secondary prevention of coronary heart disease in primary care: cohort study and comparison of inclusion and outcome with patients in randomised trials, BMJ, 2005, 330, 821–826 http://dx.doi.org/10.1136/bmj.38398.408032.8F[Crossref]
  • [11] Mancia G., Grassi G., Zanchetti A., New onset diabetes and antihypertensive drugs, J Hypertens 2007, 24, 3–10 http://dx.doi.org/10.1097/01.hjh.0000194119.42722.21[Crossref]
  • [12] World Health Organization, Introduction to Drug Utilization Research, WHO Library Cataloguing - in - Publication Data, 2003, 9–12
  • [13] Dordevic ND, Jankovic SM. Characteristics of decision-making process during prescribing in general practice. Vojnosanit. Pregl., 2006, 63, 279–285
  • [14] DREAM Trial Investigators, Bosch J., Yusuf S., Gerstein HC., Pogue J., Sheridan P., Dagenais G., et al., Effect of ramipril on the incidence of diabetes, N Engl J Med., 2006, 12, 1551–1562
  • [15] Mancia G., De Backer G., Dominiczak A., Cifkova R., Fagard R., Germano G., et al., ESH-ESC Task Force on the Management of Arterial Hypertension. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension, J Hypertens, 2007, 25, 1751–1762 http://dx.doi.org/10.1097/HJH.0b013e3282f0580f[Crossref]
  • [16] Raal A., Fischer K., Irs A., Determination of drug information needs of health care professionals in Estonia, Medicina (Kaunas), 2006, 42, 1030–1034
  • [17] Kildemoes H., Støvring H., Andersen M., Driving forces behind increasing cardiovascular drug utilization: a dynamic pharmacoepidemiological model, Br J Clin Pharmacol., 2008, 66, 885–895 http://dx.doi.org/10.1111/j.1365-2125.2008.03282.x[WoS][Crossref]
  • [18] Seamark B., Freeland K., Strand B., Bruin L., Reimbursement for drugs - A register study comparing economic outcome for five healthcare centres in areas with different socioeconomic conditions, Scand J Public Health., 2009, 22, 256–261 [WoS]
  • [19] Raman M., Presser S., Davis BR., Nwachuku C., Wright JT., Wheaton PK., et al., Renal outcomes in high-risk hypertensive patients treated with an angiotensin- converting enzyme inhibitor or a calcium channel blocker vs a diuretic: a report from the Antihypertensive and Lipid- Lowering Treatment to Prevent Heart Trial (ALLHAT), Arch Intern Med, 2005, 165, 936–946 http://dx.doi.org/10.1001/archinte.165.8.936[Crossref]
  • [20] Volpe M., Mancia G., Trimarco B., Angiotensin receptor blockers and myocardial infarction: the importance of dosage. J Hypertens. 2005, 23, 2113–2118. http://dx.doi.org/10.1097/01.hjh.0000194114.12228.16[Crossref]
  • [21] Esposti LD., Di Martino M., Saragoni S., Sgreccia A., Capone A., Buda S., Esposti ED., Pharmacoeconomics of antihypertensive drug treatment: an analysis of how long patients remain on various antihypertensive therapies, J Clin Hypetens, 2004, 6, 76–84. http://dx.doi.org/10.1111/j.1524-6175.2004.03044.x[Crossref]
  • [22] Every MJ., Heaton P., Cluxton RJ., Beta-blocker underused in secondary prevention of myocardial infarction, Ann Pharmacother, 2004, 38, 286–293
  • [23] Markovic-Pekovic V., Stoisavljevic-Satara S., Skrbic R., Utilization of cardiovascular medicines in Republic of Srpska, Bosnia and Herzegovina, 5 years study, Pharmacoepidemiol Drug Saf., 2009, 18, 320–326 http://dx.doi.org/10.1002/pds.1704[Crossref]
  • [24] Kostis JB., Wilson AC., Freudenberger RS., Cosgrove NM., Pressel SL., Davis BR., SHEP Collaborative Research Group. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes, Am J Cardiol, 2005, 95, 29–35 http://dx.doi.org/10.1016/j.amjcard.2004.08.059[Crossref]
  • [25] Sever PS., Poulter NR., Dahlof B., Wedel H., ASCOT Investigators. Antihypertensive therapy and the benefits of atorvastatin in the Anglo - Scandinavian Cardiac Outcomes Trial Lipid Lowering Arm extension, J Hypertens, 2009, 27, 947–954 http://dx.doi.org/10.1097/HJH.0b013e328326cb1a[WoS][Crossref]
  • [26] Nattional Agency for Medicines. Drug Consumption in years 2004–2007, (accesed 30, april 2009) Avalaible from: http://www.nam.fi/medicines/english/medicines/drug consumption.no
  • [27] Nordic Medico Statistical Committee 2009. Drug Consumption in Norway. (accesed 30may 2009)Avalaible from:http://www.legemiddelforbruk.no/english
  • [28] Petursson SR., Wardell WM., Curran JP., National rates and patterns of consumption of antihypertensive drugs in relation to their availability in the United states, The United Kingdom, Australia and New Zealand, Ann N Y Acad Sci, 2006, 304, 320–330 http://dx.doi.org/10.1111/j.1749-6632.1978.tb25609.x[Crossref]
  • [29] Jabary NS., Herrero AM., Gonzalez JA., The use of antihypertensive therapy in Spain (1986–1994), Am J Hypertens, 2000, 13, 607–625 http://dx.doi.org/10.1016/S0895-7061(99)00261-7[Crossref]
  • [30] Anonymous. IMS Health Forecasts 6 to 7 Percent Growth for Global Pharmaceutical Marketing 2006./(accesed 30, april 2009) Avalaible from: http://www.imshealth.com/ims/portal/front/article/htm
  • [31] Communnity prescription drug use, in DDD/1000/day for 2005 to 2007./(accesed 30, april 2009) Avalaible from http://www.health.gov.au/internet/main/publishing.nsf/Content/
  • [32] Drug Utilisation Sub-Committee (DUSC) Database as at 28 September 2009, Top 10 drugs, /(accesed 30, april 2009) Avalaible from http://www.australianprescriber.com/magazine/32/6/artid/1063/
  • [33] Brekke M., Hunskaar S., Straand J., Self reported drug utilization, health, and lifestyle factors among 70–74 years old community dwelling individuals in Western Norway. The Hordaland health Study (HUSK), BMC Public Health 2006, 6, 121–127 http://dx.doi.org/10.1186/1471-2458-6-121[Crossref]
  • [34] Stolk P., Van Wijk BL., Leufkens HG., Heerdink ER, Between- country variation in the utilization of antihypertensive agents: guidelines and clinical practice. J Hum Hypertens, 2006, 20, 917–922 http://dx.doi.org/10.1038/sj.jhh.1002089[Crossref]
  • [35] Frisk P., Mellgren TO., Hedberg N., Berlin A., Granath F., Wettermark B., Utilisation of angiotensin receptor blockers in Sweden: combining survey and register data to study adherence to prescribing guidelines, Eur J Clin Pharmacol, 2008, 64, 1223–1119 http://dx.doi.org/10.1007/s00228-008-0495-5[WoS][Crossref]
  • [36] Weitoft GR., Rosén M., Ericsson O., Ljung R., Education and drug use in Sweden -a nationwide register-based study, Pharmacoepidemiol Drug Saf, 2008, 17, 1020–1028 http://dx.doi.org/10.1002/pds.1635[WoS][Crossref]
  • [37] Jonsson L., Lundborg CS., Exploring unexplained twofold differences in sales of cardiovascular drugs between two neighboring Swedish municipalities, Pharmacoepidemiol Drug Saf, 2005, 5, 349–355 http://dx.doi.org/10.1002/pds.1079[Crossref]
  • [38] Hovstadius B., Astrand B., Petersson G., Dispensed drugs and multiple medications in the Swedish population: an individual-based register study, BMC Clin Pharmacol, 2009, 27, 11–16 http://dx.doi.org/10.1186/1472-6904-9-11[Crossref]
  • [39] Wettermark B., Hammar N., Fored CM., Leimanis A., Otterblad OP., Bergman U., et al., The new Swedish Prescribed Drug Register-opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol Drug Saf, 2008, 17, 533 http://dx.doi.org/10.1002/pds.1604[WoS][Crossref]
  • [40] Astrand B., Montelius E., Petersson G., Ekedahi A., Assessment of Prescription quality: an observational study at three mail-order pharmacies, BMC Med Inform Decis Mak, 2009, 26, 8–14 http://dx.doi.org/10.1186/1472-6947-9-8[WoS][Crossref]

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