Treatment of hypertension within primary health care in the Kyrgyz Republic: pharmacoepidemiology and control efficiency

Abstract

Aim. To study the pharmacoepidemiological aspects and efficiency of hypertension (HTN) control at the level of primary health care in the Kyrgyz Republic (and their compliance with modern clinical guidelines.Material and methods. Within the project "Analysis and evaluation of factors determining the control of management of patients with hypertension and other cardiovascular diseases in the Kyrgyz Republic", supported by the Ministry of Health of the Kyrgyz Republic and the Swiss project "Effective management and prevention of non-communicable diseases in Kyrgyzstan", we studied compliance of antihypertensives' prescription with modern clinical guidelines and the effectiveness of HTN control at the level of primary health care in the Kyrgyz Republic. We analyzed the medical records of patients registered with a diagnosis of HTN for 2022. Family doctor groups (FDGs) were used as the Primary Sampling Unit (PSU), which were sampled using probability sampling proportional to the size of the general population. Medical records of patients from FDGs were used as the Secondary Sampling Unit. We selected 40 medical records of patients from each FDG. A total of 3675 medical records of patients with hypertension were studied throughout the Kyrgyz Republic.Results. The age of patients from the selected 3675 medical records ranged from 19 to 93 years (mean age, 62±9 years). Most of the examined individuals were women (2567 respondents, or 69,9%), while men were represented by 1108 respondents (30,1%). According to the study of medical records, the proportion of individuals with HTN covered by treatment was 86,6% (including 90,3% of women and 84,6% of men, p<0,001), of which 43,8% of patients received monotherapy, 39,4% received dual therapy, 14,4% received triple therapy, and 2,4% of respondents received 4 or more antihypertensive drugs. On average, out of the total number of people receiving antihypertensive drugs, there were 1,76 drugs per patient with hypertension, and this parameter was slightly higher in women (1,83) than in men (1,66). The proportion of effectively treated patients in general among people with HTN was 42,1% (43,5% in women and 35,5% in men, p<0,0001). Hypertension control in the study cohort was 42,1%, and this parameter was also higher in women than in men (44% versus 37,8%, respectively, p<0,001).Conclusion. The study revealed a high proportion of patients covered by treatment using modern antihypertensive drugs and an increase in the effectiveness of treatment and control of HTN over the past decade in the Kyrgyz Republic.

Keywords

• primary health care
• hypertension
• pharmacoepidemiology
• control efficiency
• antihypertensive drugs