Pharmaco-economic ABC/VEN analysis of pre-hospital hypertensive crise treatment

Abstract

Aim. To analyse the pre-hospital treatment of uncomplicated hypertensive crises (HC), using complex pharmacoeconomic approach. Material and methods. A retrospective study based on the data from ambulance visits to the Kirov City patients with uncomplicated HC. Pharmacological anamnesis analysis, frequency analysis, ABC/VEN analysis. Results. The study included 482 patients with essential arterial hypertension (AH). No preceding antihypertensive treatment (AHT) was received by 20,9%, and irregular AHT was documented for 19,3%. Ambulance doctors prescribed 1-7 medications on average; the complete list included 51 medications. Total expenses (n=482) on medications and syringes were 7372,93 roubles; expenses per patient were 16,0±18,2 and 15,0±10,7 roubles for specialised and general ambulance teams (SAT, GAT), respectively. According to the ABC analysis results, the costs were mostly presented by NaCl (as a basis for intravenous injections), followed by phenazepam and magnesium sulphate. According to the VEN analysis, group V included 24,4-31,4% of all medications, while groups E and N included 20-21,6% and 47,1-55,6%, respectively. Conclusion. High HC rates in AH patients were linked to inadequate AHT at the out-patient level. AHT medication costs comprised, on average, one-fifth of the total expenses on medications prescribed by ambulance doctors. According to the frequency analysis results, SAT mostly used parenteral AHT for HC treatment, while GAT preferred oral AHT and non-recommended magnesium sulphate and dibazol. In the ABC analysis, medication distribution agreed with recommended one. The VEN analysis demonstrated over-prescription of second-line medications.

Keywords

• arterial hypertension
• hypertensive crise
• emergency medical care
• treatment
• pharmaco-economic study