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To what extent do prescribing practices for hypertension in the private sector in Zimbabwe follow the national treatment guidelines? An analysis of insurance medical claims

Overview of attention for article published in Journal of Pharmaceutical Policy and Practice, December 2017
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3 tweeters

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5 Dimensions

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41 Mendeley
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Title
To what extent do prescribing practices for hypertension in the private sector in Zimbabwe follow the national treatment guidelines? An analysis of insurance medical claims
Published in
Journal of Pharmaceutical Policy and Practice, December 2017
DOI 10.1186/s40545-017-0125-7
Pubmed ID
Authors

Victor Basopo, Paschal N. Mujasi

Abstract

Hypertension is the most prevalent cardiovascular disease in Zimbabwe. The prevalence of Hypertension in the country is above 30% regardless of the cut off used. Currently, majority of patients in Zimbabwe seek health care from the private sector due to limited government funding for the public health sector. However, Standard treatment guidelines for hypertension are only available in the public sector and are optional in the private sector. This study assesses compliance of private sector prescribing to Standard Treatment guidelines for hypertension. We reviewed hypertension prescription claims to a private health insurance company in Zimbabwe for the period Jan 1-Dec 31 2015. We used the last prescription claimed in the year on the assumption that it represented the patient's current treatment. Prescription data was analyzed by comparing medicines prescribed to those recommended in the Zimbabwe 7th Essential Medicines List and Standard Treatment Guidelines 2015. We used Microsoft Excel© 2010 to conduct the analysis. A total of 1019 prescriptions were reviewed. Most patients were either on mono or dual therapy (76%). The mostly prescribed class of antihypertensive as first line were Angiotensin Converting Enzyme Inhibitors /Angiotensin Receptor Blockers. Regardless of whether they were being used as first, second or third line this class of antihypertensives emerged as the most prescribed (639 times). Only 358 (35%) prescriptions were compliant with standard treatment guidelines; the rest (661) did not meet several criteria. Areas of non-compliance included use of second line medicines as first line, failure to consider patient characteristics when prescribing, use of contraindicated medicines for certain patients, clinically significant interactions among prescribed medicines and illogical combinations that predispose patients to toxicity. The poor compliance to standard treatment guidelines observed in our study indicates need to improve prescription practices for Hypertension in the private sector in Zimbabwe for its cost-effective management among the covered patients. However, further investigation is needed to understand the drivers of the prescribing habits and the non-compliance to the Essential Medicines List and Standard Treatment guidelines observed. This will enable design of appropriate educational, managerial and economic interventions to improve compliance.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 41 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 27%
Student > Postgraduate 4 10%
Other 3 7%
Student > Bachelor 3 7%
Researcher 3 7%
Other 8 20%
Unknown 9 22%
Readers by discipline Count As %
Medicine and Dentistry 9 22%
Nursing and Health Professions 9 22%
Pharmacology, Toxicology and Pharmaceutical Science 4 10%
Biochemistry, Genetics and Molecular Biology 2 5%
Social Sciences 2 5%
Other 3 7%
Unknown 12 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 December 2017.
All research outputs
#7,052,994
of 12,269,011 outputs
Outputs from Journal of Pharmaceutical Policy and Practice
#112
of 156 outputs
Outputs of similar age
#163,637
of 344,455 outputs
Outputs of similar age from Journal of Pharmaceutical Policy and Practice
#4
of 7 outputs
Altmetric has tracked 12,269,011 research outputs across all sources so far. This one is in the 40th percentile – i.e., 40% of other outputs scored the same or lower than it.
So far Altmetric has tracked 156 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.6. This one is in the 22nd percentile – i.e., 22% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 344,455 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 7 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.