Change of Selection to Antihypertensive Drugs in Hypertensive Patients with Diabetes Mellitus: In Pohang . Gyeongju Primary Care Research Network / 가정의학회지

BACKGROUND: Angiotensin converting enzyme inhibitors (ACEIs) or Angiotensin II type 1 receptor blockers (ARBs) are compelling indication drugs for hypertensive patients with diabetes mellitus. But prescription rate in 2005 year study of Pohang . Gyeongju area was only 30.8%. Therefore, a study on the change of prescription rate in the same area after 3 years was done. METHODS: During three months from January 2008, 152 hypertensive patients with diabetes mellitus on their prescribed antihypertensive medications by 9 family physicians in visiting order were analyzed. After the analysis, the infl uencing factors for such prescriptions were ascertained by directly visiting each physicians who prescribed them. RESULTS: A regimen of 16 antihypertensive agents were prescribed by these family physicians. Prescription count of ACEIs or ARBs was 101 cases (66.4%). ACEIs single therapy was 19 cases (12.5%), ACEIs combination therapy was 7 cases (4.6%), ARBs single therapy was 31 cases (20.4%) and ARBs combination therapy was 44 cases (28.9%). The ACEIs or ARBs which were selected by physicians that followed "compelling indication" was 5 (55.6%), "excellent reduce pressure effect" was 3 (33.3%) and "public relations of new medicine" was 1 (11.1%). CONCLUSION: In prescribing antihypertensive agents for patients with diabetes mellitus, selection of ACEIs or ARBs was increased from 30.8% to 66.4%. Education of recommended standard by participating in such study and developing of excellent new medicines may increase such change.

Selection of Antihypertensive Drugs in Hypertensive Patients with Diabetes Mellitus: In Pohang-Gyeongju Primary Care Research Network

BACKGROUND: Angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker is usually recommended for hypertensive patients with diabetes mellitus. No reports have been made on antihypertensive agents prescribed for these patients in private practice. METHODS: During a one month period of December 2004, 169 hypertensive patients with diabetes mellitus on their prescribed antihypertensive agents by ten family physicians were analyzed. The influencing factors for such prescriptions were analyzed by directly visiting each physicians who prescribed them. RESULTS: A total of 21 antihypertensive agents were prescribed by these family physicians. Single calcium channel blocker therapy was the most common with 55 cases (32.5%), followed by 20 cases (11.8%) of single angiotensin converting enzyme inhibitor therapy and 16 cases of single therapy of Angiotensin II type 1 receptor blocker. The low frequency of prescribing the Angiotensin II type 1 receptor blocker was due to insufficient effect (7), lack of information (5), resistance from the patients from changing the medications (4) and expensive costs (4). CONCLUSION: In prescribing antihypertensive agents for patients with diabetes mellitus, angiotensin converting enzyme inhibitor or Angiotensin II type 1 receptor blocker were chosen less. In order to decrease the incidence of complications in these patients, such agents should be prescribed more.

Management patterns of upper gastrointestinal symptoms

BACKGROUND: Upper gastrointestinal symptoms is the one of the most frequent symptom in primary medicine, those manifestations are various and can not find the cause in many cases. In Korea the management patterns for upper gastrointestinal symptoms are using drug store, oriental medicine, folk methods, diet therapy in addition to medical service. We have investigated the behavioral patterns for the control of upper gastrointestinal symptoms. METHODS: The authors surveyed the patients who had visited Dong guk university Kyung ju hospital with upper gastrointestinal symptoms from April 1 to June 30 in 2000. RESULTS: 269 questionnaires were collected and among them 247 completed ones were analysed. 112 subjects were used medical service only(45.3%), 135 subjects were used alternative methods also(54.7%). Among the 135 subjects who used alternative methods, 60 visited to drug store(44.4%), 36 took oriental medicine(26.7%), 18 used folk herbal remedy(26.7%), 5 used diet therapy(3.7%), 16 used folk manual therapy(11.9%), most commonly. Women more commonly used alternative methods(P<0.01). By occupation, housewives more commonly used alternative methods and specialists less commonly used alternative methods. There were no significant difference between two groups in other general characteristics, most severe symptom, cost, satisfaction. CONCLUSION: We find the behavioral patterns for relieving upper gastrointestinal symptoms are using alternative methods(drug store, oriental medicine, folk herbal remedy, folk manual therapy, diet therapy) in addition to using medical service. Women and housewives more commonly used alternative methods, and specialist less commonly used alternative methods.