Background <p>Essential hypertension incurs substantial cardiovascular morbidity and mortality, particularly in primary prevention settings. General practitioners (GPs) play a pivotal role in the management of uncomplicated hypertension in primary care, yet variations exist among GPs. The determinants shaping GPs’ antihypertensive drugs (AD) prescription patterns in the setting of hypertension remain ambiguous.</p> Objectives <p>This investigation sought to examine the correlation between GP characteristics and professional activities on the prescribing patterns of ADs within the context of uncomplicated hypertension management.</p> Methods <p>A secondary data analysis utilizing a sample of 2,165 GPs was conducted in Normandy, France, in 2019. The ratio of AD prescriptions to overall prescription volume was computed for each GP. GPs were classified as ‘low’ or ‘high’ AD prescribers based on the median of this ratio. The ratio was examined in relation to GPs’ demographic and professional variables such as age, gender, practice setting, years of experience, consultation frequency, the demographics and socioeconomic status of their patient panels, and prevalence of chronic conditions in patients. These associations were explored using both univariate and multivariate analyses.</p> Results <p>GPs categorized as low prescribers had a mean age of 51.3 ± 11.2 years and were predominantly female (56%). In multivariate logistic regression, low-prescriber status correlated with urban practice location (OR: 1.47, 95% CI: 1.14–1.88), younger GP age (OR: 1.87, 95% CI: 1.42–2.44), younger patient population (OR: 3.39, 95% CI: 2.77–4.15), higher consultation rate per patient (OR: 1.33, 95% CI: 1.11–1.61), greater proportion of low-income patients (OR: 1.44, 95% CI: 1.17–1.76), and a lower prevalence of diabetes mellitus (OR: 0.72, 95% CI: 0.59–0.88) throughout 2019.</p> Conclusion <p>Low AD prescription rates are associated with younger, urban-based GPs who experienced higher patient consultation rates in 2019 and managed populations with lower income profiles.</p> Clinical Implications <p>The prescription of antihypertensive medications might be significantly influenced by GPs' professional attributes and activities within the French healthcare setting.</p>

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Association between GP characteristics and prescription patterns for antihypertensive drugs: a secondary data analysis in Normandy, France

  • Andry Rabiaza,
  • Marc Massenet,
  • Françoise Legrand,
  • Francis Kuhn,
  • Sigolène Duver,
  • Damien Legallois,
  • Charles Dolladille,
  • Joachim Alexandre,
  • François LE Bas,
  • Raphaëlle Delpech,
  • Xavier Humbert

摘要

Background

Essential hypertension incurs substantial cardiovascular morbidity and mortality, particularly in primary prevention settings. General practitioners (GPs) play a pivotal role in the management of uncomplicated hypertension in primary care, yet variations exist among GPs. The determinants shaping GPs’ antihypertensive drugs (AD) prescription patterns in the setting of hypertension remain ambiguous.

Objectives

This investigation sought to examine the correlation between GP characteristics and professional activities on the prescribing patterns of ADs within the context of uncomplicated hypertension management.

Methods

A secondary data analysis utilizing a sample of 2,165 GPs was conducted in Normandy, France, in 2019. The ratio of AD prescriptions to overall prescription volume was computed for each GP. GPs were classified as ‘low’ or ‘high’ AD prescribers based on the median of this ratio. The ratio was examined in relation to GPs’ demographic and professional variables such as age, gender, practice setting, years of experience, consultation frequency, the demographics and socioeconomic status of their patient panels, and prevalence of chronic conditions in patients. These associations were explored using both univariate and multivariate analyses.

Results

GPs categorized as low prescribers had a mean age of 51.3 ± 11.2 years and were predominantly female (56%). In multivariate logistic regression, low-prescriber status correlated with urban practice location (OR: 1.47, 95% CI: 1.14–1.88), younger GP age (OR: 1.87, 95% CI: 1.42–2.44), younger patient population (OR: 3.39, 95% CI: 2.77–4.15), higher consultation rate per patient (OR: 1.33, 95% CI: 1.11–1.61), greater proportion of low-income patients (OR: 1.44, 95% CI: 1.17–1.76), and a lower prevalence of diabetes mellitus (OR: 0.72, 95% CI: 0.59–0.88) throughout 2019.

Conclusion

Low AD prescription rates are associated with younger, urban-based GPs who experienced higher patient consultation rates in 2019 and managed populations with lower income profiles.

Clinical Implications

The prescription of antihypertensive medications might be significantly influenced by GPs' professional attributes and activities within the French healthcare setting.