Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

ANTI-HYPERTENSIVE PRESCRIPTION PATTERN IN PRIMARY CARE FOR MALAYSIAN ELDERLY

Author

K K Lim, S Sivasampu, S Kumar

Institution

 

Abstract

Objectives: To determine anti-hypertensive prescription pattern for elderly patients in Malaysian primary care setting, which has not been given much attention despite its high prevalence.

Methods: Data was extracted from the National Medical Care Survey, a cross-sectional self- reporting prescription study conducted in 2010, responded by 122 public and 652 private primary care clinics. Patients = 60 years old with hypertension were included. Anti-hypertensive prescription pattern was described. Odds ratios (OR) for having combination therapy and fixed- dose regimen were determined.

Results: Out of 614 patients included, 53.1% were on monotherapy, 31.6% dual, 12.2% triple, 2.8% quadruple and 0.3% quintuple. Patients from public clinics were more likely to be prescribed combination therapy (OR 1.69; 95%CI 1.22-2.36). Of the 1017 medications taken, calcium-channel blockers were the most frequently prescribed (27.1%), followed by beta-blockers (25.5%) and diuretics (23.3%), with significant difference between sectors (p<0.001). A minority (1.3%) was given alpha-blocker or methyldopa monotherapy. Patients with private third-party payment were more likely to receive a fixed-dose regimen than those under government subsidy and those paying out-of-pocket.

Conclusion: The study highlighted the pattern, discrepancies and safety issues concerning anti- hypertensive utilization among study population. Feedback should be provided to doctors to reflect on own prescribing practices in accordance with current evidences.