Abstract
BackgroundTo investigate the nationwide trend of ambulatory prescriptions of short-acting nifedipine on a PRN (pro re nata) order over a fifteen-year period in Taiwan.MethodsThe systematic sampling claims datasets (0.2% sampling ratio) of ambulatory care visits within Taiwan's National Health Insurance from 1997 to 2011 were analyzed. The prescriptions of short-acting capsule-form nifedipine on a PRN order were stratified by the patient's age, the prescribing physician's specialty, and the setting of healthcare facility for each year.ResultsDuring the study period, 8,189,681 visits were analyzed. While the utilization rate of calcium channel blockers changed with time from 2.8% (13,767/489,636) in 1997 to 5.1% (31,349/614,719) in 2011, that of short-acting nifedipine were from 1.0% (n = 5,070) to 0.2% (n = 1,246). However, short-acting capsule-form nifedipine on a PRN order still existed (from 447 prescriptions in 1997 to 784 in 2011). More than one half of these PRN nifedipines were prescribed by the internists and to the elderly patients; almost four-fifths of PRN nifedipines were prescribed during non-emergent consultations.ConclusionThe physicians in Taiwan still had the habit of prescribing short-acting nifedipines for PRN use. The reason for such practices and the impact on patients' health deserve attention.
Highlights
Calcium channel blockers (CCBs) are antihypertensive agents widely prescribed for decades [1,2]
Because the route of medication was not contained in the NHIRD datasets, we identified the nifedipines prescribed as a PRN order from the field of medication frequency of the prescription files
Based on the nationally sampled datasets, our study revealed that the CCBs continued to be the popular antihypertensive agents in Taiwan from 1997 to 2011
Summary
Calcium channel blockers (CCBs) are antihypertensive agents widely prescribed for decades [1,2]. CCBs are heterogeneous, in ingredient and formulation, and in indication [3]. Short-acting nifedipine used to be a common treatment option for severe hypertension [4]. Several studies have reported the serious outcome from rapid fluctuation of blood pressure after sublingual use of nifedipine [5,6]. Administration (FDA) in the USA has announced the warning about the use of short-acting nifedipine in the management of hypertension crisis in 1996 [7], such a medical practice is still observed worldwide [8,9]. A long-term observational study of short-acting nifedipine use has been seldom reported. To investigate the nationwide trend of ambulatory prescriptions of short-acting nifedipine on a PRN (pro re nata) order over a fifteen-year period in Taiwan
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