Drug utilization review on high blood pressure and diabetes mellitus in St. Lucia - abstract

ABSTRACT

During a three-month period in 1991, the Eastern Caribbean Drug Service conducted a drug utilization review of hypertension and diabetes mellitus in St. Lucia. The survey was designe to assess the prescribing trends of drugs for these two highly prevalent diseases with emphasis on ther resulting medical and financial consequences. This prospective study utilized a quota sampling technique whereby an equal number of prescriptions were drawn from selected private and public clinics. One thousand, four hundred and eighteen prescriptions were collected. The percentage of women (68.3 percent) treated was more than double that of the men (31.7 percent). Seventy-three per cent (73 percent) of patient visits were for the treatment of hypertension, while the remaining twenty-seven per cent (27 percent) were for diabetes mellitus. As many as 10.4 percent of all prescriptions were for patients with co-existing hypertension and diabetes mellitus. The most commonly prescribed anti-hypertensive drug was bendrofluazide, which is inexpensive and highly effective in black populations. However, the traditional daily dose of 5 mg or more was usually given rather than the current recommended lower dose of 2.5 mg. Chlorpropamide was the most frequently prescribed hypoglycaemic agent (50 percent). It was surprising that metformin, useful in the treatment of obese diabetics, accounted for only 4 percent of all diabetic prescriptions. For a population of only 140,000, the Government issued 130,000 insulin syringes. The Ministry of Health could realise significant savings if patients who self-administer insulin reuse the syringe, and by conducting sharing the cost of health care with the private sector (AU)