(193) Temporal Trends In The Dispensing Of Anti-Hypertensive Medications In Ireland And The United Kingdom From 2017-2023

Background: The burden of hypertension is increasing worldwide. Due to effective blood pressure management reducing the risk of stroke, heart attack, and heart failure, up to date population level data on prescribing and dispensing trends are required.

Objectives: This study aimed to investigate trends in the dispensing of different anti-hypertension medications in Ireland and the United Kingdom.

Methods: This was a cross-sectional study using population level data. Irish data were obtained from the Health Service Executive Primary Care Reimbursement Service “top 100” database, which details monthly figures for the top 100 dispensed products submitted for reimbursement by community pharmacies. Approximately 2 million residents were eligible for the community drug schemes in this database during the study period. United Kingdom data were obtained from the National Health Service English Prescribing Dataset which includes details on prescriptions issued in England and dispensed across England, Wales, Scotland, Guernsey, Alderney, Jersey, and the Isle of Man. Monthly and annual dispensing frequencies of angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers, antiadrenergic agents, diuretics, β-blocking agents, and calcium channel blockers from January 2017-March 2023 were examined.

Results: In Ireland, β-blockers were the most frequently dispensed antihypertensive class, with a dispensing frequency of approximately 15 million from 2017 to March 2023. In the UK, ACEIs were the most frequently dispensed antihypertensive class, with a dispensing frequency of approximately 9.8 billion in the same timeframe. In Ireland, anti-adrenergic agents exhibited the lowest dispensing frequencies, with a frequency of approximately 1.8 million. The UK demonstrated a similar trend, with anti-adrenergic medications being the least commonly dispensed class, with a frequency of approximately 1.9 billion. Both regions experienced a sharp increase in all antihypertensive medication prescriptions in March 2020. This was followed by a temporary reduction in dispensing of all antihypertensive medications in April 2020.

Conclusions: This study displays the inter-country variation in prescribing for hypertension, despite both regions typically adapting the same prescribing guidelines. As β-blockers have many indications, co-morbidities may explain dispensing differences. The dispensing frequency fluctuations in March and April 2020 may reflect changes in patient behaviour, with patients obtaining medication supplies for April in March due to anticipated access restrictions as a result of COVID-19. Further investigation is necessary to explore potential reasons for the divergent dispensing patterns in both regions.