To describe the patterns of antihypertensive medicines (AHM) in a selected national population in Ghana. We analysed the claims data for all privately-insured patients in Ghana over three years to 2018. We examined the medicines, class and dose by time, gender and age, and generic status. We estimate the use in De ned Daily Dose (DDD) per 1000 population per day. Classes of AHM prescribed were CCB, ARB, ACEI, diuretics and BB. Amlodipine, nifedipine, losartan, lisinopril, and bendro umethiazide accounted for 74% of all use. The most widely used single CCB was amlodipine 3.92 DDD/1,000 population/day in 2016, 3.92 DDD/1,000 population/day in 2017, and 4.92 DDD/1,000 population/day in 2018. In those aged 51-60 years, use of CCB in women (74.0 DDD/1,000 population/day) was almost twice that of men (38.3 DDD/1,000 population/day). The top ten medicines accounted for 93% of all single medicine products in 2018. Most single medicine products was generic (76.5% in 2016; 79.9% in 2017 and 83.1% in 2018) whiles most xed combination products were branded (73.0% in 2016; 89.7% in 2017 and 91.3% in 2018). The patterns of AHM use are clinically expected although the Ghana Standard Treatment guidelines are not directive about lines of treatment. countries in sub-Saharan Africa. In Ghana the prevalence of hypertension ranges between 19% and 48%. ( 3) It has been one of the top ve outpatient department (OPD) diseases and the leading cause of deaths among adults. (4, 5) Despite the increasing prevalence of hypertension in Ghana there is low awareness, treatment, and control. (6) Antihypertensive medicines (AHM) combined with lifestyle modi cations can control the condition and prevent complications and deaths. ( 7) Although modifying one's lifestyle is important in managing hypertension, most individuals require two or more AHM to maintain their blood pressure within acceptable ranges. (8, 9) There are ve main classes of AHM and their effectiveness in preventing cardiovascular events is well documented. ( 8)Exploring AHM use will yield more knowledge about the distribution of use, bene ts, adverse effects, and availability. Monitoring trends in AHM use can provide insight into the effectiveness of primary prevention, management and control of diseases, procurement, and guide policy making to improve healthcare. It can also explore adherence to guideline recommendations promoting the safe use and management of medicines in clinical practice. Studies of AHM use in Ghana are often hospital audits or cross-sectional surveys. There are no studies on AHM use among patients using national data. We aimed to describe the use of AHM in a nationwide dataset of privately-insured patients in Ghana.
Methods
Data sourcesIn Ghana there are two main types of health insurance namely the public National Health Insurance Scheme (NHIS) and private health insurance (PHI).We sourced de-identi ed claims data of all PHI organisations, and their members, in Ghana. The data are collected in near real time from 1,423 healthcare facilities in the (now) 16 r...
