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According to official data, hypertension has been diagnosed in more than 500,000 Lithuanians, but doctors warn that there may be many more patients.
The order, which radically changes the conditions for the prescription of drugs for hypertensive diseases, was signed by Health Minister A. Veryga in January this year.
Immediately afterwards, both patients and doctors expressed great concern about the ministry’s intentions. They drew attention to many flawed provisions in the law, as the contribution of the task force established in January 2019 to prepare the inventory was simply ignored.
As a result, the entry into force of the order was postponed even twice, initially until May and then until October. While the minister said that the entry into force was postponed in order to convene a working group for a new meeting, even after more than half a year, this did not happen and the prescribing information was not updated. As a result, physicians are particularly concerned about the recommendations for this description.
The document has changed dramatically
“By order of the Minister of SAM, a working group was approved to prepare recommendations for the treatment of arterial hypertension. It was made up of representatives of both universities, scientific societies, family doctors and medical specialists, SAM, IWT, representatives of health insurance funds. The working group worked responsibly: citing documents of the European society, discussing among themselves, seeking a consensus acceptable to all. A research-based document has been developed in line with European guidelines, adapted to the daily work of a doctor.
Unfortunately, the document has changed during the approval process and differs significantly from the prepared working group. The document became controversial, complicating the doctor’s daily work. I think it is wrong to ignore the opinion of specialists and change it unilaterally, ”says Gintarė Šakalytė, member of the medical working group, professor at LSMU and head of the Department of Heart Failure and Defects at the Kaunas Cardiology Clinic, LSMU Hospital.
Every fourth Lithuanian treatment will be reversed
Hypertension has been diagnosed in more than 500,000 Lithuanians, but according to medical estimates, there may be more than 0.7 million patients. population. It is because of the sheer scale of the disease that the new order is causing discontent among physicians.
“The new procedure will complicate the treatment of one in four Lithuanians. A significant proportion of deaths in Lithuania are identified as complications caused by hypertension. Can you imagine the responsibility that falls on our shoulders, when even knowing the risks of the disease, Will we be forced to prescribe not the most appropriate drugs, but the cheapest ones? ”Says Gediminas Urbonas, associate professor at the LSMU MA Family Medicine Clinic.
According to the doctors, the SAM antihypertensive drug regimen will avoid the most innovative drugs and instead of a multi-problem combination tablet, doctors will be forced to prescribe a handful of individual tablets.
When a combined tablet is replaced by separate tablets, this affects not only the comfort of the patient but also the effectiveness of the treatment. Studies show that the higher the number of tablets, the worse their use. For example, in 2017. In Hungary, more than 109 thousand. Patient data revealed that patients treated with individual medications were twice as likely to discontinue their treatment as those who took a single tablet.
Interrupted or incomplete treatment with only a fraction of the essential drugs results in more hospitalizations and increased mortality. A study published by Current Medical Research and Opinion states that the combination drug reduces mortality by almost two times compared to individual tablets.
“I invite all those who care about the health of the Lithuanian population and the treatment of arterial hypertension in our country to follow the international guidelines,” says the president of the Lithuanian Hypertension Society, prof. “We urge you to take into account the recommendations we have made and not modify them.”
He worked in the Ministry of Health and drew attention to the shortcomings of the order, which will soon enter into force. M. Miglinas, prof. G. Šakalytė, prof. I. Skarupskienė, J. Dūdienė, V. Juknevičius, doc. G. Urbonas, doc. J. Barysienė, D. Makarevičienė.
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