Table 2 Barriers to prescribing thiazides for the treatment of hypertension, and possible interventions to address these
Possible barriers | Possible interventions |
|---|---|
Physicians are neither familiar with the relevant brand-names nor to the use and follow-up of these drugs | - Pre-printed prescriptions, also in electronic format - Patient information - Support for the clinical follow-up |
Few other clinicians use these drugs | - Patient information - Active promotion of thiazides (through educational outreach visits) - Point out the consensus among guidelines that thiazides are a first-line drug |
Specialists may be prescribing other drugs | - Identify opinion leaders that advocate the use of thiazides - Look into possible conflicts of interest |
Advocacy by pharmaceutical companies | - Point attention to the importance of clinically relevant endpoints when studies are quoted (during educational outreach visits) - Review advertisements to identify the main lines of reasoning that are being used |
Physicians are worried about possible side-effects and lack of anti-hypertensive effect. | - Educational outreach visits |
Thiazides considered old-fashioned | - Argue that these drugs have been thoroughly tested over many years (during educational outreach visits) |