An assessment of antihypertensive drug prescription patterns and adherence to joint national committee-8 hypertension treatment guidelines among hypertensive patients attending a tertiary care teaching hospital

Abstract

Background:The new guidelines issued by the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC-8) emphasize that aggressive blood pressure (BP) control is essential to reducing morbidity and mortality. Patient non-adherence is a serious obstacle to the effective treatment of many acute and chronic disorders. Successful treatment and outcome of a chronic disease such as hypertension depend on many factors, including resources (e.g., funds, space, and people), avoidance of serious adverse events, patient adherence with treatment plans, and the availability of effective therapies. The aim of this study is to assess the antihypertensive drug prescription patterns and adherence to joint national committee (JNC-8) hypertension (HT) treatment recommendations among hypertensive patients attending a tertiary care teaching hospital. Methods: An observational and cross-sectional prospective prescription audit study was carried over a period of 1 year in ambulatory patients attending medicine OPD. A total of 500 prescriptions prescribed to diagnose HT were analyzed. Drug prescription patterns, and their adherence to JNC-8 report was assessed. Results: Out of 500 patients, 299 (59.8%) were male and 201 (40.2%) were female. Mean age of male and female patients were found to be 57.68±15.32 and 61.29±12.65 years respectively. As per present study, most of the physicians prescribed single drug (monotherapy, 34.6%) to control BP followed by two-drug combination (18.4%), three-drug combination (11.8%) and four-drug combination (3%). Two drugs regimen was prescribed in 18.4% of the hypertensive patients. Angiotensin receptor blocker + diuretic combination (4.4%) was mostly used in two drug combination therapy followed by Angiotensin receptor blockers + Diuretics (3.6%) and Calcium channel blocker + ACEIs combination (2.6%). No combination of ACEIs + ARBs was prescribed in any prescription. The overall rate of adherence was 16.5 % (Pre-hypertension); 87.90% (Stage 1 hypertension); and 68.20% (Stage 2 hypertension). Conclusions:In conclusion, present study demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with comorbid conditions.

Evaluation of Antihypertensive Drug Prescription Patterns, Rationality, and Adherence to Joint National Committee-8 Hypertension Treatment Guidelines among Patients Attending Medicine OPD in a Tertiary Care Hospital.

“…This study also reveals that hypertension is more prevalent in elderly patients belonging to age group 40-60 or more. Study conducted by Romday et al13 and Tiwari et al19 found most Present study results fall in line of the study by Romday R et al (2016) 13. Study done by Amira et al23 and Kothari et al16 found 36.6% and 47.72% patients respectively were suffering with comorbid conditions.…”

Current prescription status of anti hypertensives in cardiology

“…According to (Singla et al, 2018) ARB (45.47%), BB(9.09%), CCB(22.75%), ACEI(20.64%), DI (2.05%). According to (Romday et al, 2016) DI (29.48%) is highly used but it's a contradict result to our observations. CCB (21.96%) which is next to highly used similar to our observations.…”

“…In our study we observed BB+ ARB are highly used it occupies 19.73% and complies with Haq et al (2019) and (Singla et al, 2018) (47.46%) but (4.81%) according to (Romday et al, 2016) entirely contradict to our observation. BB+CCB (17.27%) and in (Singla et al, 2018) (4.13%) but (Romday et al, 2016) indicates 12.04% similar to our observations. (17.12%) ARB+DI but according to (Singla et al, 2018) (24.76%) indicating next highly used combination and 21.67% indicated in (Romday et al, 2016).…”

An Assessment of Potential Drug-Drug Interactions in Hypertensive Patients in a Tertiary Care Hospital

“…The study revealed that the highest number of diseases and comorbid conditions were hypertension alone were 162 (40.90%), hypertension+diabetes were 68 (17.17%), and Hypertension+ Cardiovascular diseases were 41 (10.35%), the most co-morbidities disease in hypertensive patients, and also the most of the female patients had found to be hypertensive and shown PDDIs (table 6), a similar study conducted by Romday et al (2016) [14] reported that Diabetes mellitus (9.36%, males; 8.96%, females), other cardiovascular diseases (14.05%, males; 13.43%, females), acid peptic disease (7.69%, males; 7.46%, females) and dyslipidemia (11.70%, males; 13.43%, females) are the most common comorbidities in hypertension patients.…”