Antihypertensive use, prescription patterns, and cost of medications in a Teaching Hospital in Lagos, Nigeria

Bakare, Omowumi Q.; Akinyinka, Modupe Rebekah; Goodman, OlayinkaO; Kuyinu, Yetunde; Wright, Kikelomo Ololade; Adeniran, Adeyinka; Odusanya, Olumuyiwa O.; Osibogun, Akin

doi:10.4103/1119-3077.188709

Cited by 34 publications

(59 citation statements)

References 16 publications

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“…In our sample, a small proportion 22.5% of the patient was treated with monotherapy, this is supported by reports from Nigeria 2.5% [44], 20% [45] and India 27.7% [22]. In contrast, an Indian study [46] reported most CVD patients to be treated with monotherapy and Patel et al [47] reported the use of monotherapy to treat diabetic patients.…”

Section: Discussionsupporting

confidence: 82%

Prescription Pattern of Cardiovascular and/or Antidiabetic Drugs in Abuja District Hospitals

Osuafor¹,

Ukwe²,

Okonta³

2019

Int J Pharm Pharm Sci

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Objective:The study aimed to describe the prescription pattern of cardiovascular and/or anti-diabetic drugs and adherence to the World Health Organization (WHO) prescribing indicators in Abuja District Hospitals.Methods: This descriptive retrospective study was carried out in Asokoro and Maitama District Hospitals Abuja. One thousand and nine prescriptions that contained a cardiovascular drug (CVD) and/or anti-diabetic drug issued between June 2017 and May 2018 from the Medical Outpatient Department were analyzed. Data were collected from the pharmacy electronic database, prescription pattern and adherence to WHO prescribing indicators were assessed. The analysis was done using descriptive statistics. Results were presented as percentages, means, and standard deviations. Results:The frequency of treatment was higher among women (58.8%) and the age group of 41-60 (54.8%). The average number of drugs prescribed was 3.3±1.6: the percentage of drugs prescribed in generic was (64%) and (78.8%) were from the Essential Drug List (EDL). Calcium Channel Blockers (CCB, 71.7%) and Biguanides (B, 92.4%) were the most prescribed CVD and anti-diabetic drug. The majority of the CVD (74.5%) and diabetes (63.6%) patients were on combination therapy. The most frequent CVD combination was CCB plus Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers (29.7%). Compared to men, the proportion of females taking one or more CVD (61.3%) or antidiabetic (56.4%) was higher. Conclusion:The prescribing indicators are not optimal in Abuja district hospitals. Women received more treatment for cardiovascular and diabetes diseases than men while the age range of 41-60 was more treated than other age groups.

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Section: Discussionsupporting

confidence: 82%

Prescription Pattern of Cardiovascular and/or Antidiabetic Drugs in Abuja District Hospitals

Osuafor¹,

Ukwe²,

Okonta³

2019

Int J Pharm Pharm Sci

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“…Therefore, this could be the reason to have a tendency to prescribe an ARB, even though ACE inhibitors are more affordable. Unlike the present study, ARBs were the least chosen drugs in studies conducted in Nigeria and Bahrain [12,15]. This may be due to the high cost of the newer ARBs.…”

Section: Pharmacotherapy Of Hypertension In North Cyprus фармакотерапcontrasting

confidence: 63%

“…In addition, unlike the guidelines according to the ATC-2 subclassification, diuretics were the fourth chosen drug whereas according to the ATC-5 subclassification a high-ceiling diuretic, furosemide was the third-chosen drug in hypertension treatment. In a study conducted in Turkey and in Nigeria, diuretics was the most preferred drugs [15,16]. In this study, it was observed that the most common prescribed diuretics were the highceiling diuretics and potassium-sparing agents.…”

Section: Pharmacotherapy Of Hypertension In North Cyprus фармакотерапmentioning

confidence: 72%

“…В дополнение к этому, в отличие от рекомендаций по подклассу АТХ-2, диуретики являлись четвертыми по частоте назначения; по подклассу АТХ-5 петлевой диуретик фуросемид был третьим по назначаемости препаратом при АГ. По данным исследований, проведенных в Турции и Нигерии, диуретики являлись наиболее предпочтительными средствами [15,16]. Настоящее исследование выявило, что назначенные диуретики в основном относились к группам петлевых и калийсберегающих, и такие результаты позволили предположить, что врачи избегают применять диуретики в качестве препаратов выбора из-за их побочного действия в виде гипокалиемии.…”

Section: Discussionunclassified

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Antihypertensive Drug Utilization in Two Districts of Northern Cyprus

Tamirci

Demirdamar

2019

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. Since the irrational use of medicine increases the risk of morbidity and mortality in hypertension, this study was aimed to evaluate antihypertensive pharmacotherapy at two districts of Northern Cyprus (NC).Material and methods. A total of 148 prescriptions including antihypertensive drugs (n=181) were obtained by the aid of five pharmacists between November 2017 August 2018 and evaluated regarding the antihypertensive drug choices and good prescribing principles. The prescribed antihypertensive agents were classified according to the Anatomical Therapeutic Chemical Classification System (ATC) 2, 3 and 5 and the prescriptions were evaluated regarding the availability of format information.Results. The mean of antihypertensive agents per prescription was 1.2±0.6. According to the ATC-3 subclassification, beta-blockers (22.1%), angiotensin receptor blockers (ARBs) (22.1%), calcium channel blockers (20.4%), angiotensin converting enzyme inhibitor (ACE) inhibitors (17.7%), diuretics (13.8%) and anti-adrenergic drugs (3.9%) were prescribed. According to the ATC-5 subclassification, the most common prescribed antihypertensives were metoprolol (16.6%), amlodipine (16.0%), furosemide (8.8%), captopril (7.7%) and losartan (6.6%). There were no significant relation between the prescribed antihypertensive agents and gender and the physicians serving either in governmental or private hospitals. There were shortcomings in the prescriptions such as age, diagnosis and drug information which were crucial for the chosen of an appropriate antihypertensive agent.Conclusion. This first pharmacoepidemiological study about antihypertensive drug utilization in NC indicates the imperfections of physicians in terms of prescribing antihypertensive agents according to the guidelines and writing a “legible and good” prescription that contains full information. These findings underline necessity of educational interventions for physicians to disseminate rational use of medicine (RUM) in the NC.

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“…13 In Nigeria, adopting a general guide on cost-effective prescribing in the treatment of hypertension has not been possible, despite the efforts made by some researchers in the past. [14][15][16][17][18][19]3 This is partly due to the fact that prices of antihypertensive drugs are not uniform throughout the country, depending on the sources from which the drugs are procured, and partly because the perspectives of these pharmacoeconomics studies also differ from one another.…”

Section: Introductionmentioning

confidence: 99%

Prescribing patterns in systemic hypertension and pharmaco-economics (cost effectiveness and cost minimisation analyses) of the commonly prescribed antihypertensives in a district hospital in Enugu State, Southeast Nigeria

Umegbolu¹

2017

Int J Res Med Sci

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Background: Prescribing patterns in systemic hypertension vary from place to place. Studies have shown that cost could be one of the factors responsible for non-adherence to treatment among hypertensive patients. Nigerian pharmacoeconomics studies have not provided a general guide on cost-effective prescribing for hypertensive patients in the country. The aim of the study was to examine the prescribing patterns, do cost effectiveness and cost minimisation analyses of the commonly prescribed antihypertensives, and determine if cost is a major reason many of the hypertensive patients of the District Hospital are usually lost to follow up.Methods: 5267 adult (≥18 years) non-antenatal patients’ cards of 2016 were reviewed for hypertension. Examination of the prescriptions, cost-effectiveness and cost-minimisation analyses of the commonly prescribed antihypertensives were done.Results: 12.6% of the patients were hypertensive. 73% of these hypertensive patients were treated pharmacologically. 40.8% adhered to treatment. 73% of the adherent ones responded to treatment. Amlodipine was the most expensive prescribed antihypertensive (N22). Amiloride-hydrochlorothiazide with the largest cost effectiveness ratio (CER) (9) was the most cost effective of all the combinations. Lisinopril- hydrochlorothiazide (N17) was preferable to the triple combination of lisinopril-amlodipine-hydrochlorothiazide (N39), and amlodipine-hydrochlorothiazide (N32) in cost minimisation.Conclusions: Cost of drugs probably had played a significant role in non-adherence to treatment among hypertensive patients in the District Hospital in 2016, since moduretic with the largest CER (9) and nifedipine with the greatest BP reduction when combined with hydrochlorothiazide (56/22 mm Hg) were rarely prescribed.

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Antihypertensive use, prescription patterns, and cost of medications in a Teaching Hospital in Lagos, Nigeria

Cited by 34 publications

References 16 publications

Prescription Pattern of Cardiovascular and/or Antidiabetic Drugs in Abuja District Hospitals

Prescription Pattern of Cardiovascular and/or Antidiabetic Drugs in Abuja District Hospitals

Antihypertensive Drug Utilization in Two Districts of Northern Cyprus

Prescribing patterns in systemic hypertension and pharmaco-economics (cost effectiveness and cost minimisation analyses) of the commonly prescribed antihypertensives in a district hospital in Enugu State, Southeast Nigeria

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