Prescribing Patterns of Antihypertensive Drugs in Patients Attending Tertiary Care Hospitals in Pakistan

Ahmed, Aziza; Saqlain, Muhammad; Tanveer, Maria; Nawaz, Muhammad; Rehman, Kashif Ur; Safdar, Ali; Tayyeb, Muhammad; Ali, Zain; Shinwari, Maryam; Baig, Rizwan Ullah

doi:10.1007/s42399-020-00696-0

Cited by 13 publications

(9 citation statements)

References 24 publications

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“…These issues must be identified and resolved to achieve their therapeutic goals and achieve the best possible outcomes from their drug therapy. Given the high number of DRPs reported by studies in Pakistan [ 56 – 61 ], clinical pharmacists in Pakistan have an excellent opportunity to resolve these issues and improve patients’ health outcomes. We found cross-sectional [ 62 , 63 ] and qualitative studies [ 64 , 65 ] from community pharmacy settings, but we couldn’t find any follow-up studies from community pharmacy settings, so we recommend further development of pharmacist activities at community pharmacies as these provide an alternative for the public to obtain medicines and access to basic, minor health-related services.…”

Section: Discussionmentioning

confidence: 99%

The impact of clinical pharmacist services on patient health outcomes in Pakistan: a systematic review

Ahmed

Saqlain

Tanveer

et al. 2021

BMC Health Serv Res

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Background The pharmacist’s role shifts from dispensing to bedside care, resulting in better patient health outcomes. Pharmacists in developed countries ensure rational drug use, improve clinical outcomes, and promote health status by working as part of a multidisciplinary team of healthcare professionals. However, clinical pharmacist services on healthcare utilization in low-and middle-income countries (LMICs) like Pakistan are unclear. As a result, we aim to systematically review pharmacists’ clinical roles in improving Pakistani patients’ therapeutic, safety, humanistic, and economic outcomes. Methods We searched PubMed, Scopus, EMBASE, CINAHL, and Cochrane Library for relevant articles published from inception to 28th February 2021. All authors were involved in the screening and selection of studies. Original studies investigating the therapeutic, humanistic, safety, and economic impact of clinical pharmacists in Pakistani patients (hospitalised or outpatients) were selected. Two reviewers independently assessed the risk of bias in studies, and discrepancies were resolved through mutual consensus. All of the included studies were descriptively synthesised, and PRISMA reporting guidelines were followed. Results The literature search found 751 articles from which nine studies were included; seven were randomized controlled trials (RCTs), and two were observational studies. Three RCTs included were having a low risk of bias (ROB), two RCTs were having an unclear ROB, while two RCTs were having a high ROB. The nature of clinical pharmacist interventions included one or more components such as disease-related education, lifestyle changes, medication adherence counselling, medication therapy management, and discussions with physicians about prescription modification if necessary. Clinical pharmacist interventions reduce medication-related errors, improve therapeutic outcomes such as blood pressure, glycemic control, lipid control, CD4 T lymphocytes, and renal functions, and improve humanistic outcomes such as patient knowledge, adherence, and health-related quality of life. However, no study reported the economic outcomes of interventions. Conclusions The findings of the studies included in this systematic review suggest that clinical pharmacists play important roles in improving patients’ health outcomes in Pakistan; however, it should be noted that the majority of the studies have a high risk of bias, and more research with appropriate study designs is needed.

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Section: Discussionmentioning

confidence: 99%

The impact of clinical pharmacist services on patient health outcomes in Pakistan: a systematic review

Ahmed

Saqlain

Tanveer

et al. 2021

BMC Health Serv Res

Self Cite

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“…Many studies conducted in the past to explore the causes of suboptimal BP control focused on patient factors such as socio-demographic, medical profile, and patient’s treatment compliance [ 17 – 20 ]. However, prescribing patterns and clinicians’ adherence to guidelines are also important factors affecting hypertension treatment outcomes [ 21 – 24 ].…”

Section: Introductionmentioning

confidence: 99%

Clinicians’ prescribing pattern, rate of patients’ medication adherence and its determinants among adult hypertensive patients at Jimma University Medical Center: Prospective cohort study

2021

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Background Many studies conducted in the past focused on patients’ sociodemographic factors and medical profiles to identify the determinants of suboptimal blood pressure control. However, prescribing patterns and clinicians’ adherence to guidelines are also important factors affecting the rate of blood pressure control. Therefore, this study aimed to determine clinicians’ prescribing patterns, patients’ medication adherence, and its determinants among hypertensive patients at Jimma University Medical Center. Methods A general prospective cohort study was conducted among hypertensive patients who had regular follow-up at Jimma university ambulatory cardiac clinic from March 20, 2018, to June 20, 2018. Patients’ specific data was collected with a face-to-face interview and from their medical charts. Clinicians’ related data were collected through a self-administered questionnaire. Data were analyzed using SPSS version 21.0. Bivariate and multivariable logistic regression analyses were done to identify key independent variables influencing patients’ adherence. P-Values of less than 0.05 were considered statically significant. Results From the total of 416 patients, 237(57.0%) of them were males with a mean age of 56.50 ± 11.96 years. Angiotensin-converting enzyme inhibitors were the most frequently prescribed class of antihypertensives, accounting for 261(63.7%) prescriptions. Combination therapy was used by the majority of patients, with 275 (66.1%) patients receiving two or more antihypertensive drugs. Patients’ medication adherence was 46.6%, while clinicians’ guideline adherence was 44.2%. Patients with merchant occupation (P = 0.020), physical inactivity (P = 0.033), and diabetes mellitus co-morbidity (P = 0.008) were significantly associated with a higher rate of medication non-adherence. Conclusion The rate of medication adherence was poor among hypertensive patients. Physicians were not-adherent to standard treatment guideline. The most commonly prescribed class of drugs were angiotensin-converting enzyme inhibitors. Effective education should be given to patients to improve medication adherence. Prescribers should be trained on treatment guidelines regularly to keep them up-to-date with current trends of hypertension treatment and for better treatment outcomes.

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“…The prevalence of HTN is greater in low-middleincome countries (31.5%) than in higher-income countries (28.5%) [1]. The occurrence of HTN in Pakistan is increasing continuously; there are more than 33% of individuals over the age of 40 having HTN [2]. The disease burden is increasing constantly due to inappropriate drugs prescriptions, lack of education, and lack of patient compliance [2].…”

Section: Introductionmentioning

confidence: 99%

“…The occurrence of HTN in Pakistan is increasing continuously; there are more than 33% of individuals over the age of 40 having HTN [2]. The disease burden is increasing constantly due to inappropriate drugs prescriptions, lack of education, and lack of patient compliance [2]. Besides HTN, Diabetes Mellitus (DM) is also one of the major issues among developing countries.…”

Section: Introductionmentioning

confidence: 99%

Prescribing Pattern of Antihypertensive Drugs in Hypertensive Patients with Non-Insulin Dependent Diabetes Mellitus at Tertiary Care Hospitals in Karachi Pakistan

Shah

Baig

Ali

et al. 2021

JPRI

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Introduction: Hypertension (HTN) is one of the most serious public health issues in the world, affecting around 1.4 billion people worldwide. HTN is becoming highly prevalent in Pakistan, about more than 33% of people over the age of 40 years suffering from the HTN. The illness burden is continuously growing due to the incorrect medicine prescriptions, a lack of education, and a lack of patient compliance. The existence of comorbidities such as Diabetes Mellitus (DM) should be properly considered while choosing an Antihypertensive medication. Similarly, the prescriptions of Oral Hypoglycemic agent’s appropriate consideration are essential. Oral hypoglycemic medications are divided into several categories. Physicians face a challenge in rationally selecting a regimen from a variety of classes, and the situation becomes more complicated when the patients have additional non-communicable illnesses, such as HTN. The combination therapy of ailments not only effects the patient`s economic status but also effects the quality of life. Objective: To study the prescribing pattern of Antihypertensive drugs in Hypertensive patients with Type 2 Diabetes Mellitus at Tertiary care hospitals in Karachi, Pakistan. Methods: A cross sectional study was undertaken for six months in medicine outpatient department at tertiary care hospitals of Karachi. The study population was observed for the prescribed pattern of Antihypertensive medicines by assessing the 300 prescriptions of Hypertensive patients with Type 2 Diabetes Mellitus. Statistical analysis was performed using SPSS version 20. Data was presented as frequencies and percentages. Results: The result revealed that the most commonly prescribed single antihypertensive drug was Enalapril 66 (22%) followed by Amlodipine 63(21%), Ramipril 57(19%), Diltiazem 33(11%), Lisinopril 21(7%) losartan k 6(2%), Nebivolol 6(2%), Bisoprolol 3(1%). Dual therapy included Ramipril and Nebivolol 1(0.33%) and Amlodipine+Valsartan 35 (11.67%), Amlodipine+Valsartan+HCTZ 9 (3%) were the antihypertensive drugs prescribed as fixed dose combinations. Conclusion: The present study shows Enalapril belonging to Angiotensin Converting Enzyme Inhibitor (ACEI) class was frequently used as single Antihypertensive agent and Amlodipine+Valsartan belonging Calcium Channel Blockers (CCBs) and Angiotensin Receptor Blockers (ARBs) was the most frequently prescribed fixed dose combination while managing Hypertension of Hypertensive patients with Type 2 Diabetes Mellitus.

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Prescribing Patterns of Antihypertensive Drugs in Patients Attending Tertiary Care Hospitals in Pakistan

Cited by 13 publications

References 24 publications

The impact of clinical pharmacist services on patient health outcomes in Pakistan: a systematic review

The impact of clinical pharmacist services on patient health outcomes in Pakistan: a systematic review

Clinicians’ prescribing pattern, rate of patients’ medication adherence and its determinants among adult hypertensive patients at Jimma University Medical Center: Prospective cohort study

Prescribing Pattern of Antihypertensive Drugs in Hypertensive Patients with Non-Insulin Dependent Diabetes Mellitus at Tertiary Care Hospitals in Karachi Pakistan

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