Drug prescription/blood pressure control in patients on monotherapy attending a tertiary hospital in Nigeria

Akunne, Onyinye O.; Adedapo, Aduragbenro Deborah

doi:10.5455/2319-2003.ijbcp20141202

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…The most prescribed drug class as monotherapy was diuretics to 42 patients followed by CCBs to 36 patients. This agrees with a previous study on patterns of monotherapy prescription [30]. More than a third of patients on monotherapy were prescribed renin-angiotensin blockers.…”

Section: Discussionsupporting

confidence: 92%

Antihypertensive prescription among black patients without compelling indications: prescription, effectiveness, quality and cost of medication

Akunne

Adedapo

2019

BMC Health Serv Res

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Background Hypertension remains one of the leading causes of death in Nigeria. Appropriate and cost-effective treatment of the disease is necessary to reduce mortality. This study evaluates (i) the prescription patterns and quality (ii) blood pressure control and (iii) cost of medication among patients with hypertension uncomplicated by co-morbid diseases or compelling indications. Method Patients with uncomplicated hypertension attending three clinics in the University College Hospital, Ibadan in Nigeria were recruited into this study. Information on demographics, antihypertensive medication prescribed, blood pressure measurements, and cost of medications were collected for each patient. Antihypertensive medications were classified according to the Anatomical Therapeutic Chemical (ATC) classification system and the Defined Daily Dose (DDD) system. The frequency of usage of each drug class and their prescribed doses per patient/day were calculated and compared with the DDD to assess the quality of prescription. Cost of antihypertensive medication was calculated for each patient and reported as cost per patient/day and cost per patient/month. Effect of variables on BP control was ascertained. Statistical analyses were done using SPSS, chi-square and correlation test was used to test for associations. Result A total number of 1050 hypertensive patients were included in this study. The mean age was 60 years, females made up 62% of the study population. A high level of polypharmacy (87%) and sub-optimal blood pressure control was observed. An increase in blood pressure was observed with increase in the number of medication prescribed (χ 2 = 33.618, p < 0.001; r = .18, p < 0.001). The most prescribed antihypertensive medication either as a single therapy or a fixed-dose combination was diuretic. About 54% of the prescribed daily doses of antihypertensive medication exceeded the DDD. The total monthly expenditure on antihypertensive drugs was approximately N3.2 million ($15,300). Conclusion Study findings show a high level of polypharmacy and non-generic prescribing. Increased prescribing of drugs that are cost-effective, as well as prescription of fixed dose combinations (FDCs), is recommended in hypertensive patients. This is necessary to control blood pressure while increasing treatment adherence.

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Section: Discussionsupporting

confidence: 92%

Antihypertensive prescription among black patients without compelling indications: prescription, effectiveness, quality and cost of medication

Akunne

Adedapo

2019

BMC Health Serv Res

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“…The proportion of subjects with good BP control in this study was similar to that found in previous studies that used similar criteria. 16 , 17 , 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Prescription pattern of antihypertensive medications and blood pressure control among hypertensive outpatients at the University of Benin Teaching Hospital in Benin City, Nigeria

Adejumo¹,

Okaka²,

Iyawe³

2017

Mal. Med. J

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BackgroundThe prevalence of hypertension and attendant cardiovascular disease burden is increasing globally. Auditing antihypertensive prescriptions and assessing patients with hypertension for blood pressure (BP) control are important steps on the path to reducing hypertensionrelated morbidity, mortality, and health expenditure. This study assessed the prescription pattern of antihypertensive medications and BP control among hypertensive outpatients at the University of Benin Teaching Hospital in Benin City, Nigeria. Methods This was a cross-sectional descriptive study that involved 224 hypertensive patients. Information obtained from participants included sociodemographic data, duration of hypertension, history of diabetes mellitus, and number and classes of antihypertensive medications used. Good BP control was defined as a mean BP less than 140/90mmHg. ResultsThe mean age of hypertensive subjects was 59.6 ± 12.2 years, with a male:female ratio of 1:1.9 and a median duration of hypertension of 5 years. Twenty-four participants (10.7%) had both hypertension and diabetes. The common classes of antihypertensive medications used were diuretics, calcium channel blockers (CCB), and angiotensin converting enzyme inhibitors (ACEIs). Forty participants (17.8%) were on monotherapy, while the rest were on multidrug therapy. The most commonly prescribed antihypertensive combination was diuretic + ACEI/angiotensin receptor blocker (ARB), followed by diuretic + CCB + ACEI/ARB. Good BP control was observed in 120 participants (53.6%). The proportion of patients with good BP control was largest among patients on monotherapy and those with tertiary education, though these observations were not statistically significant. ConclusionsThe pattern of prescribed antihypertensive medications complied with recommended guidelines. Blood pressure control amongst hypertensive patients was unsatisfactory. More efforts should be geared towards better BP control.

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“…While the majority of pharmacists correctly identified statins as the first line treatment for high cholesterol, less than half were able to identify the most common side effect of statin therapy [ 28 ]. A review of prescriptions in patients admitted at a tertiary hospital in southwestern Nigeria between January 2012 and August 2013 found that 59 patients (out of 1,280) received a total of 62 statin prescriptions–two patients were prescribed more than one statin–and only 29.0% of these statins were prescribed by their generic name [ 29 ]. In South Africa, although the overall percentage of facilities that had at least one of atorvastatin, simvastatin, or rosuvastatin in stock on the day of the survey was high (93.0%), qualitative research by the investigators revealed that there was widespread belief in the community that stockouts were common [ 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…In this study, barriers to the availability of simvastatin were identified, including county-level variation in medicine procurement and distribution; $1 per treatment per month still being above international median reference prices; many patients purchasing medicines at private sector outlets which were not included in the program; and, contradictions between treatment guidelines and the EML. In Nigeria, under-dosing (prescribed daily dose compared to the defined daily dose) was observed in 56.0% of the statin prescriptions [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

Barriers to accessibility of medicines for hyperlipidemia in low- and middle-income countries

Li,

Spencer,

Husain

et al. 2024

PLOS Glob Public Health

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Despite the high burden of hyperlipidemia and the effectiveness of treatment, evidence suggests that the accessibility of hyperlipidemia medicines can be low in many low- and middle-income countries (LMICs). The aim of this study was to identify common barriers to the accessibility of medicines for hyperlipidemia in LMICs. A multimethod analysis and multiple data sources were used to assess the accessibility and barriers of medicines for hyperlipidemia in selected LMICs. The overall median availability of statins for hyperlipidemia in public facilities was 0% and 5.4%, for originators and generics, respectively. In private facilities, median availability was 13.3% and 35.9%, for originators and generics, respectively. Statin availability was lowest in Africa and South-East Asia. Private facilities generally had higher availability than public facilities. Statins are less affordable in lower-income countries, costing around 6 days’ wages per month. Originator statins are less affordable than generics in countries of all income-levels. The median cost for statin medications per month ranges from a low of $1 in Kenya to a high of $62 in Mexico, with most countries having a median monthly cost between $3.6 and $17.0. The key informant interviews suggested that accessibility to hyperlipidemia medicines in LMICs faces barriers in multiple dimensions of health systems. The availability and affordability of statins are generally low in LMICs. Several steps could be implemented to improve the accessibility of hyperlipidemia medicines, including private sector engagement, physician education, investment in technology, and enhancement of health systems.

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Drug prescription/blood pressure control in patients on monotherapy attending a tertiary hospital in Nigeria

Cited by 3 publications

References 16 publications

Antihypertensive prescription among black patients without compelling indications: prescription, effectiveness, quality and cost of medication

Antihypertensive prescription among black patients without compelling indications: prescription, effectiveness, quality and cost of medication

Prescription pattern of antihypertensive medications and blood pressure control among hypertensive outpatients at the University of Benin Teaching Hospital in Benin City, Nigeria

Barriers to accessibility of medicines for hyperlipidemia in low- and middle-income countries

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