Drug utilization study of antihypertensive drugs and prevalence of blood pressure control in adult hypertensive patients based on JNC VIII guidelines in a tertiary care hospital: a cross sectional study

Abstract

Background: Hypertension is a major independent risk factor for coronary artery disease, congestive heart failure, stroke, chronic kidney disease and peripheral vascular diseases if left untreated. Drug utilization study of antihypertensive drugs and the study on prevalence of blood pressure control would help in reducing the burden of the disease and health expenditure.Methods: The study was conducted in the Outpatient Department of Medicine in Government Medical College, Thrissur. Patients aged 18yrs or above diagnosed with hypertension, on antihypertensive drugs were enrolled in the study. Patients suffering from secondary hypertension and acutely ill were excluded. Patients were enrolled after taking an informed consent. Demographic data, present treatment for hypertension, associated co- morbid conditions if any, and treatment of the same were recorded. BP was recorded, and cost of treatment was calculated using CIMS.Results: A total of 250 patients were included in the study. Mono therapy was used in 64.8% patients and combination therapy in 35.2%. Overall drug utilization pattern showed that CCBs (42.8%) were most commonly prescribed, followed by ACEIs (32.4%) and ARBs (29.2%). Most commonly prescribed combination therapy was ACE I + BB (29.3%), followed by ARB + CCB (21.3%). Mean cost of antihypertensive drug therapy was 3057.8 Rs / yr. Recommended target BP was achieved in 49.6% of patients.Conclusions: The prescription pattern of antihypertensive drug was in accordance to the JNC-VIII guidelines. The blood pressure target was achieved only in less than 50% of patients.

Drug utilization study in patients of hypertension in tertiary care hospital

“…Similar trend was observed in a study conducted in rural areas of Kerala by Ramadas et al that reported 4.19 as average number of drugs per prescription. 25 Maximum number of patients received multiple drug therapy (67.69%) which are comparable to findings in studies by Abegaz et al and Gupta et al that showed adequate management of HTN by utilising combination therapy. 20,26 It was observed that CCBs (19.23%) was the most commonly prescribed antihypertensive agent as monotherapy.…”

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“…This finding was also supported by a study by Raikar, Shrinivas R. et al 7 Average number of antihypertensive drugs per prescription in our study was 1.34 which were in favor of findings of other studies. According to Rimoy et al, 8 average number of antihypertensives was 1.6 whereas Ramada S. et al, 9 reported a similar number of average 1.4 antihypertensive drugs. The reason for a higher number of average drugs per prescription can be explained by the fact that most of the patients had associated comorbidity with hypertension.…”

Hubungan antara Rasionalitas Penggunaan Antihipertensi terhadap Keberhasilan Terapi Pasien Hipertensi di RSND Semarang

“…Selain itu tujuan utama dari terapi hipertensi ini adalah mencapai serta mempertahankan target tekanan darah (Muhadi, 2016). Penurunan tekanan darah dengan modifikasi gaya hidup serta penggunaan obat antihipertensi dapat efektif dalam pengurangan penyakit ini (Ramadas et al, 2019). Pemilihan obat antihipertensi, dimana banyaknya obat antihipertensi yang semuanya efektif dalam menurunkan tekanan darah merupakan suatu yang sangat kompleks.…”

“…Tidak adanya kesadaran dan kurangnya kepatuhan juga menjadi faktor penyebabnya. Kebiasaan sosial seperti alkoholisme dan merokok bersamaan dengan tidak adanya atau ketidakcukupan intervensi gaya hidup seperti olahraga rutin setiap hari, penurunan berat badan, dan pembatasan garam juga dapat menghambat pengendalian tekanan darah (Ramadas et al, 2019).…”