Prescription Pattern and Factors Associated With the Control of Blood Pressure Among Hypertensive Patients Receiving Care in a Nigerian Tertiary Hospital

Abstract

Objective: Despite the numerous Pharmacological and non-Pharmacological modalities available for the management of Hypertension, majority of the patients. The study aimed to identify the factors associated with the control of blood pressure among hypertensive patients receiving care in a Nigerian Tertiary Hospital. Design and method: The study was a retrospective cross sectional study carried out at the University of Nigeria Teaching Hospital Ituku/Ozalla, Enugu State Nigeria. A well Structured Pro-forma was used to extract variables from patient folders. These variables include Age, gender, marital status, religion, state of origin, educational level, occupation, age at first dose of antihypertensive, co-morbidities (diabetes, CKD), antihypertensive(s) used, duration of therapy, reasons for stopping (if stopped). Quantitative data was managed using Microsoft office excel and statistical product and services solution (SPSS) for windows. Continuous variables were expressed as mean ± SD and categorical variables as percentages with 95% confidence intervals. The students’t-test and the paired sample t-test were used to compare continuous variables while the pearson chi square test and fishers exact test will be used to compare categorical variables. All statistical test will be considered significant when the 2- sided p-value is <0.05. Results: Three hundred and Ninety patient Folders were used for the study. About 174 (42.4%) of the patients were male while 216 (52.7%) were female with a mean age of 62 years. Amlodipine with a frequency of 182 (64%) was the most prescribed antihypertensive in this study followed by losartan 182 (46.43%) and the least being atenolol and nebivolol with frequency of 4 (1.03%) each. 302 (94.4%) patients had hypertension and an existing comorbidity while 88(22.6%) had no comorbidities. The most common comorbidities were diabetes mellitus and chronic kidney disease. About 197 (50.3%) of the patients had their blood pressure under control while 193(49.7%) had uncontrolled blood pressure. Age, Monthly income, educational status and presence of comorbidity were the major predictors of uncontrolled blood pressure. Conclusions: Amlodipine was the most frequently prescribed antihypertensive. About half of the patient had their blood pressure uncontrolled. Age and monthly income were associated with uncontrolled blood pressure.

Knowledge and attitude towards hypertension among female community health volunteers of Bharatpur Metropolitan: a cross-sectional study in Nepal

“…18 In contrast to our study, only 30.2% Nigerian people had correctly responded the normal range of blood pressure. 19 Similarly, most of the participants knew that low intake of salt (86.5%) and losing weight (58.9%) were the effective preventive strategies against hypertension which is consistent with previous study conducted in Lebanon i.e. 95.5% and 81%, respectively.…”

“…18 A good proportion of the participants (>60%) were aware that hypertension can cause the complications like stroke, heart attack, cancer and kidney problems that is comparable to studies conducted in Nigeria (65.4%), Zimbabwe (91.4%), Africa (92%) and Saudi (75.6%). [19][20][21][22] Our study showed more than 90% of the participants were agreed that behavioral factors like diet modification, low intake of salt, avoiding smoking and alcohol, regular physical exercise, reducing stress and regular monitoring of blood pressure can help to reduce the risk of hypertension. All these results followed are compatible to the study conducted by Sulaiman et al among public, Rusmevichientong et al in Thailand and Kebede et al in East Africa.…”

“…This study found that the attitude mean score was significantly associated with an individual history of hypertension that is similar to the study conducted in Lebanon but contrary to the findings of Nigeria. 18,19 This could be as a result of constant counselling over the years as they visit a health care facility for the treatment. This study showed there was no association between family history of hypertension and attitude mean score.…”

Drug-Related Problems and Pharmacists’ Interventions in Hypertensive Outpatients: A Multicenter Prospective Study in 3 Vietnamese Hospitals

“…The third most common DRP was nonconformity indication (17.8%). The first explanation for this DRP was inappropriate drug choice compared with guidelines (14.6%) which was lower than the finding reported by Ukoha-Kalu et al 28 (18.9%), but higher than the finding presented by Zaman Huri et al 6 (8.8%). The second explanation was contraindication (1.8%) which was lower than the figure published by Zaman Huri et al 6 (7.5%), but higher than the figure published by Kefale et al 10 (0.8%).…”

Prevalence and factors associated with drug therapy problems among hypertensive patients at hypertension clinic of Mbarara Regional Referral Hospital, Uganda: a |cross-sectional study

“…This finding is higher than that reported in Indonesia, Malaysia and Nigeria; ranging from 5.2% to 7.7%. 35 , 37 , 38 Furthermore, the dosage too low in our study is also higher than 18.5% and 16.8% in two studies conducted in Ethiopia. 14 , 26 The discrepancy in findings could be due to variations in study population and medical practitioner’s expertise and experience.…”