Evaluation of Antihypertensive Drug Prescription Patterns, Rationality, and Adherence to Joint National Committee-8 Hypertension Treatment Guidelines among Patients Attending Medicine OPD in a Tertiary Care Hospital.

Abstract

Introduction: The increasing prevalence of hypertension is attributed to population growth, ageing and behavioural risk factors, such as unhealthy diet, harmful use of alcohol, lack of physical activity, excess weight and exposure to persistent stress. The present study was conducted to study on various facets of antihypertensive drugs prescribing at present scenario at Dr B.C. Roy Hospital, Haldia, and with objectives of studying prescribing patterns and rationality of antihypertensive drugs in essential hypertension with or without specific co-morbid conditions and to check compliance of treatment as per JNC-8 hypertension treatment guidelines in the outpatients attending the Department of Medicine. Material and Methods: Data regarding anti-HTN monotherapy and combination therapy was recorded. Evaluation for rational drug therapy by evaluating average number of drugs per prescription, fixed dose combination (FDC) prescription rate, prescription laying down importance of lifestyle management, prescription with defined anti-HTN goals, prescriptions with correct dose strength and dosage schedule was evaluated. Results: Out of 100 hypertensive patients under evaluation 67 was males (67%) with a M:F ratio of 2.03:1. Mean SBP was slightly higher in male patients. Hypertension was classified according to JNC-8 guidelines and found 22 (22%) (Prehypertension/pre-HTN), 57 (57%) (Stage 1 hypertension), and 13% (stage 2 hypertension) cases. Dyslipidemia was noted much more common associated disorders among newly diagnosed hypertensive of either sex. Conclusion: Diuretics (8%) were most widely prescribed drugs followed by ARBs (6%), ACE Inhibitors (5%) and calcium channel blockers (4%) as monotherapy. Adherence of JNC 8 guidelines among all study hypertensive participants while prescribing medications varied between 62% to 92%, with an average of 75%. None of the prescriptions mentioned ban drug formulation(s). Still 15% of the prescriptions had suggested combined drugs with debated rationality formulations.