Antihypertensive Drug Use Pattern in a Tertiary Care Hospital of Western Region of Nepal: A Cross-Sectional Study
Abstract
Introduction: Assessing antihypertensive drug use pattern always plays an important role to mitigate the burden of hypertension and also helps doctors to prescribe the drugs rationally. This study was conducted to assess antihypertensive drug use pattern in a tertiary care hospital. Methods: An observational cross-sectional study was conducted in the Internal Medicine department of Lumbini Medical College and Teaching Hospital from July 2021 to December 2021 for the duration of five months after ethics approval. Hypertensive patients who were prescribed one or more antihypertensive drugs irrespective of age and gender were included. Socio-demographic profiles, clinical characteristics, and antihypertensive drug use-related data were collected. A convenience sampling technique was used. Categorical variables were expressed as frequency and percentage while continuous variables were reported as mean ± standard deviation. Results: A total of 224 patients were included. The average number of antihypertensive drugs per patient was 1.7 ± 0.8. Combination drug therapy (54.5%) was commonly used. Calcium channel blockers (Amlodipine) were commonly prescribed (66.5%). Moreover, 98.7% and 41.5% patients were prescribed drugs from Essential Drug List of Nepal (Revised 2016) and in Fixed Dose Combination respectively. Use of combination drug therapy was higher among male patients (p = 0.003) and patients with stage II hypertension (p < 0.001). Conclusion: Calcium channel blockers were commonly used as monotherapy and in combination therapy as well. In approximately all of the patients, antihypertensive drugs were used from the essential drug list of Nepal which is an essential component of rational use of medicine.
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References
World Health Organization. A global brief on hypertension: Silent killer, global public health crisis: World Health Day 2013. WHO. Document number: WHO/DCO/WHD/2013.2, 2013. Available from:https://apps.who.int/iris/handle/10665/79059
World Health Organization. Hypertension [Internet]. Geneva: WHO; 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension [Cited 20 June 2021]
Department of Health Services. Annual Report 2075/76 (2018/19). Department of Health Services, Kathmandu, Nepal. Report number: DoHS-Annual-Report-FY-075-76-,pdf, 2020. Available from: https://dohs.gov.np/wp-content/uploads/2020/11/DoHS-Annual-Report-FY-075-76-.pdf
Adejumo O, Okaka E, Iyawe I. Prescription pattern of antihypertensive medications and blood pressure control among hypertensive outpatients at the University of Benin Teaching Hospital in Benin City, Nigeria. Malawi Med J. 2017;29(2):113-7. PMID: 28955417. DOI: https://doi.org/10.4314/mmj.v29i2.7
Busari OA, Oluyonbo R, Fasae AJ, Gabriel OE, Ayodele LM, Agboola SM et al. Prescribing Pattern and Utilization of Antihypertensive Drugs and Blood Pressure Control in Adult Patients with Systemic Hypertension in a Rural Tertiary Hospital in Nigeria. American Journal of Internal Medicine. 2014;2(6):144-9. Available from:http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=252&doi=10.11648/j.ajim.20140206.18
Mishra PS, Gawali UP, Rizvi SH, Kaur S. Drug utilization study in patients of hypertension in tertiary care hospital. International Journal of Basic & Clinical Pharmacology. 2020;9(8):1275-9. DOI:http://dx.doi.org/10.18203/2319-2003.ijbcp20203148
Lamsal KS, Neupane KR, Kafle RS. Prescription patterns of antihypertensive drugs at tertiary care hospital: A descriptive cross sectional study. Journal of Nobel Medical College. 2020;9(16):22-6. DOI:https://doi.org/10.3126/jonmc.v9i1.29462
Degu G, Tessema F. Biostatistics. University of Gondar, Ethiopia Public Health Training Initiative, The Carter Center. 2005. Available from: https://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_notes/env_health_science_students/ln_biostat_hss_final.pdf
American College of Cardiology. New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension [Internet]. Washington: ACC; 2017 [Cited 2021 May 1]Available from: https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017
WHO Collaborating Centre for Drug Statistics Methodology. Guideline for ATC Classification and DDD assignment 2021. Oslo, Norway. Report number: ISBN 978-82-8406-165-8; 2021. Available from: https://www.whocc.no/filearchive/publications/2022_guidelines_web.pdf
Department of Drug Administration, Ministry of Health, Nepal. National List of essential medicines Nepal (Fifth Revision) 2016. Department of Drug Administration, Kathmandu Nepal, 2016 Available from: https://www.who.int/selection_medicines/country_lists/npl_eml_.pdf
Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. 2012;4(5):135-47. PMID: 22655162 DOI: https://doi.org/10.4330/wjc.v4.i5.135
Vashista K. Study on drug utilization pattern of antihypertensive medication in tertiary care hospital of Telangana, India. International Journal of Basic and Clinical Pharmacology. 2018;7(9):1770-4. DOI: https://dx.doi.org/10.18203/2319-2003.ijbcp20183487
Datta S. Utilization Study of Antihypertensives in a South Indian Tertiary Care Teaching Hospital and Adherence to Standard treatment Guidelines. J Basic Clin Pharm. 2016;8(1):33-7. PMID: 28104972. DOI: https://doi.org/10.4103/0976-0105.195100
Neupane GP. Prescription pattern and drug utilization of antihypertensive agents at Nepalgunj Medical College hospital Kohalpur, Nepal. Journal of Clinical and Experimental Pharmacology. 2016;6(4):86. DOI:http://dx.doi.org/10.4172/2161-1459.C1.014
Pr R, Hv A, Shivamurthy Mc. Antihypertensive prescribing patterns and cost analysis for primary hypertension: a retrospective study. J ClinDiagn Res. 2014;8(9):HC19-22. PMID: 25386458 DOI: https://doi.org/10.7860/jcdr/2014/9567.4890
Liu PH, Wang JD. Antihypertensive medication prescription patterns and time trends for newly-diagnosed uncomplicated hypertension patients in Taiwan. BMC Health Serv Res. 2008;8(0):133. PMID: 18559115 DOI: https://doi.org/10.1186/1472-6963-8-133
Alkaabi MS, Rabbani SA, Rao PGM, Ali SR. Prescription Pattern of Antihypertensive Drugs: An Experience from a Secondary Care Hospital in the United Arab Emirates. J Res Pharm Pract. 2019;8(2):92-100. PMID: 31367644 DOI: https://doi.org/10.4103/jrpp.jrpp_18_85
Bakare OQ, Akinyinko MR, Goodman O, Kuyinu YA, Wright OK, Adeniran A, et al. Antihypertensive use, prescription patterns, and cost of medications in a Teaching Hospital in Lagos, Nigeria. Niger J ClinPract. 2016;19(5):668-72. PMID: 27538558. DOI: https://doi.org/10.4103/1119-3077.188709
Paradkar SG, Sinha SR. Drug utilization among hypertensive patients in the outpatient department of medicine in a tertiary care hospital: A cross-sectional study. ClinExpHypertens. 2018;40(2):150-4. PMID: 28816547 DOI: https://doi.org/10.1080/10641963.2017.1346112
Demeke B, Molla F, Assen A, Melkam W, Abrha S, Masresha B, et al. Evaluation of drugs utilization pattern using WHO prescribing indicators in Ayder Referral Hospital, Northern Ethiopia. International Journal of Pharma Sciences and Research. 2015; 6(2):343-347. Available from: http://www.ijpsr.info/docs/IJPSR15-06-02-038.pdf
Karki N, Joshi R, Shrestha B, Prasad P. Drug utilization pattern by using WHO core prescribing indicators in orthopaedics and obstetrics / gynecology departments of a tertiary care hospital. Journal of Lumbini Medical College. 2019;7(1):18-23. DOI:https://doi.org/10.22502/jlmc.v7i1.280
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