DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20174775

A descriptive study on drug prescribing pattern in hypertensive patients in a tertiary care teaching hospital

Syed Sajad Hussain, Samina Farhat, Parvaiz Ahmad Zargar, Zorawar Singh Bali

Abstract


Background: Hypertension is highly prevalent and the goal of antihypertensive therapy is to abolish the risks associated with blood pressure (BP) elevation without adversely affecting quality of life. Drug selection is based on efficacy in lowering BP and in reducing cardiovascular (CV) end points including stroke, myocardial infarction, and heart failure. Not many studies are conducted in this part of world regarding drug utilization of antihypertensive drugs and hence this study was planned.

Methods: A descriptive cross-sectional study was conducted for a period 6 month in outpatient department of a tertiary care centre of Government Medical College, Srinagar, Jammu and Kashmir. The prescriptions containing antihypertensive drugs were collected from the patients attending the outpatient department.

Results: During the study period a total of 230 prescriptions were collected, out of which 196 were included for the final analysis. Mean age was found to be 62.42±7.77 years. In majority of cases (44.89%), a combination of two drugs was prescribed and among the two-drug combination, Angiotensin Receptor Blockers (ARBs) and Calcium Channel Blockers (CCBs) were used most commonly (40.90%). Angiotension receptor blockers were used as single drug in most number of patients (41.66%). Proton pump inhibitors were the most common (35.71%) co-prescribed drug, followed by Anti platelet drugs (27.55%), Anti diabetics (16.32%) and Statins (16.32).

Conclusions: Present study represents the current prescribing trend for antihypertensive agents. It implies that ARBs are the leading group of antihypertensive agents both when used singly and in combination. Further studies focused on the rationale for choice of drugs based on demographic data, economic status, associated comorbid conditions and complications would give additional insights into prescribing patterns in hypertension in India.


Keywords


Anti-hypertensive drugs, Drug utilization, Prescribing pattern

Full Text:

PDF

References


Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J, et al. Global burden of hypertension: Analysis of worldwide data. Lancet 2005;365 (9455):217-23.

Blood Pressure Lowering Treatment Trials Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure lowering drugs: results of prospectively designed overviews of randomized trials. Lancet. 2000;355:1955-64.

Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet. 2001;358:1305-15.

Gupta N, Sharma D, Garg SK, Bhargava VK. Auditing of prescriptions to study utilization of antimicrobials in tertiary hospital. Indian J Pharmacol. 1997;29:411-5.

Kapoor B, Raina RK, Kapoor S. Drug prescribing pattern in a teaching hospital. Ind J Pharmacol. 1985;17:168.

Pradhan SC, Shewade DG, Shashindran CH, Bapna JS. Drug utilization studies. National Med J India. 1988;1:185.

Yuen YH, Chang S, Chong CK, Lee SC, Critchley JA, Chan JC. Drug utilization in hospital general medical outpatient Clinic with particular reference to antihypertensive and antidiabetic drugs. J Clin Pharm Ther. 1998;23:287-94.

Sutharson L, Hariharan RS, Vamsadhara C. Drug utilization study in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003;35:237-38.

Bakssas I, Lunde PKM. National drug policies: the need for drug utilization studies. Trends Pharmacol Sci. 1986;7:331

Tiwari H, Kumar A, Kulkarni SK. Prescription monitoring of anti-hypertensive drug utilization at the Panjab University Health Centre in India. Singapore Med. J. 2004;45:117-20.

Pittrow D, Kirch W, Bramlage P, Lehnert H, Höfler M. Patterns of antihypertensive drug utilization in primary care. Eur J Clin Pharmacol. 2004;60:135-42.

Lee PK, Li RKL, Chan JCN, Chang S, Lee SC. A prescription survey in a hospital hypertension outpatient clinic. Br. J Clin Pharmacol. 1997;44:577-82.

Haribabu R, Reddy M, Vidyadhar S. Drug utilization of antihypertensive agents in an urban primary health care center in south India. Int J of Inno Pharma Res. 2012;3:244-6.

Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network metanalysis. Lancet. 2007;369:201-7.

European Society of Hypertension-European Society of Cardiology Guidelines Committee. J Hypertens. 2003;21(6):1011-53.

Pai PG, Shenoy J, Sanji N. Prescribing Patterns of antihypertensives drugs in a south Indian tertiary care hospital. Drug Invention Today. 2011;3:38-40.

Philipp T, Smith TR, Glazer R. Two multicenter, 8-week, randomized, double-blind, placebo-controlled, parallel-group studies evaluating the efficacy and tolerability of amlodipine and valsartan in combination and as monotherapy in adult patients with mild to moderate essential hypertension. Clin Ther. 2007; 9:563-80.

Chrysant SG, Melino M, Karki S. The combination of olmesartan medoxomil and amlodipine besylate in controlling high blood pressure: COACH, a randomized, double-blind, controlled, 8-week factorial efficacy and safety study. Clin Ther. 2008;30:587-604.

Gradman AH, Cutler NR, Davis PJ. Combined enalapril and felodipine extended release (ER) for systemic hypertension. Am J Cardiol. 1997;79:431-5.

Gradman AH, Kad R. Renin inhibition in hypertension. J Am Coll Cardiol. 2008;51:519-28.