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 isattributed to population growth, ageing and behavioural riskfactors, such as unhealthy diet, harmful use of alcohol, lackof physical activity, excess weight and exposure to persistentstress. The present study was conducted to study on variousfacets of antihypertensive drugs prescribing at present scenarioat Dr B.C. Roy Hospital, Haldia, and with objectives of studyingprescribing patterns and rationality of antihypertensive drugsin essential hypertension with or without specific co-morbidconditions and to check compliance of treatment as per JNC-8hypertension treatment guidelines in the outpatients attendingthe Department of Medicine.Material and Methods: Data regarding anti-HTN monotherapy and combination therapy was recorded. Evaluation forrational drug therapy by evaluating average number of drugsper prescription, fixed dose combination (FDC) prescriptionrate, prescription laying down importance of lifestylemanagement, prescription with defined anti-HTN goals,prescriptions with correct dose strength and dosage schedulewas evaluated.Results: Out of 100 hypertensive patients under evaluation 67was males (67%) with a MF ratio of 2.031. Mean SBP wasslightly higher in male patients. Hypertension was classifiedaccording to JNC-8 guidelines and found 22 (22%) (Prehypertension/pre-HTN), 57 (57%) (Stage 1 hypertension),and 13% (stage 2 hypertension) cases. Dyslipidemia wasnoted much more common associated disorders among newlydiagnosed hypertensive of either sex.Conclusion: Diuretics (8%) were most widely prescribeddrugs followed by ARBs (6%), ACE Inhibitors (5%) andcalcium channel blockers (4%) as monotherapy. Adherence ofJNC 8 guidelines among all study hypertensive participantswhile prescribing medications varied between 62% to 92%,with an average of 75%. None of the prescriptions mentionedban drug formulation(s). Still 15% of the prescriptionshad suggested combined drugs with debated rationalityformulations.