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A Study of Prescribing Pattern in Patients of Hypertension


Affiliations
1 Department of Pharmacology, GMC Patiala, 147001, Punjab, India
2 Department of Medicine, GMC Patiala, 147001, Punjab, India
 

Introduction: Hypertension is a multi-factorial and complex disease that has both environmental and genetic determinants. It is the single most significant risk factor for heart diseases and kidney diseases. Hypertension is a leading contributor to global burden of morbidity and mortality. It is considered as a silent killer because most of the time it is asymptomatic and goes undetected. Hence, hypertensive patients should be prescribed properly. Objectives: To evaluate the prescribing pattern of anti-hypertensive drugs in patients of hypertension. Material and Methods: This was an observational, cross sectional study conducted over a period of 1 year on hypertensive patients attending the Cardiology out-patient department of Government Medical College and Rajindra Hospital, Patiala and fulfilling the inclusion and exclusion criteria. The prescriptions were evaluated. Results: 22% of prescriptions had monotherapy, amongst which beta-blockers were most commonly prescribed. Majority of prescriptions had two drug therapy (47%), among which ARB+ beta blockers (17%) were most frequently prescribed. Beta blockers +CCB (9%) was the most common Fixed Drug Combination (FDC) prescribed. ARB+beta blockers+diuretics (14%) and ACEI+ARB+beta blockers+diuretics (1%) were most commonly prescribed three drug combinations. Among four drug combinations, only ACEI+ARB+beta blockers+diuretics was prescribed to 1% patients. Hypolipidemic drugs (66%) were maximally co-prescribed. Conclusions: A high trend of polypharmacy was observed in hypertensive patients. So, emphasis is needed to reevaluate the prescribing trends in these patients.

Keywords

Anti-Hypertensive Drugs, Fixed Drug Combination, Hypertension, Prescription Pattern, Drug Utilization.
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  • Artham SM, Lavie CJ, Milani RV, Ventura HO. Obesity and Hypertension, Heart Failure, and Coronary Heart DiseaseRisk Factor, Paradox, and Recommendations for Weight Loss. The Ochsner Journal. 2009; 9:124–32. PMid:21603427 PMCid:PMC3096264

  • Benjamin EJ, Virani SS, Callaway CW, Cheng AR, Cheng S, Chiuve SE, et al., on behalf of the American Heart Association council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics -2018 update: A report from the American Heart Association [ published online ahead of print January 31, 2018]. Circulation DOI: 10.1161/ CIR. 0000000000000558

  • Hypertension: The silent killer. Indian Council of Medical Research. Department of Health Research- Ministry of Health and Family Welfare. Available from: https://www.icmr.nic.in/sites/default/files/press_realease_files/Hypertension.pdf

  • Gupta R, Mohan I, Narula J. Trends in coronary heart disease epidemiology in India. Ann Glob Health. 2016; 82:307–15. https://doi.org/10.1016/j.aogh.2016.04.002 PMid:27372534

  • A global brief on Hypertension. Silent Killer, global public health crisis. World Health Day 2013. Geneva, Switzerland. Available from: http://ish-world.com/downloads/pdf/ global brief hypertension.pdf

  • Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure; the JNC report. JAMA. 2003; 289(19):2560–72. https://doi.org/10.1001/jama.289.19.2560 PMid:12748199

  • Gupta R, Yusuf S. Towards better hypertension management in India. Indian J Med Res. 2014;139(5):657– 60. PMid:25027073 PMCid:PMC4140027

  • Sharma AK, Dahiya N, Kairi JK, Bharati SM. Prescription patterns of antihypertensive drugs in a tertiary care hospital in India. Int J Basic Clin Pharmacol. 2015; 4(1):55–9. https://doi.org/10.5455/2319-2003.ijbcp20150208

  • Roobiya A, Ranjith J. Prescription pattern and patient counselling of hypertention patients in a tertiary care hospital. International Journal of Innovative Research and Advanced Studies. 2018 Jan; 5(1):242–55.

  • Jhawat V, Gupta S, Agarwal BK, Saini V. Comparison of the prescription pattern of antihypertensive drug therapy over time and its association with severity of essential hypertension. Int J Pharma Res Health Sci. 2017; 5(6):1994–8.

  • Khurshid F, Aqil M, Alam MS, Kapur P, Pillai KK. Antihypertensive Medication Prescribing Patterns in a University Teaching Hospital in South Delhi. Int J Pharm Sci Res. 2012; 3(7):2057–63.

  • Sutters M. Systemic hypertension. In: Papadakis MA, McPhee SJ, Rabow MW, editors. Current Medical Diagnosis and Treatment. 52nded. New York: McGraw Hill; 2013. p. 433–63.

  • Cidda M, Mateti UV, Batchu MK, Martha S. Study of prescribing patterns of antihypertensives in South Indian population. Int J Basic Clin Pharmacol. 2014; 3(2):303–7. https://doi.org/10.5455/2319-2003.ijbcp20140409

  • Panja M, Mondal S, Bhattacharya P, Mondal D. Beta Blocker in Combination with Other Antihypertensives. Supplement of JAPI. 2009; 57:35–7.

  • Murti K, Khan MA, Dey A, Sethi MK, Das P, Pandey K. Prescription pattern of anti-hypertensive drugs in adherence to JNC- 7 guidelines. American Journal of Pharmacology and Toxicology. 2015; 10(1):27–31. https:// doi.org/10.3844/ajptsp.2015.27.31

  • Cidda M, Mateti UV, Batchu MK, Martha S. Study of prescribing patterns of antihypertensives in South Indian population. Int J Basic Clin Pharmacol. 2014; 3(2):303–7. https://doi.org/10.5455/2319-2003.ijbcp20140409

  • Tandon VR, Sharma S, Mahajan S, Mahajan A, Khajuria V, Mahajan V, et al. Antihypertensive drug prescription patterns, rationality, and adherence to Joint National Committee-7 hypertension treatment guidelines among Indian postmenopausal women. J Mid-life Health. 2014; 5:78–83. https://doi.org/10.4103/0976-7800.133994 PMid:24970986 PMCid:PMC4071649

  • Beg MA, Dutta S, Varma A, Kant R, Bawa S, Anjoom M, et al. A study on drug prescribing pattern in hypertensive patients in a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Med Sci Public Health. 2014; 3(8):922–6. https://doi.org/10.5455/ijmsph.2014.170420146


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  • A Study of Prescribing Pattern in Patients of Hypertension

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Authors

Faiziul Haq
Department of Pharmacology, GMC Patiala, 147001, Punjab, India
Harinder Singh
Department of Pharmacology, GMC Patiala, 147001, Punjab, India
Vijay K. Sehgal
Department of Pharmacology, GMC Patiala, 147001, Punjab, India
Sanjeev Kumar
Department of Medicine, GMC Patiala, 147001, Punjab, India
Anjleen Kaur
Department of Pharmacology, GMC Patiala, 147001, Punjab, India

Abstract


Introduction: Hypertension is a multi-factorial and complex disease that has both environmental and genetic determinants. It is the single most significant risk factor for heart diseases and kidney diseases. Hypertension is a leading contributor to global burden of morbidity and mortality. It is considered as a silent killer because most of the time it is asymptomatic and goes undetected. Hence, hypertensive patients should be prescribed properly. Objectives: To evaluate the prescribing pattern of anti-hypertensive drugs in patients of hypertension. Material and Methods: This was an observational, cross sectional study conducted over a period of 1 year on hypertensive patients attending the Cardiology out-patient department of Government Medical College and Rajindra Hospital, Patiala and fulfilling the inclusion and exclusion criteria. The prescriptions were evaluated. Results: 22% of prescriptions had monotherapy, amongst which beta-blockers were most commonly prescribed. Majority of prescriptions had two drug therapy (47%), among which ARB+ beta blockers (17%) were most frequently prescribed. Beta blockers +CCB (9%) was the most common Fixed Drug Combination (FDC) prescribed. ARB+beta blockers+diuretics (14%) and ACEI+ARB+beta blockers+diuretics (1%) were most commonly prescribed three drug combinations. Among four drug combinations, only ACEI+ARB+beta blockers+diuretics was prescribed to 1% patients. Hypolipidemic drugs (66%) were maximally co-prescribed. Conclusions: A high trend of polypharmacy was observed in hypertensive patients. So, emphasis is needed to reevaluate the prescribing trends in these patients.

Keywords


Anti-Hypertensive Drugs, Fixed Drug Combination, Hypertension, Prescription Pattern, Drug Utilization.

References





DOI: https://doi.org/10.18311/ijmdsjssmes%2F2019%2F184482