Survey of prescription pattern of antihypertensive drugs in hypertensive and diabetic hypertensive patients (original) (raw)
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Prescription Pattern of Antihypertensive Drugs for HypertensivePatients with Type-2 Diabetes
Background: It is said that, people with both diabetes and hypertension have approximately twice the risk of cardiovascular disease as non-diabetic people with hypertension. Hypertensive diabetic patients are also at increased risk for diabetes-specific complications including retinopathy and nephropathy.Prescription pattern is one of the indicators of the current situation of a specific patient community or group. Aim of the study: The aim of this study was to assess theprescription pattern of antihypertensive drugs for hypertensive patients with type-2 diabetes. Methods: This was an observational cross sectional study and it was conducted in Dhaka Medical College Hospital and BIRDEM Hospital during the period from July2016 to June 2017. In total 140 diagnosed hypertensive patients with type 2diabetes mellitus attending to the Endocrine Departments of Dhaka Medical College Hospital and BIRDEM Hospital completed the full tenure of the study were finalized as the study population.After data analysis, results were find out according to the objectives, study result were presented in the form of tables, charts and description of the key findings according to need. The collected data were also be entered and analyzed using statistical software SPSS version 16. Result: In this study commonly used antihypertensive drugs were ARBs, CCBs, diuretics, Beta-Blockers and ACEIs and that were used in 31%, 24%, 19%, 18% and 8% patients respectively. In total 66 (47.1%) patients taken single drug and 74 (52.9%) patients taken combination drugs. In total 73%, 23% and 4% patients taken double, triple and quadruple combination of antihypertensive drugs respectively. As monotherapy, ARBs, CCBs, ACEIs, Beta Blockers, and diuretics were used in 35%, 23%, 20%, 16% and 6% patients respectively. In DMCH, ARB + Diuretics (8) and ARB +CCB (8) were most commonly used combinations. In 11.40% cases injectable drugs were used whereas in 88.80% cases no injectable drug had been used. In this study in most of the cases (71%) drugs from Essential Drug List of Bangladesh had been used. Conclusion: There was higher use of ARB and less use of diuretics in our study. Still there is room for better control of hypertension and optimization of antihypertensive therapy. In spite of these data and published guidelines, inconsistencies exist towards treatment approach, because of which physicians sometimes have to individualize the therapy, based on specific patient characteristics and response to treatment.
Study on Prescribing Pattern of Antihypertensive Drugs in a Tertiary Care Hospital
Advances in Pharmacology and Pharmacy, 2017
Objective: To analyze prescription pattern of antihypertensive drugs in patients with hypertension alone and with coexisting diseases. Methodology: A descriptive cross-sectional study was conducted in outpatient department of tertiary care hospital in south India. A total of 286 prescriptions of patients diagnosed to have hypertension with or without coexisting diseases were collected. Details of prescriptions were entered in the preformed pro forma and analyzed. Result: The study included 138 (48.25%) male and 148 (51.75%) female. Out of 286 hypertensives, 122 (42.66%) patients were having co-existing type 2 diabetes mellitus (T2DM). And remaining 164 patients (57.34%) were only hypertensives. Out of 286 patients, 227 (79.31%) patients were on monotherapy, 49 (17.13%) were on dual therapy and remaining 10 patients were on triple anti-hypertensive drugs. Among 150 antihypertensive drugs that are prescribed for hypertensive patients withT2DM, 57 (38%) were calcium channel blocker (CCB), 40 (26.66%) were angiotensin converting enzyme inhibitors (ACEI), 31 (20.66%) were angiotensin receptor blockers (ARB), 13 (8.66%) were diuretics and remaining 9 (6%) were beta blockers. Similarly, among 206 antihypertensive drugs prescribed for hypertension alone patients, 97 (47%) were CCB, 37 (17.96%) were ACEI, 31 (15%) were ARB, 26 (12.62%) were diuretics and remaining 15 (7.28%) were beta blockers. Conclusion: The study has shown that majority of patients were on monotherapy (79.31%) and calcium channel blockers were commonly prescribed for hypertension in patients with or without type 2 diabetes mellitus followed by ACE inhibitors, ARB and beta blockers.
ANTI HYPERTENSIVE MEDICATION PRESCRIBING PATTERNS IN A UNIVERSITY TEACHING HOSPITAL IN SOUTH DELHI
To investigate the use of antihypertensive drugs in hypertensive patients and to identify whether such pattern of prescription is appropriate in accordance with international guidelines for management of hypertension. Methods: This was a prospective analysis. A prescription based survey among patients with established hypertension was conducted at the Medicine Out-Patient Department of University Teaching Hospital in South Delhi, India. Data were collected from patients' medical records as well as patients' interviews. Results: A total of 192 hypertensive patients fulfilled the criteria for inclusion in the study analysis. Combination therapy was used more commonly than monotherapy (54.6% vs 45.4). Among the monotherapy category, the various classes of drugs used were as follows: beta-blockers (28.8%), diuretics (24.1%), calcium channel blockers (21.8%), ACE inhibitors (18.4%), angiotensin II receptor blockers (5.7%) and α 1-blocker (1.1%). With respect to overall utilization pattern, diuretics (42.2%) were the most frequently prescribed class, beta-blockers (41.2%) ranked second followed by calcium channel blockers (39.1%), ACE inhibitors (26.0%), angiotensin II receptor blockers (23.4%) and α 1-blocker (9.4%). As for individual medicines, amlodipine (35.4%) was the most commonly prescribed antihypertensive drug followed by atenolol (17.8%), ramipril (17.2 %) and furosemide (13.0 %). Among the combination therapies, 2-drug treatment was preferred for 75% of the hypertensive patients with CCB and β-blocker being the most frequent drug combination (22.4%). Conclusion: The general pattern of antihypertensive utilization seems to be in accordance with the international guidelines for management of hypertension.
A study on drug utilization pattern of antihypertensive drugs in hypertensive diabetic patients
International Journal of Basic & Clinical Pharmacology
Background: Hypertension management is of paramount importance in diabetic patients for reduction of cardiovascular and other complications. The objective of the present study was to assess prescribing pattern of antihypertensive drugs in hypertensive type 2 diabetic patients and evaluate them by comparing with Eighth Joint National Committee (JNC-8) hypertension treatment guidelines.Methods: A prospective observational study was carried out on 110 hypertensive type 2 diabetic patients of age 41-80 years visiting outpatient department of Medicine at G.S. Medical College and Hospital, UP, India for 4 months. JNC-8 hypertension management guideline was considered while evaluating the prescribed drugs. All the relevant data was collected from the prescription card of the patient on a preformed performa and analyzed using descriptive statistics.Results: Total of 176 drugs was prescribed to the study patients among which two drug combination therapy (55.45%) was mostly used. The most com...
CHOICE OF ANTIHYPERTENSIVE AND ITS EFFECTS ON DIABETIC-HYPERTENSIVE POPULATION
The microvascular and macrovascular events are quite common in the diabetic hypertensive patients. Tight blood pressure control and appropriate anti-hypertensive medication does prevent or delay such complications. Data was collected prospectively for a period of six months, from October 2014 to March 2015. Patients with a blood pressure above ≥140/90 mmHg were eligible for the study. Statistical analysis was performed according with the use of SPSS software. A survival curve was estimated according to the Kaplan–Meier procedure, and different variables were analyzed by multivariate cox-regression analysis to find the association with the occurrence of an event and the treatment given. 199 patients were enrolled in the study. The mean age of the study population were found to be 62.95±12.33 years. Gender wise distribution showed that the majority of them were males, 59.8 %. The mean duration of diagnosis of Diabetes was 5.66 ±4.5 years and for hypertension were 3.81±3.33 years. There were 104 patients (52%) with Stage I hypertension and 95 patients (48 %) with Stage II hypertension. Telmisartan (28.1%) was the most frequently prescribed medication, followed by Amlodipine (17.1%). ARB's (34.8%) was the frequently prescribed class of drug. Occurrences of microvascular and macrovascular events were reported in 82 (41.2 %) patients. In Kaplan Meier analysis age, duration of diagnosis of hypertension and diabetes as well as treatment given before admission to the hospital showed significance to the end points. On multivariate analysis, patients treated with Angiotensin receptor blockers on monotherapy showed
International Journal of Pharmacy and Pharmaceutical Sciences, 2016
Objective: To study the prescribing patterns of antihypertensive (AHT) drugs in hypertensive (HTN) patients and hypertension with diabetes mellitus (HTN with DM) patients in tertiary care hospital, to assess the rationality of prescribing patterns, to compare the hypertension management with Joint National Committee-7 guidelines (JNC-7). Methods: A prospective study was conducted over a period of 6 mo in the medicine department of Bharati Hospital and Research Centre, Pune. HTN and (HTN with DM patients. Who met the study criteria were enrolled in the study. The pattern of antihypertensive medications prescribed was studied and analyzed using Microsoft excel 2010 and Statistical. The rational prescribing pattern was assessed by using JNC 7 guidelines and World Health Organization (WHO) indicators. Results: Total of 60 patients included in this study, 43 (71.7 %) were HTN patients, and 17 (28.3 %) were HTN with DM patients. There were 29 (48.33 %) males and 31 (51.66 %) female patients were involved. 45 % of patients had pre-hypertension, 33.33 % had stage-1 hypertension, 8.4 % had stage-2 hypertension other 13.33 % patients are on Antihypertensive medications and whose Blood Pressure (BP) were normal according to JNC-7. In hypertensive 47.05 % patient had prescribed Calcium Channel Blockers (CCBs) as monotherapy along with 87.5 % Angiotensin Receptor Blockers (ARBs) with diuretics as combination therapy. In HTN with DM 46.15 % patients had prescribed Angiotensin Converting Enzymes (ACEs) as monotherapy along with 62.5 % CCBs with BBs were prescribed according to JNC-7. As per WHO indicators, average no. of medicines prescribed per prescription was 2.91 and all antihypertensive medicines in the study population were prescribed rationally. Conclusion: The present study represents the current prescribing trend for antihypertensive agents. It implies that. In hypertensive patients ARBs are the leading group of antihypertensive agents as monotherapy and ARBs with diuretics as a combination therapy according to JNC 7.
International Journal of Pharmacy and Pharmaceutical Sciences, 2016
The aim of the study is to assess the various prescribing patterns in hypertension with different compelling indications. Methods: It is a prospective observational study and carried out for a period of 1 y from Feb-2014 to Feb-2015. All the required data was collected from patients through personal interview and prescriptions. The data collected from the participants was entered into Microsoft excel spreadsheet and descriptive statistics were used. The mean and standard deviation (SD) were calculated. Results: A total of 394 hypertensive patients with different comorbidities were included in which 251(63.70%) males and 143(36.29%) females were present with a mean (SD) age of 59.21±1.54. The most commonly reported first three co-morbidities along with hypertension were diabetes mellitus 191 (48.47%), stroke accounts for 57 (14.46%) and coronary artery disease in 32 (8.12%). Monotherapy was given in almost 200 (50.76%) patients and dual drug therapy was indicated in 166 (42.13%) patients, triple therapy was used only in 24 (6.09%) patients in the total sample size. Quadruple therapy is the least preferred combination therapy accounts only in 4 (1.01%) patients. Conclusion: We conclude that calcium channel blockers and angiotensin II receptor blockers were the most commonly prescribed class of drugs either alone or in combination with other class of drugs for effective control of blood pressure patients with different compelling indications. Monotherapy was preferred than combination therapy.
Evaluation of Prescribing Pattern Of Antihypertensives Against The Clinical Condition
IOSR Journal of Pharmacy and Biological Sciences, 2014
Background :The prescribing pattern of antihypertensives by different physicians is not in compliance with that of the standard guidelines given by WHO/JNC-7.The patient factors associated with hypertension like age,sex,the presence or absence of co-morbid diseases along with hypertension will also play a major role in prescribing a particular class of antihypertensive drug. If the standard guidelines and the patient factors are not taken into consideration while prescribing the drugs then the final BP control remains unsatisfactory. Objective:The purpose of this study was to evaluate the prescribing pattern,to determine the factors associated with the treatment of the disease. Methods: It is an observational,prospective,non-interventional study in which prescriptions were collected during July-2013 to January-2014 (for a duration of 7 months) in a tertiary care hospital to comprise a study population of 400 hypertensive patients. Results: As monotherapy ACE-Inhibitors (38.25%) were the most commonly prescribed antihypertensives followed by calcium channel blockers(19.25%), Diuretics (13.25%) ranked third in the prescribing pattern.combination treatment usually consisted of 2 antihypertensive drugs as a coformulation.the most common combination was a ACE-Inh+CCB(5%), followed by Beta-blocker+CCB(3.5%).patients gender,age and comobidities significantly influenced which treatment was prescribed. Limitations: The main limitation of this study was that all the prescriptions were collected from inpatient from a single hospital and it may not be a representative of prescribing pattern across the city. Conclusion: In this study it was observed that the ACE-Inhibitors are the most commonly prescribed monotherapy agents (38.25%) and their prescribing pattern was in consistent with the global trends.Thiazides and the combination drugs were underutilized in this study,despite robust evidence to support their use.
A Review on Hypertensive Drug Prescription
Asian Journal of Pharmaceutical Research and Development
Hypertension is considered to be the vital reason of mobidity and mortality in the society. It is an important risk aspect for cerebro-vascular, cardiovascular, and renal problems. A number of national and international guidelines for the management of hypertension have been published. The increasing occurrence of hypertension and the frequently escalating expenditure of its treatment control the prescribing patterns amongst physicians and compliance to the treatment by the patients. from the time when several years ago, diuretics were calculated as the first-line drugs for management of hypertension therapy; however, the recent guidelines by the Joint National Commission (JNC8 guidelines) advise both calcium channel blockers in addition to angiotensin converting enzyme inhibitors as first-line drugs, in adding up to diuretics. This assessment aims on the antihypertensive medication utilization, adherence to treatment by patients, and physicians’ adherence to guidelines in prescribi...
Indian Research Journal of Pharmacy and Science, 2018
Background: Hypertension is the continuous increased arterial blood pressure. More than 25 antihypertensive agents are present for therapy according to patient factors. Administration of agents depends on the scale of therapy according to degree of hypertension. Aim: To follow up the model use of antihypertensive agents in hypertensive Jordanian subjects for hypertension control. Methods: This prospective and double blind investigation included 211 outpatient adult hypertensive participants having or not other Comorbid diseases , aged 30-70 years, of both sexes and who visited the general medicine clinic at Prince Hashim military hospital, Zarqa, JORDAN, during the period Apr 2016-Feb 2018. The data's for use of antihypertensive agents were collected from patient's medical files. The antihypertensive agents included were: Beta Blockers (BBs), Diuretics, Angiotensin Converting Enzyme Inhibitors (ACEI), Calcium Channel Blockers (CCBs), and angiotensin receptor blockers (ARBs) .Antihypertensive agents use prevalence and percentage as single or multiple therapy was evaluated. Z test was used to record the P value of age difference between two sexes. P value was considered statistically significant if it was less than 0.05. Results: The most commonly single used antihypertensive agents were Angiotensin Converting Enzyme Inhibitors (ACEI) (28.3%). In decreasing order come: Calcium Channel Blockers (CCBs) (23.3%), BBs (Beta Blockers)(18.3%), angiotensin receptor blockers (ARBs) (18.3%) and diuretics(11.7%). Multiple therapies was administered more in 71.6% (151) of patients than single therapy which was administered in 28.4% (60) of patients. Hypertension was more in men with increasing age than women. Conclusion: Angiotensin Converting Enzyme Inhibitors were the commonest antihypertensive used agents whether in single or multiple therapies.