A study on drug utilization pattern of antihypertensive drugs in hypertensive diabetic 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.
Panacea Journal of Medical Sciences, 2020
Background: Hypertension and Type 2 diabetes are the two factors having a great impact on the mortality and morbidity of a substantial amount of population over the globe. It has also been identified that Hypertension and Type 2 diabetes co-exist in the majority of the patients. There is a wide range of antihypertensive drugs available for the management of hypertension namely, enzyme inhibitors (ACEIs), diuretics (D), beta-blockers (β Bs), calcium-channel blockers (CCBs), and angiotensin receptor blockers (ARBs). Aim: To study the Efficacy and tolerability of antihypertensive drugs in Diabetic and Non-Diabetic patients at a tertiary care centre in Ganjam, Odisha Materials and Methods: A prospective study with 400 patients was conducted in which 200 were included in the non-diabetic group, and 200 were included in the diabetic group. The study period was six months, from June 2019 to November 2019, and it was conducted at the MKCG Medical College Berhampur, Ganjam Odisha. Patients with Type 1 diabetes were excluded from the study. All the patients suffering from mild and moderate hypertension were included in the study. Also, the patients with and without type 2 diabetes were included in the study. Results: Fifty of the non-diabetics with hypertension belonged to 51-70 years of age group. Similarly, 52.5% of the patient in the Diabetics with Hypertension group belonged to 51-70 years. There was no statistically significant difference among the different mean values among the diabetic and non-diabetic patients except the mean values of diabetic and non-diabetic patients under AST when given ßB + CCB + D + ACEI. There was no statistically significant difference among the renal function of various drugs among the diabetic and non-diabetic group. More people were given two drugs combination as compared to monotherapy, three drugs combination and four drugs combination. There was no statistically significant difference among the various drug combinations on the systolic blood pressure. It was identified various mean urea, mean creatinine and mean uric acid values for different drug combinations. There was no statistically significant difference among the renal function of various drugs among the diabetic and nondiabetic group. Conclusion: The study concluded that antihypertensive drugs were significantly helpful in treating systolic blood pressure. The BP was controlled substantially in the diabetics and non-diabetics using the ACEI drug.
Asian Journal of Pharmaceutical and Clinical Research
Objective: This study was conducted in order to establish the drug prescribing trend of anti-hypertensive agents in hypertensives and diabetic hypertensives in General Medicine Methods: A prospective study of 2 months duration was conducted at the Veer Surendra Sai Medical College and Hospital, Sambalpur. The prescriptions containing antihypertensives were collected from the patients attending the outpatient department of general medicine. Pregnant women were excluded from the study.
Journal of Pharmaceutical Research International, 2021
Introduction: Hypertension (HTN) is one of the most serious public health issues in the world, affecting around 1.4 billion people worldwide. HTN is becoming highly prevalent in Pakistan, about more than 33% of people over the age of 40 years suffering from the HTN. The illness burden is continuously growing due to the incorrect medicine prescriptions, a lack of education, and a lack of patient compliance. The existence of comorbidities such as Diabetes Mellitus (DM) should be properly considered while choosing an Antihypertensive medication. Similarly, the prescriptions of Oral Hypoglycemic agent’s appropriate consideration are essential. Oral hypoglycemic medications are divided into several categories. Physicians face a challenge in rationally selecting a regimen from a variety of classes, and the situation becomes more complicated when the patients have additional non-communicable illnesses, such as HTN. The combination therapy of ailments not only effects the patient`s economic...
Sunsari Technical College Journal, 2016
This study was conducted to assess the drug prescribing trend of anti-hypertensive and hypoglycemic agents in hypertensive and diabetic patients in tertiary care private Hospital. The study was prospective, cross-sectional and observational study. A total of 100 prescriptions were recorded. 56% were males as compared to 44% females. The age group of the patients varied from 30 to 90 years with majority individual above 50 years of age. 59% patients were hypertensive; 26% patients were diabetic and 15% had both the diseases. For the treatment of HTN, both mono-therapy and combination therapy were followed. In mono-therapy, amlodipine was most commonly prescribed followed by losartan. In combination therapy, a twodrug combination consisting of calcium channel blockers (amlodipine) and diuretics (furosemide /hydrochlorothiazide) were given to the majority of patients, followed by Diuretics and Angiotensin receptor blocker combination. Among diabetic hypertensive, 66.67% of patients were treated with single anti-hypertensive drug and 33.35% of patients were treated with anti-hypertensive drug combinations with oral hypoglycemics. This study showed that calcium channel blockers were the most prescribed antihypertensive agents while biguanides were the mostly prescribed among anti-diabetic agents. Combination therapy was observed in a high percentage of prescriptions in hypertensive patients. Prescribing pattern among antihypertensive showed some dubitable adherences to existing evidence-based JNC guidelines.
Utilization of Antihypertensive Drugs in Diabetic Patients in Sultan Qaboos University Hospital
Biomedical Journal of Scientific & Technical Research, 2021
Hypertension is very common among patients with diabetes. Approximately, 10 to 30% of type 1 and 60% of type 2 diabetic patients have hypertension. The patterns of utilization of antihypertensive drugs in diabetic patients were studied retrospectively in 101 hypertensive diabetic patients. Study findings focused on showing if there is any reason behind the differences. This study helps to implement interventions aimed at improving antihypertensive drug utilization and reducing medication errors. Drug factors such as dosage form, average daily dose, and adverse drug reactions were assessed. 53.5% of patients were on angiotensin II receptor blockers. 59.4% of the patients were on multiple drug therapy. Average daily dosages were almost comparable with the American Society of Hypertension and the International Society of Hypertension guidelines. Patients in the age group (≥ 60) used β-blockers with a higher percentage than patients of the age group (18-59). Vasodilators, calcium channel blockers, and β-blockers showed higher use percentages in patients with diabetic nephropathy compared to patients with no nephropathy whereas the percentage of angiotensin-converting-enzyme inhibitors was higher in no nephropathy status. 84.2% of patients had uncontrolled systolic blood pressure, and 43.6% of patients had uncontrolled diastolic blood pressure.
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.
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
Objective: The objective of this study was to observe the pattern of utilization of different groups of antihypertensive drugs in patients with diabetes in a tertiary care hospital and correlate the data obtained from the study. Methods: It was an institution-based cross-sectional study; the present study was carried out at M.G.M. Medical College and L.S.K. Hospital in Kishanganj, Bihar, in the Department of Pharmacology. This study included 520 diabetes mellitus patients with hypertensive disorders who presented to the Department of Medicine at M.G.M. Medical College and L.S.K. Hospital, Kishanganj, during the study period (June 2021-May 2022). Results: When we appeared at the prescribing patterns of antidiabetic drugs, we found that metformin was the most common (80%), followed by sulfonylureas (65%), DDP4 inhibitors (56.7%), and alpha-glucosidase inhibitors (5%). An evaluation of the pattern of hypertensive drugs prescribed to study subjects revealed that monotherapy was the preferred option (77.1%) over combination therapy (22.9%). Telmisartan (32.4%) is the most common drug used in monotherapy among the study subjects included in the present study, followed by Amlodipine (27.4%) and Metoprolol (14.5%), Bisoprolol (14.5%), and Clinidipine (11.2%), respectively. Conclusion: The evaluation of all medications prescribed was reasonable and in compliance with JNC-8 treatment guidelines. Further, research is needed to qualify the rationale for drug choice based on demographics, economic status, comorbidities, and complications to provide additional insight into antihypertensive drug prescribing patterns in people with diabetes so the results can be translated for broader and more real benefits can become a medical community.
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.
Evaluation of prescribing patterns in diabetic and hypertensive patients in a South Delhi Hospital
International Journal of Basic & Clinical Pharmacology, 2014
The main aim of drug utilization studies (DUS) are to evaluate the factors related to the prescribing, dispensing, administration and consumption of medicines, and its associated events (either beneficial or adverse). DUS defined by the World Health Organization as the marketing, distribution, prescription and use of drugs in a society, considering its consequences, either medical, social, and economic. 1 DUS began in the early 60's basically with market-only purposes, then for evaluating the quality of medical prescription so that rational use of drugs could be promoted and patterns of use of specific drugs could be compared. Presently DUS are an evolving area. Their scope is to evaluate the present state and future trends of drug usage, to estimate disease prevalence, drug expenditures, appropriateness of prescriptions and adherence to evidence-based recommendations. The increasing importance of DUS as a valuable investigation resource in pharmacoepidemiology has been linking it ABSTRACT Background: Drug utilization studies (DUS) defined by World Health Organization as the marketing, distribution, prescription and use of drugs in a society, considering its consequences, either medical, social, and economic. The increasing importance of DUS as a valuable investigation resource in pharmacoepidemiology has been linking it with other health related areas, such as public health, pharmacovigilance, pharmacoeconomics, and pharmacogenetics. Methods: The study was a prospective DUS carried out in medicine OPD of