Drug Utilization Study of Anti-Hypertensive Drugs and Their Adverse Effects in Patients Attending Medicine Opd of a Tertiary Care Hospital (original) (raw)
Related papers
Drug utilization pattern of antihypertensive drugs at tertiary care teaching hospital
International Journal of Advanced Research in Medicine, 2020
Introduction: Hypertension represents a major health problem primarily because of its role in contributing to the initiation and progression of major cardiovascular diseases. This cross-sectional observational study aims at analysing the utilization pattern of antihypertensives used for the treatment of hypertension at a tertiary care hospital in perspective of standard treatment guidelines. Materials and Methods: This is a prospective, cross sectional and observational study carried out in the outpatient of Department of General Medicine of NC Medical College and Hospital. All patients with proven hypertension and put on antihypertensive medications were recruited from the Department of Medicine. The total duration of the study was 1 year i.e. December 2019 to November 2020. Results: In our study, the mean systolic blood pressure (mean±S.D) of the patients was 154.34±9.43 and the median was 153. Test of proportion showed most of the patients 53 (44.1%) were significantly higher systolic blood pressure ranging from 160-179 mmHg. The mean diastolic blood pressure (mean±S.D) of the patients was 98.32±8.43. Test of proportion showed most of the patients 51 (42.5%) were significantly higher diastolic blood pressure ranging from 100-119 mmHg. Test of proportion showed most of the patients 62 (51.6%) were on Mono therapy significantly higher than dual therapy, triple therapy and poly therapy, 34 (26.6%), 13 (10.8%), 11 (9.1%) respectively. Causality assessment of ADRs was done using WHOUMC scale which categorizes ADRs as "certain", "probable", "possible" and "unlikely". Table 8 shows that type of reactions and their percentage are as certain (9.6%), Probable/ Likely (67.7%), Possible (19.3%), and Unlikely (3.2%). Conclusions: In this study usage of anti-hypertensive drugs were prescribed rationally in tertiary care hospital. The study emphasizes that need for effective continuing medical education and also preventive measures in hypertensive individuals.
International Journal of Pharmacy and Pharmaceutical Sciences, 2018
Objective: To monitor drug utilization based adverse drug reactions (ADRs) of antihypertensive agents prescribed in Al-Quwayiyah general hospital, Saudi Arabia. Methods: An open, non-comparative, observational study was conducted on hypertensive patients attending the medicine outpatient department of Al-Quwayyah general hospital, Al-Quwayyah, Saudi arabia. Data were collected by conducting patient interviews. Data were captured for adverse drug reaction monitoring based on Narinjo scale and WHO format. Results: 25 ADRs were observed out of 212 hypertensive patients. Incidence was found to be higher in patients more than 40 y age, and females experienced more ADRs (n = 16, 7.54%) than males, 9 (4.62%). Combination therapy was associated with more number of ADRs (64.0%) as against monotherapy (36.0%). Calcium channel blockers were found to be the most frequently associated drugs with ADRs (n = 8), followed by diuretics (n = 6), and β-blockers (n = 5). Among individual drugs, amlodipine was found to be the commonest drug associated with ADRs (n = 8), followed by torasemide (n = 4). ADRs associated with the central nervous system was found to be the most frequent (48.0%) followed by musculoskeletal complaints (20.0%) and respiratory system disorders (16.0%). Conclusion: ADRs were experienced by taking the antihypertensive drugs prescribed in Al-Quwayyah general hospital, Saudi arabia. The findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with ADRs.
Drug Utilisation Study in the Treatment of Hypertension in a Tertiary Care Hospital
Journal of Evidence Based Medicine and Healthcare, 2017
BACKGROUND Hypertension, a common clinical problem is considered as an 'iceberg disease' because its unknown morbidity far exceeds the known morbidity. In terms of attributable deaths, it is one of the leading behavioural and physiological risk factors amounting to 13% of global deaths. Drug selection is based on efficacy in lowering BP (blood pressure) and in reducing Cardiovascular (CV) endpoints like stroke, myocardial infarction and heart failure. This study was carried out to evaluate the pattern, extent, rationality and frequency of the use of antihypertensive drugs in the treatment of hypertension. The aim of the study is to analyse drug utilisation in the treatment of hypertension in a tertiary care hospital. MATERIALS AND METHODS This study was conducted during January 2014 to December 2015 in Medicine OPD (Outpatient Department) in a tertiary care hospital. The sample size was selected as per the WHO recommendations on conducting Drug Utilisation Studies (DUS). Statistical Analysis-The collected data was numerically coded and entered in Microsoft Excel 2007 and analysed by SPSS version 16. Settings and Design-Prospective, cross-sectional, observational study. RESULTS Out of 612 patients, 262 (42.81%) were in the age group of 60 and above. Considering gender distribution, 328 (53.59%) were males and 284 (46.41%) were females. Of these, 274 (44.78%) were prescribed monotherapy, 256 (41.83%) were prescribed two-drug therapy, 72 (11.76%) were prescribed three-drug therapy and 10 (1.63%) were prescribed four-drug therapy. Among 274 (44.78%) patients prescribed with monotherapy, 112 (40.87%) were prescribed with CCB (calcium channel blocker), 76 (27.73%) were given BB (B-blocker), 45 (16.42%) were prescribed ACEI (angiotensin converting enzyme inhibitor), 35 (12.77%) were prescribed with ARB (angiotensin receptor blocker) and 6 (2.18%) were prescribed with Diuretics (D). Of the total antihypertensive drugs prescribed, 68.30% were prescribed by generic name, while 25.98% were prescribed as FDCs (fixed drug combination) and 39.05% of antihypertensive drugs were from NLEM (national list of essential medicine). Average number of drugs prescribed per encounter in our study was 2.42, while number of antihypertensive drugs per encounter were 1.34. CONCLUSION The findings of our study suggest that majority of prescriptions had generic names of the drugs. Improving practitioners' knowledge and attitude in rational prescribing can prove to be a cornerstone in achieving rational use of antihypertensive drugs.
A Study on Drug Utilization Pattern of Antihypertensive Drugs in Tertiary Care Hospital
INDIAN RESEARCH JOURNAL OF PHARMACY AND SCIENCE, 2020
Background: The JNC 8 guidelines published in 2014 are the most recent guidelines for the management of hypertension in different clinical settings. antihypertensive drugs in concordance with the guidelines. Aim: The aim of the study is the utilization of anti Method: A total of 150 patients were recruit the pattern of utilization of antihypertensive drugs data was sorted on the basis of demographic characteristic, drug category. Result: It was found that prevalence of (48%). Most of the patients were found to have diabetes as the co morbid condition. The prescribed category of antihypertensive drugs utilized were (68.6%), diuretics (45.4%), calcium channel blocker (38%), beta blocker (26.6%) and alpha blockers (3.4%). ACEI/ARB was the most frequently prescribed antihypertensive class of drug. Conclusion: ACEI/ARB was the most common a for better therapeutic outcomes.
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.
Prescription pattern of Anti-hypertensive drugs in a tertiary care hospital
Background: Elevated Blood pressure is one of the most important modifiable risk factors for cardiovascular diseases. Recently a number of newer and effective anti-hypertensive medications have come into practice. Therefore it is important to find out patient compliance, recent trends in prescribing anti-hypertensive medications and its effectiveness in upcoming medical practice. Objective: To evaluate the recent trends in prescribing anti hypertensive drugs, in outpatients in the Departments of General Medicine and Cardiology at a tertiary care hospital. Methods: The present study was a cross sectional observational study. This was conducted in the Departments of Cardiology and General Medicine, Pondicherry Institute of Medical Sciences (PIMS), Puducherry. Adult patients diagnosed to have mild to severe systemic hypertension and on treatment without any other co morbid conditions of either sex attending the out patient clinic were included in the study. The study duration was three months with a sample size of 300 patients. The following data were obtained from their outpatient files: Demographic details, BP, drugs used to treat the elevated BP. The data will be presented as descriptive statistics. Results: Majority of patients were between the age groups of 41-60 years. Amongst them 84% of male patients and 61.90% of female patients had good control of BP with anti-hypertensive therapy. 71.70% of patients had their BP within the normal range with a single anti-hypertensive drug. The most commonly prescribed drug is calcium channel blockers followed by beta-blockers, ACE inhibitors, ARBs and diuretics. The most commonly used combination is calcium channel blocker with beta-blocker. Conclusion: The present study represents the current prescribing trend for anti-hypertensive agents. The use of single anti-hypertensive has been found to provide good control of blood pressure in majority of patients, but about 28% of patients required more than one drug for blood pressure control. Though the rate of usage of AR blockers and ACE inhibitors has been increasing, the Calcium channel blockers and β blockers top the list in the most commonly prescribed anti-hypertensive agents.
DRUG UTILIZATION PATTERN OF ANTIHYPERTENSIVE MEDICATIONS IN A TERTIARY CARE HOSPITAL, SOUTH INDIA
Asian Journal of Pharmaceutical and Clinical Research, 2021
Objective: The objective of the study is to assess drug use pattern of antihypertensive medications in hypertensive patients. Methods: It is a prospective cross-sectional study conducted in the outpatient dispensary, Government Medical College, Thiruvananthapuram for the period of 6 months from January 2019 to June 2019. About 500 prescriptions of patients visiting outpatient dispensary with an antihypertensive prescription were enrolled for the study. Drug use patterns of different classes of antihypertensive medications were analyzed from individual prescriptions. Results: A total of 500 patients were included in this study, among which 281 were male (56.2%) and 219 (43.8%) were female. In 500 patients, 133 patients were treated with monotherapy. In that 42.1% of patients were treated with amlodipine, 28.57% of patients were treated with losartan. In combination therapy most commonly used was double therapy (42.8%) followed by triple therapy (24.2%). Calcium Channel Blockers (56.2%) was most prescribed class of drug followed by Angiotensin Receptor Blockers. Conclusion: This study reveals that calcium channel blockers as most prescribed class of antihypertensive and Amlodipine was the most prescribed antihypertensive. In our study, most of the patients were treated with combination therapy in that double drug therapy was most common. There is a chance of various medication errors, development of adverse drug reaction as majority (290) of patients belong to age above 60 and chances of getting error also increases as combination therapy is most used. Therefore close monitoring is required for such patients.
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.
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
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.