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J Basic Clin Physiol Pharmacol. 2019 Sep 10. pii: /j/jbcpp.ahead-of-print/jbcpp-2019-0133/jbcpp-2019-0133.xml. doi: 10.1515/jbcpp-2019-0133. [Epub ahead of print]

Prescribing pattern of antihypertensive medication and adherence to Joint National Commission-8 guidelines in a rural tertiary care Indian teaching hospital.

Author information

1
Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, Nagamangala, Karnataka 571448, India.
2
Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, BG Nagara, Nagamangala, Karnataka 571448, India, Mobile: +91-9886880633.
3
Department of General Medicine, Adichunchanagiri Institute of Medical Science, Adichunchanagiri Hospital and Research Center, Adichunchanagiri University, BG Nagara, Nagamangala, Karnataka 571448, India.

Abstract

Background Antihypertensive medications are one among the most highly used drugs across the globe as well as in India, and their prescribing pattern will be erratic despite the various clinical guidelines. Few studies address the pattern and adherence to the standard treatment guidelines in India. This study aimed to review the prescribing pattern of antihypertensive medications in a rural tertiary care teaching Indian hospital and to investigate the adherence to the Joint National Commission-8 (JNC-8) guidelines on prevention, detection, evaluation, and treatment of hypertension in adults. Methods A prospective observational study was conducted among the participants from four different inpatient wards who are aged >18 years, without gender restriction. The prescription pattern was reviewed and adherence to the JNC-8 guidelines was also assessed. A purposive sampling technique was adopted and descriptive statistics were used in Statistical Package for the Social Sciences v16. Results Of the 101 participants included in the study, 62 (61.39%) were female, 23.76% were aged <30 and >60 years, and the other 52.48% belong to the range of 30-60 years. As per JNC-8 guidelines, 4.95%, 17.82%, 44.55%, and 32.67% of patients were classified as normal, pre-hypertensive, stage I, and stage II, respectively. Most of them (31.68%) were free from comorbidities. The most (23.76%) prescribed drug was calcium channel blocker (CCB), and 15.84% of the patients received combination therapy. Treatment was effective in 70.30% of the patients through analyzing their blood pressure even though the adherence to the JNC-8 guidelines was only in 54.46%. Conclusions Our study revealed that CCB was the most prescribed drug, and in spite of the only 50% adherence rate, treatment was effective in the majority of the population. The treatment outcome can be improved if the adherence rate is increased further.

KEYWORDS:

JNC-8; adherence; antihypertensive; drug use review; outcome review

PMID:
31503542
DOI:
10.1515/jbcpp-2019-0133

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