Drug utilization study of anti-hypertensive drugs at a tertiary care hospital
Keywords:Drug utilization, Anti-hypertensive, Tertiary care hospital
Background: The increasing prevalence of hypertension influence the prescribing patterns of antihypertensive drug. Prescribing against evidence-based guidelines in hypertension treatment leads to the increase cost of medications and problems in providing affordable prescriptions to population. The aim of present study was to analyse anti-hypertensive prescribing pattern in Government Medical College and Hospital, Aurangabad, Maharashtra, India.
Methods: Study was prospective, observational, open label and descriptive clinical study. It included 336 patients admitted in MICU during January 2018 to June 2019 fulfilling inclusion criteria.
Results: 54.46% patients were between 51-70 years of age, followed by 33.63% in 31 to 50 age group. Of total enrolled hypertensive patients 69% patients had various comorbidities. Drug prescribed was 28.27% ARBs, 26.84% CCBs, 17.62% beta blockers, 6.14% high ceiling diuretics, 4.50% ACE inhibitors, 2.45% thiazide diuretics and 2.04% received alpha blocker. As monotherapy, 31.82% patients received telmisartan as most commonly prescribed drug followed by 27.31% patients received Amlodipine followed by other drugs. In combination therapy telmisartan and hydrochlorothiazide was prescribed most commonly followed by beta blocker and CCB and ARB and CCB. 33.60% of drugs were prescribed in generic names while 66.39% of drugs prescribed in brand names. Average number of drugs prescribed per prescription was 1.45 of which 33.60% of drugs were prescribed by generic names.
Conclusions: With average number of drugs per prescription in hypertension 1.45, the study showed that poly pharmacy is unavoidable in hypertension due to associated comorbid conditions.
India New Delhi: Government of India; 2006. Ministry of Health and Family welfare: National Health Accounts.
Guo JD, Liu GG, Christensen DB, Fu AZ. How well have practices followed guidelines in prescribing antihypertensive drugs: the role of health insurance. Value Health. 2003;6:18-28.
Akhtar AK, Divya V, Pillai KK, Kiran D. Drug prescribing practices in pediatric department of a North Indian University Teaching Hospital. Asian J Pharm Clin Res. 2012;5:146-9.
Sutharson L, Hariharan RS, Vamsadhara C. Drug utilization study in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003;35:237-40.
Bakssas I, Lunde PK. National drug policies: The need for drug utilization studies. Trends Pharmacol Sci. 1986;:331-4.
Yuen YH, Chang S, Chong CK, Lee SC, Critchley JA, Chan JC. Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and ant diabetic drugs. J Clin Pharm Ther. 1998;23:287-94.
Rachana PR, Anuradha HV, Shivamurthy M. Anti-hypertensive prescribing patterns and cost analysis for primary hypertension: a retrospective study. J Clin Diagn Res. 2014;8:19-22.
Gupta R. Trends in hypertension epidemiology in India. J Hum Hypertens. 2004;18:73-8.
Fischer MA, Avorn J. Economic implications of evidence-based prescribing for hypertension: Can better care cost less. JAMA. 2004;291:1850-6.
Kapoor B, Raina RK, Kapoor S. Drug prescribing pattern in a teaching hospital. Ind J Pharmacol. 1985;17(1):168.
Pradhan SC, Shewade DG, Shashindran CH, Bapna JS. Drug utilization studies. National Med J India. 1988;1:185.
Jangir RA, Ali A, Ahemad J, Gehlot A, Vyas A, Batar KK. A Prospective Study of Prescription Patterns of Anti-hypertensive Drugs in Hypertensive Patients at a Tertiary Care Hospital. JMSCR. 2019:7(3):1146-57.
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.
Sindhu PR, Reddy MS. Study of Prescriptive Patterns of Antihypertensive Drugs in South India. Int J Advancements Res Technology. 2013;2(6):295-311.
Pai PG, Shenoy J, Sanji N. Prescribing patterns of antihypertensive drugs in a South Indian tertiary care hospital. Drug Invention Today. 2011;3:38-40.
Solanki KC, Mistry RA, Singh AP, Jadav SP, Patel NM, Trivedi HR. Drug utilization study of anti-hypertensive drugs and their adverse effects in patients of a tertiary care hospital. J Clin Experimental Res. 2013;1(3):58-67.
Jainaf N, Parimalakrishnan S, Ramakrishna RM. Study of drug utilization pattern of antihypertensive medications on outpatient and in patients in a tertiary care teaching hospital: a cross sectional study. African J Pharmacy Pharmacol. 2014;9(11):383-96.
Panda BB, Sahu PK, Pati MR. Survey of prescription pattern of antihypertensive drugs in hypertensive and diabetic hypertensive patients. Asian J Pharm Clin Res. 2015;8(1):250-2.
Xavier D, Mathew N, Pradeep J, Pais P. Pattern of drug use in hypertension in a tertiary hospital: a cross sectional study in the in-patient wards. Indian J Pharmacol. 2001;33(6):456-7.
Cheng H. Prescribing pattern of antihypertensive drugs in a general hospital in central China. Int J Clin Pharm. 2011;33(2):215-20.
Billa G, Joshi S, Salagre S, Thakkar K. A Prospective Drug Utilization Study in Geriatric Hypertensive Patients in a Tertiary Care Hospital, Mumbai. British J Medicine Med Res. 2015;5(2):178-90.
Madhwar A, Gupta D, Singh S, Ansari NA. Study of drug utilization pattern of antihypertensive drugs in hypertensive nephropathy in a tertiary care teaching hospital, Bareilly, UP. Indian J Pharmacy Pharmacol. 2015;2(1):10-5.
Mahalli EAA. WHO/INRUD drug prescribing indicators at primary health care centers in Eastern province, Saudi Arabia. EMHJ. 2012;18(11):1091-6.
Fattouh R, Hamad AB. Impact of using essential drug list: analysis of drug use indicators in Gaza Strip. Eastern Mediterranean Health J. 2010;16(8):886-92.