Prescribing pattern of antihypertensive medication and adherence to Joint National Commission-8 guidelines in a rural tertiary care Indian teaching hospital
-
Rajesh Venkataraman
,
Muhammed Rashid
,
Bhat Shashikantha
,
Ayyappankalathil Soumya
,
Greeshma Vijayan
,
Gloriya Grifth Manuel
and
Shahinur Islam
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.
Acknowledgments
The participants and their caretakers are highly acknowledged for their time and support for this study.
Author contributions: Rashid M, Venkataraman R, Shashikantha, Soumya A, Vijayan G, and Islam S contributed to study conception and design; Rashid M, Soumya A, and Vijayan G contributed to data acquisition, data analysis and interpretation, and writing of the article; Rashid M, Shashikantha, Venkataraman R, Soumya A, Vijayan G, Manuel GG, and Islam S contributed to editing, reviewing, revising, and final approval of the article. All authors have accepted responsibility for the entire content of the submitted manuscript and approved the submission.
Research funding: No funding was received from any organization or funders.
Competing interests: The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Informed consent: A written undersigned informed consent was obtained from all the participants after explaining the study procedures and right of patients in English or in common language (Kannada) whenever necessary.
Ethical approval: All study procedures were carried out according to the Declaration of Helsinki, and the study was approved by institutional ethical committee (AIMS/IEC/1342/2018-19). An experienced consultant physician and practicing clinical pharmacists were directly involved in conducting the study.
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Articles in the same Issue
- Minireview
- Pharmacokinetics and pharmacodynamics of mitragynine, the principle alkaloid of Mitragyna speciosa: present knowledge and future directions in perspective of pain
- Original Articles
- Trehalose protects against spinal cord injury through regulating heat shock proteins 27 and 70 and caspase-3 genes expression
- Evaluation of cytogenotoxic potential of Morinda lucida leaf extract on Swiss albino male mice using two bioassays
- Acute and subacute toxicity evaluation of calcium carbide and ethylene glycol in Wistar albino rats
- Evaluation of the possible hepatotoxic and nephrotoxic potentials of the Averrhoa carambola juice extract in female albino rats
- Chlorpyrifos and its metabolite modulates angiogenesis in the chorioallantoic membrane of chick embryo
- Prescribing pattern of antihypertensive medication and adherence to Joint National Commission-8 guidelines in a rural tertiary care Indian teaching hospital
- Assessment of cardiac risk in chronic asymptomatic alcoholics using blood pressure and electrocardiogram, and the relation with duration of drinking
- Effect of ghrelin on VEGF-B and connexin-43 in a rat model of doxorubicin-induced cardiomyopathy
- In vitro antioxidant and enzyme inhibitory properties of the n-butanol fraction of Senna podocarpa (Guill. and Perr.) leaf
- Blood pressure-reducing activity of Gongronema latifolium Benth. (Apocynaeceae) and the identification of its main phytochemicals by UHPLC Q-Orbitrap mass spectrometry
- Evaluation of the anticonvulsant and anxiolytic-like activities of aqueous leaf extract of Cymbopogon citratus in mice
- Terpenoids and phytosteroids isolated from Commelina benghalensis Linn. with antioxidant activity
- Miscellaneous
- Suspected reactivation of extrapulmonary tuberculosis focus after non-medical abuse of anabolic androgenic steroids: a case report
- Acknowledgment
