ASSESSMENT OF PROFESSIONALâ€™S ADHERENCE TO JOINT NATIONAL COMMITTEE 8 GUIDELINES IN THE MANAGEMENT OF HYPERTENSION
Objectives: Hypertension is the most insidious ailment in primary care with its management being a daily affair. The avail of antihypertensive medications has affirmed their efficacy in blood pressure alleviation. Yet, the methodical choice of medication with which treatment ought to commence at the precise blood pressure threshold and maintained at a target level was undiscerned. Consequently, the Eighth Joint National Committee grants an evidence-based tool, which was employed in the appraisal of professionalâ€™s adherence to joint national committee 8 guidelines.
Methods: A prospective, observational study was governed. Aggregate patients with hypertension with/without diabetes mellitus (DM) and/ or chronic kidney failure admitted in general medicine and the dialysis unit of the tertiary health care hospital, for 4 months were enrolled. The rationality of antihypertensive medications and target blood pressure was noted.
Results: Patients matriculated to 125, 90 males and 35 females. Average age perceived was between 51 and 60 years, with the length of stay 14.39 (standard deviation [SD]Â±1.52) and 9.3 (SDÂ±0.46) days in the respective unit. The gross medication endorsed represents 1085 medications, incorporating 337 antihypertensive medications. The optimal choice of an antihypertensive medicine was clonidine and amlodipine. Adherence in the populace with lone hypertension was cent percent, trailed by hypertension with DM 82.35% and minimal in hypertension with chronic kidney disease.
Conclusion: 86-medication compiled adherence to the guidelines (25.52%). Rationality of medication depicts 25.6% were rational and 73.6% distinguish as non-rational, amid a demise of a sole victim. A significant high-grade defiance of health-care practitioners to the Eighth Joint National Committee guidelines was evidenced from our study.
2. Oâ€™Callaghan CJ, Goh MY, Rong P. Hypertension - The difficult decisions. Aust Fam Physician 2013;42:376-9.
3. Jackson JH, Sobolski J, Krienke R, Wong KS, Frech-Tamas F, Nightengale B, et al. Blood pressure control and pharmacotherapy patterns in the United States before and after the release of the joint national committee on the prevention, detection, evaluation, and treatment of high blood pressure (JNC 7) guidelines. J Am Board Fam Med 2008;21:512-21.
4. Raju S, Solomon S, Karthik N, Clara AJ, Venkatanarayanan A. Assessment of prescribing pattern for hypertension and comparison with JNC-8 guidelines-proposed intervention by clinical pharmacist. J Young Pharm 2016;8:133-5.
5. Sunitha P, Kaveri DL, Soumya P, Arundhati D. Effect of pharmacist mediated patient counseling in hypertensive patients in terms of knowledge, compliance and lifestyle modification. Int J Pharm Pharm Sci 2014;4:277-81.
6. Galav A, Bhatnagar R, Meghwal SC, Jain M. Prevalence of hypertension among rural and urban population in Southern Rajasthan. Nat J Community Med 2015;6:174-8.
7. Mohan V, Seedat YK, Pradeepa R. The rising burden of diabetes and hypertension in Southeast Asian and African regions: Need for effective strategies for prevention and control in primary health care settings. Int J Hypertens 2013;2013:409083.
8. Ku E, Glidden DV, Johansen KL, Sarnak M, Tighiouart H, Grimes B, et al. Association between strict blood pressure control during chronic kidney disease and lower mortality after onset of end-stage renal disease. Kidney Int 2015;87:1055-60.
9. Dhanaraj E, Raval A, Yadav R, Bhansali A, Tiwari P. Prescription pattern of antihypertensive agents in T2DM patients visiting tertiary care centre in north India. Int J Hypertens 2012;2012:520915.
10. Patel RD, Shah NN. Control of blood pressure and anti-hypertensive medication profile in end stage renal disease patients undergoing maintenances hemodialysis: An observation and a retrospective study. Ind J Pharm Pract 2014;7:19-26.
11. Reynolds K, Gu D, Muntner P, Kusek JW, Chen J, Wu X, et al. A population-based, prospective study of blood pressure and risk for end-stage renal disease in China. J Am Soc Nephrol 2007;18:1928-35.
12. Surapaneni SS, Arifa SN, Venigalla S, Peter H PL, Pingili R, Challa SR. Assessment of antihypertensive medication utilization patterns and adherence to JNC-7 guidelines in South indian tertiary care teaching hospital. Ind J Pharm Pract 2015;8:177-82.
13. Touyz RM, Dominiczak AF. Hypertension guidelines is it time to reappraise blood pressure thresholds and targets? Am Heart Asso 2016;2016:1-2.
14. Kothari N, Ganguly B. Adherence to JNC-VII and WHO-ISH guidelines of antihypertensive medications prescribed to hypertensive patients with co-morbid conditions. Indian J Physiol Pharmacol 2015;59:48-56.
15. Romday R, Gupta AJ, Pawan Bhambani P. An assessment of antihypertensive medication prescription patterns and adherence to joint national committee-8 hypertension treatment guidelines among hypertensive patients attending a tertiary care teaching hospital. Int J Res Med Sci 2016;4:5125-33.
16. Sabouhi F, Babaee S, Naji H, Zadeh AH. Knowledge, awareness, attitudes, and practice about hypertension in hypertensive patients referring to public health care centers in Khoor and Biabanak. Indian J Neonatal Med Res/Winter 2011;16:34-40.
17. Reisin E, Harris RC, Rahman M. Commentary on the 2014 BP guidelines from the panel appointed to the eighth joint national committee (JNC 8). J Am Soc Nephrol 2014;26:1-6.
18. Deepali PL, Ashiya M, Sunitha P, Arundhati D. An overview of rational prescribing pattern in hypertensive patients in tertiary care hospital. Int J Pharm Pharm sci 2016;2:273-6.
19. Tadvi AY, Bandi JR. Study of prevalence of hypertension in a young adult population of age group 20 to 40 years in an urban slum of Mumbai, Maharashtra, India. Int J Community Med Public Health 2016;3:3325-31.
20. Shah J, Khakhkhar T, Bhirud S, Shah RB, Date S. Study of utilization pattern of anti-hypertensive medications in hypertensive diabetic patients with or without reduced renal function at tertiary care teaching hospital. Int J Med Sci Public Health 2013;2:175-80.
21. Mohan M. Medication utilization evaluation of antihypertensives in a superspeciality hospital. Int J Pham Res Rev 2016;5:1-8.
22. Sweileh WM, Sawalha AF, Zyoud SH, Al-Jabi SW, Tameem EJ. Patterns of anti-hypertensive therapy in diabetic patients with and without reduced renal function. Saudi J Kidney Dis Transpl 2010;21:652-9.
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