DRUG UTILISATION EVALUATION OF ANTIHYPERTENSIVES IN GERIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL
Objective: Hypertension is a leading contributor to the global burden of cardiovascular morbidity and mortality. The main objective of the present study was to assess the drug utilization patterns of antihypertensives in geriatric patients in a teaching hospital.
Methods: A Single centre Prospective Observational study was carried out for a period of three months in an out-patient department of Owaisi Hospital & Research Centre. Elderly patients who have been diagnosed with hypertension as per JNC-7 guidelines and patients receiving or prescribed with antihypertensive drugs were included.
Results: A total of 100 prescriptions were analyzed during the three month study period. 72% of the patients were in the age group of 65-67 years and this was found to be higher in men 68%. During the study period 80% of the patients were Pre-Hypertensive systolic (80-89 mmHg) and Diastolic (120-139 mmHg) followed by Stage-I Hypertension and Stage-II Hypertension. The most common drug classes involved in the study was Calcium Channel Blockers 37% followed by Angiotensin II receptor antagonists 21% and the most commonly prescribed drugs in the study population were Amlodipine 37%, Losartan 11% and Telmisartan 10%. The most common anti-hypertensive fixed dose combination therapy involved in the study was Telmisartan + Hydrochlorothiazide 15% and most common two drug combination therapy involved in the study was Amlodipine + Atenolol 7% followed by Metoprolol + Amlodipine 1%.
Conclusion: Our study shows that the most commonly prescribed drug classes involved were Calcium Channel Blockers followed by Angiotensin II receptor antagonists and the anti-hypertensive drug combinations among hypertensive patients were considerable and this practice positively impacted on the overall blood pressure control.
2. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension 1988-2008. JAMA 2010;303:2043-50.
3. Cunningham G, Dodd TR, Grant DJ, Murdo ME, Richards RM. Drug related problems in elderly patients admitted to Tayside hospitals, methods for prevention and subsequent reassessment. Age Ageing 1997;26:375-82.
4. Mannesse CK, Derkx FH, Ridder MA, Man Veld AJ, Van D, Cammen TJ, et al. Adverse drug reactions in elderly patients as contributing factor for hospital admission:cross sectional study. BMJ 1997;315:1057-8.
5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure:the JNC 7 report. JAMA 2003;289:2560-72.
6. Psaty BM, Lumley T, Furberg CD, Schellenbaum G, Pahor M, Alderman MH, et al. Health outcomes associated with antihypertensive therapies used as first line agents. A systematic review and meta-analysis. JAMA 1997;277:739-45.
7. Chaturvedi M, Jindal S, Kumar R. Lifestyle modification in hypertension in the Indian context. J Indian Acad Commun Med 2009;10:46-51.
8. MacMahon S, Rodgers A. The effects of blood pressure reduction in older patients:an overview of five randomised controlled trials in elderly hypertensives. Clin Exp Hypertens 1993;15:967-78.
9. Datta S, Sharma C. Prescribing pattern of antihypertensives in patients having comorbid ischemic heart disease:study in a tertiary care hospital. J Pharm Res 2010;3:2142-4.
10. Datta S. Use of antihypertensives in patients having associated renal parenchymal disorders:Cross sectional prescription pattern study in a tertiary care hospital. Int J Pharm Sci Drug Res 2011;3:256-9.
11. Almas A, Salik RI, Ehtamam A, Khan AH. Spectrum of antihypertensive therapy in south Asians at a tertiary care hospital in Pakistan. BMC Res Notes 2011;4:318.
12. Neal B, McMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure lowering drugs:results of prospectively designed overviews of randomized trials. Lancet 2000;356:1955-64.