AN OVERVIEW OF RATIONAL PRESCRIBING PATTERN IN HYPERTENSIVE PATIENTS IN TERTIARY CARE HOSPITAL
Objective: To study the prescribing patterns of antihypertensive (AHT) drugs in hypertensive (HTN) patients and hypertension with diabetes mellitus (HTN with DM) patients in tertiary care hospital, to assess the rationality of prescribing patterns, to compare the hypertension management with Joint National Committee-7 guidelines (JNC-7).
Methods: A prospective study was conducted over a period of 6 mo in the medicine department of Bharati Hospital and Research Centre, Pune. HTN and (HTN with DM patients. Who met the study criteria were enrolled in the study. The pattern of antihypertensive medications prescribed was studied and analyzed using Microsoft excel 2010 and Statistical. The rational prescribing pattern was assessed by using JNC 7 guidelines and World Health Organization (WHO) indicators.
Results: Total of 60 patients included in this study, 43 (71.7 %) were HTN patients, and 17 (28.3 %) were HTN with DM patients. There were 29 (48.33 %) males and 31 (51.66 %) female patients were involved. 45 % of patients had pre-hypertension, 33.33 % had stage-1 hypertension, 8.4 % had stage-2 hypertension other 13.33 % patients are on Antihypertensive medications and whose Blood Pressure (BP) were normal according to JNC-7. In hypertensive 47.05 % patient had prescribed Calcium Channel Blockers (CCBs) as monotherapy along with 87.5 % Angiotensin Receptor Blockers (ARBs) with diuretics as combination therapy. In HTN with DM 46.15 % patients had prescribed Angiotensin Converting Enzymes (ACEs) as monotherapy along with 62.5 % CCBs with BBs were prescribed according to JNC-7. As per WHO indicators, average no. of medicines prescribed per prescription was 2.91 and all antihypertensive medicines in the study population were prescribed rationally.
Conclusion: The present study represents the current prescribing trend for antihypertensive agents. It implies that. In hypertensive patients ARBs are the leading group of antihypertensive agents as monotherapy and ARBs with diuretics as a combination therapy according to JNC 7.
Keywords: Joint National Committee (JNC-7), World Health Organization (WHO), Hypertension (HTN), Diabetes mellitus (DM)
2. Fowad Khurshid, Mohammed Aqli, Mohammad Shamir Alam, Prem Kapoor, Krishna K Pillai. Prescribing pattern in a university teaching hospital in south Delhi. Int J Pharm Sci Res 2012;3:2057-63.
3. T Janagan, R Kavita, SA Sridev, V Veerendra. Prescription pattern of antihypertensive drugs used in hypertensive patients with associated type-2 DM in a tertiary care hospital. Int J Pharma Res Rev 2014;3:1-5.
4. Munnalal Rajan, Geetha Jayaprakash, Adepu Ramesh, B Gopalkrishna, HS Yogesh. Assessment of prescribing pattern in hypertensive patients. Int J Pharm Sci 2013;3:1349-57.
5. Subish Palaian. Patient counselling by pharmacist-a focus on chronic illness. Pak J Pharm Sci 2006;19:65-72.
6. Ananad R Kalamdani, Basavraj Bhandare, Hemamalini M B, Krishna MV. A prospective study of the prescribing pattern of antihypertensive drugs in tertiary care hospital Bangalore. J Eval Med Dental Sci 2014;2:10339-44.
7. Syed Aziz Ullah Ghori, Mirza Misba Ali Baig, Ilyaz, Mohammad Areif, Neha Tobassum. Evaluation of prescribing pattern of antihypertensive against the clinical condition. IOSR J Pharm Biol Sci 2014;9:133-40.
8. V Pavani, Manasi Cidda, T Ramya Krishna, Mihir Y Parmar, M Nalini. Study of prescribing patterns of antihypertensive drugs. Int J Pharm Biol Sci 2012;2:317-27.
9. Mahanjit Konawar, Pranab Kumar Paul, Swarnamoni Das. Prescribing pattern of antihypertensive drugs in essential hypertensive in medicine outpatient department in a tertiary care hospital. Asian J Pharm Clin Res 2014;7:143-4.
10. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The 7th report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. U. S. Department of health and human services; 2003.
11. Mirza Atif Beg, Shaktibala Datta, Amit Varma, Ravi Kant. Drug prescribing pattern in hypertensive patients in a tertiary care teaching hospital at dehradun. Int J Med Sci Public Health 2014;3:923-6.
12. J Keerthi Sagar, S Narendranath, HS Soma Sankar, SR Reshma, Susheela Somppa Hallemani. Prescribing pattern of antihypertensive in patient with coexisting DM. Int J Curr Biomed Pharm Res 2012;2:300-3.
13. YN Clement, S Ali, S Harripaulsingh, K Lacaille, O Mohmmed. Drug prescribing for hypertension at primary healthcare facilities in trinidad. West Med Indian J 2012;61:45-7.
14. Alam K, Mishra P, Madhu M, Shankar PR. A study of rational prescribing and dispensing in outpatients in a tertiary care teaching hospital of western Nepal. Kathmandu University Med J 2006;4:436-43.
15. Popuri Rupa sindhu. Study of prescription pattern of antihypertensive drugs in south India. Int J Adv Technol 2013;2:295-311.