Study of Prescribing Pattern and Evaluation of the Efficacy of Monotherapy vs. Polytherapy Antihypertensive Drugs in Diabetes Patients

Background: Hypertension is the leading cause of morbidity and mortality worldwide which requires long term therapy to prevent complication associated with it. As drugs are used for longer duration it is necessary to know potential undesirable effects for making the appropriate choice. Aim and objective of the study was to monitor the adverse drug reactions (ADRs) and to know prescribing pattern of antihypertensive monotherapy.Methods: The present work was an open, non-comparative, observational study conducted on seventy-three (73) hypertensive patients who were prescribed single antihypertensive drug at medical OPD of Nepalgunj Medical college by conducting patient interviews, recording the data on ADR monitoring form.Results: Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n=12), followed by diuretics (n= 6), Angiotensin converting enzyme inhibitors (n=3), β-blockers (n= 2) and Angiotensin receptor blocker (n=1). Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 10). On analysis of prescription pattern again amlodipine was most commonly prescribed antihypertensive monotherapy followed by hydrochlorothiazide.Conclusions:Amlodipine was most commonly associated with ADRs and it was also most commonly prescribed antihypertensive drugs as monotherapy. The above findings would be useful for physicians in rational prescribing.

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Trends and pattern of the utilization of cardiovascular medicines in Lithuania in 2003–2012

Acta medica Lituanica ◽

10.6001/actamedica.v21i3.2999 ◽

2014 ◽

Vol 21 (3) ◽

pp. 143-150

Author(s):

Ingrida Lisauskienė ◽

Kristina Garuolienė ◽

Jolanta Gulbinovič

Keyword(s):

Antihypertensive Drugs ◽

Renin Angiotensin System ◽

Angiotensin Converting Enzyme Inhibitors ◽

Insurance Fund ◽

Channel Blockers ◽

Prescribing Pattern ◽

Converting Enzyme Inhibitors ◽

Mortality And Morbidity ◽

High Consumption ◽

Lipid Modifying Agents

Background. Despite the wide use of cardiovascular (CV) drugs, CV diseases are still the leading cause of mortality and morbidity. Analysis of drug utilization gives a possibility to evaluate effectiveness of interventions. Materials and methods. The aim of the study was to evaluate CV medicines consumption in Lithuania in 2003–2012. Data was retrieved from the SVEIDRA database of the National Health Insurance Fund. Utilization of the following groups of CVM (ATC group C) was analyzed: C02 – antihypertensive drugs, C03 – diuretics, C07 – beta blocking agents (BBs), C08 – calcium channel blockers (CCBs), C09 – agents acting on the renin–angiotensin system, C10 – lipid modifying agents. ATC/DDD methodology was used. Data was expressed as a number of DDD per 1 000 inhabitants per day (DDD/TID). Results. Consumption of CVM went from 134.5 DDD/TID in 2003 to 352.2 in 2012. Angiotensin converting enzyme inhibitors (ACEI) were the most consumed ones (66–114.8 DDD/TID), followed by CCBs (19.4–38.8 DDD/TID) and BBs (12.5–52.6 DDD/TID).There was high consumption of antihypertensives (4.7–23.9 DDD) and low consumption of diuretics (9.4–16.9 DDD/TID) and lipid modyfing agents (0.4–7.4 DDD/TID). Increasing utilization was noticed in the angiotensin II antagonist (ARBs) group (42 DDD/TID), ACEI combinations (38.6 DDD/TID) and ARBs combinations (12.9 DDD/TID) in 2012. Conclusions. Utilization of CV medicines increased in Lithuania in 2003–2012. ACEI held the first position. An extremely low utilization of lipid modifying agents, diuretics and high consumption of alpha-receptor blockers showed the need of actions on changing the prescribing pattern of CV drugs.

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Study of prescribing pattern of antihypertensive drugs in diabetic patients in a tertiary care centre, Vizianagaram, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20192183 ◽

2019 ◽

Vol 8 (6) ◽

pp. 1192

Author(s):

Vanathi Elenchezhiyan ◽

Sachidananda Moorthy ◽

Sagar M. K. ◽

Bheemesh Naidu Mattam ◽

Suresh Babu Sayana

Keyword(s):

Combination Therapy ◽

Antihypertensive Drug ◽

Antihypertensive Drugs ◽

Tertiary Care ◽

Prescribing Patterns ◽

Diabetic Patients ◽

Care Hospital ◽

Tertiary Care Centre ◽

Prescribing Pattern ◽

Hypertensive Patients

Background: Diabetes mellitus (DM) and Hypertension (HTN) are the two major chronic disorders frequently coexisting, with increased incidence with age. HTN is about twice as common in patients with DM. Prescribing pattern are powerful tools to ascertain the role of drugs in society. There are many variations in prescribing patterns of antihypertensive drugs in patients with HTN and DM. Since these patients requires lifelong treatment it has enormously increased the burden of patients particularly in developing countries like India. Physician needs to be more concerned while choosing drugs for the patients with HTN and DM. In a tertiary care hospital, there is a real need for drug utilization study to determine the appropriate, more safe and effective patterns of drug therapy among diabetic hypertensive patients.Methods: A Cross sectional observational study was conducted in Maharajah’s Institute of Medical Sciences from December 2016 to May 2018. A total of 360 prescriptions of the patients with hypertension and coexisting diabetes were analyzed. The prescriptions prescribed to these patients were collected, assessed and the following parameters were noted. The treatment pattern of different group of drugs for HTN with co-existing DM was evaluated. The intended work was divided into three steps: Step 1: To collect the prescriptions of hypertensive patients with DM. Step 2: To separate the prescriptions prescribing anti hypertensive Drugs. Step 3: To statistically analyze the prescriptions. Relevant information was recorded in a structured proforma & data was evaluated.Results: In this study it was found that 36% of the patients were in the age group of 51-60 years with female preponderance among diabetic hypertensive patients. 77% of patients were treated with single antihypertensive drug and 23% of patients were treated with antihypertensive drug combinations. In monotherapy, telmisartan was most commonly prescribed. In combination therapy, amlodipine and telmisartan followed by amlodipine and atenolol were used.Conclusions: In this study monotherapy was preferred compared to combination therapy and adherence to the JNC 7 guidelines was good except in case of usage of diuretics.

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Prescribing pattern of antihypertensive drugs in a general hospital in central China

International Journal of Clinical Pharmacy ◽

10.1007/s11096-010-9476-8 ◽

2011 ◽

Vol 33 (2) ◽

pp. 215-220 ◽

Cited By ~ 5

Author(s):

Hong Cheng

Keyword(s):

General Hospital ◽

Antihypertensive Drugs ◽

Central China ◽

Prescribing Pattern

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Prescribing Pattern of Anti-Hypertensive Drugs and Adherence to JNC VII Guideline

Proceedings ◽

10.3390/iecehs-1-05708 ◽

2018 ◽

Vol 6 (1) ◽

pp. 11

Author(s):

Biswash Sapkota ◽

Heamant Shrestha ◽

Nischal Khatri ◽

Krishna Shrestha

Keyword(s):

Public Health ◽

Drug Utilization ◽

Antihypertensive Drugs ◽

Angiotensin Receptor Blockers ◽

Significant Risk ◽

Health Concern ◽

National Committee ◽

Age Group ◽

Prescribing Pattern ◽

Hypertensive Patients

Introduction: Hypertension is an important public health concern because of its associated morbidity, mortality and economic impact on society. It is a significant risk factor for cardiovascular, cerebrovascular and renal complications. A number of national and international guidelines for the management of hypertension have been published. The Joint National Committee (JNC) in 2003 published a series of guidelines to recommend the appropriate antihypertensive therapy based on the best available evidence. Objectives: This drug utilization study was intended to find out the preferred drug group prescribed either alone or in combinations and their adherence to the JNC 7 guidelines. Materials and Methods: This was a prospective cross-sectional study. Drug utilization data on 100 hypertensive patients were collected from various hospitals in Nepal. The patients who received antihypertensive drugs during their treatment period in SPSS V. 16.0. The prescribed drugs were compared with JNC 7 guidelines. Results: It was found that 40% of patients were male and 60% were female. The largest subset of female hypertensive patients (45.0%) were in the age group of >60 years and a plurality of male hypertensive patients (45.0%) were in the age group of 40–60 years. It was found that 45% of the patients had Stage 1 hypertension, 32% of the patients were in prehypertension, 17% of the patients had Stage 2 hypertension. The most frequently prescribed antihypertensive drug regimens were angiotensin receptor blockers (ARBs) (32.44%), ARB + thiazide (15.94%), diuretics (11.59%), calcium channel blockers (CCBs) + beta blockers (9.42%) and CCBs (8.7%). Thirty-nine percent received monotherapy while the remaining 61% received combination therapy. Seventy-four percent of the total prescriptions followed JNC 7 guidelines. Conclusion: There is a need to follow official guidelines in managing hypertension as a chronic disease, since these guidelines are based on various clinical trials, and the successful attainment of a target BP in patients will be made much easier by implementing them. National health policymakers should consider the evaluation and treatment of hypertension as a right in the public health system for better outcomes in terms of morbidity and mortality from hypertension.

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