scholarly journals Prescribing patterns of antihypertensive medications and blood pressure control among hypertensive patients in a primary care setting in Malaysia

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Jun-Ming Ng ◽  
Kok Pim Kua ◽  
Shaun Wen Huey Lee
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Control ◽  
Primary Care Clinic ◽  
Care Facility ◽  
Pressure Control ◽  
Prescribing Patterns ◽  
Antihypertensive Medications ◽  
Care Clinic ◽  
Utilisation Data

Aims: This study aims to describe the prescribing patterns of antihypertensive medications and short term outcomes of these patients, defined as repeat blood pressure measurements by a medical professional within 6 months, in a primary care facility in Puchong, located within the state of Selangor in Malaysia. Methods: This study was a cross-sectional, retrospective analysis of patients with essential hypertension, aged 18 and above, with blood pressure recorded at least twice within a 6-month period in an urban primary care clinic in Malaysia. Patients with history of co-morbidities were excluded. The prescribing patterns of antihypertensive medications and proportion of patients who achieved blood pressure control of less than 140/90 mmHg were ascertained. Results: A total of 200 prescriptions were analysed, including 52.5% females taking a mean of 1.7 (0.7) antihypertensive medications with a mean age of 57.9 (12.4) years. Most of the patients were prescribed either a single medication (n=90, 45.0%) or two medications (n=90; 45.0%) to control their blood pressure. Only 20 patients (10.0%) were prescribed three antihypertensive medications. A total of 127 (63.5%) patients met the blood pressure target of less than 140/90 mmHg. All participants exhibited a significant drop in systolic blood pressure, reducing from 143.0 (16.0) mmHg at baseline to 135.3 (14.8) mmHg at the end of 6 months (p<0.001). Diastolic blood pressure also decreased significantly from 83.5 (11.7) mmHg at baseline to 79.0 (10.2) mmHg at the end of 6 months (p<0.001). The choice of antihypertensive medications by the prescribers was compliant with the hypertension guidelines of Malaysia. Conclusion: The most commonly prescribed antihypertensive class was calcium channel blockers. Significant reduction in blood pressure was observed in patients from baseline to the follow-up visit. Further research of larger sample size and longer monitoring period is necessary to provide more robust epidemiology and drug utilisation data.

scholarly journals Effect of Home Telemonitoring on Glycemic and Blood Pressure Control in Primary Care Clinic Patients with Diabetes

2014 ◽  
Vol 20 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Bonnie J. Wakefield ◽  
Richelle J. Koopman ◽  
Lynn E. Keplinger ◽  
Marilee Bomar ◽  
Beth Bernt ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Control ◽  
Primary Care Clinic ◽  
Pressure Control ◽  
Care Clinic ◽  
Home Telemonitoring ◽  
Patients With Diabetes

scholarly journals Compliance with the Prescription of Antihypertensive Medications and Blood Pressure Control in Primary Care

2017 ◽  
Author(s):  
Mayra Faria Novello ◽  
Maria Luiza Garcia Rosa ◽  
Ranier Tagarro Ferreira ◽  
Icaro Gusmão Nunes ◽  
Antonio José Lagoeiro Jorge ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Antihypertensive Medications

scholarly journals Experiences and Beliefs of Low‐Income Patients with Hypertension in Louisiana and Mississippi during the COVID‐19 Pandemic

2020 ◽  
Author(s):  
Katherine T. Mills ◽  
Erin Peacock ◽  
Jing Chen ◽  
Amanda Zimmerman ◽  
Hua He ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Primary Care Clinic ◽  
Treatment Strategies ◽  
Pressure Control ◽  
Healthcare Services ◽  
Poverty Level ◽  
Antihypertensive Medications ◽  
Patient Centered ◽  
Care Clinic

Abstract Background The coronavirus disease 2019 (COVID‐19) pandemic disproportionately affects individuals with hypertension and health disparities. Methods and Results We assessed experiences and beliefs of low‐income and minority patients with hypertension during the COVID‐19 pandemic. Participants (N=587) from the Implementation of Multifaceted Patient‐Centered Treatment Strategies for Intensive Blood Pressure Control (IMPACTS‐BP) study completed a telephone survey in May and June of 2020. Participants were 65.1% Black, 59.7% female, and 57.7% reported an income below the federal poverty level. Overall, 2.7% tested positive and 15.3% lost a family member or friend to COVID‐19. These experiences were significantly more common in Black (3.9% and 19.4%, respectively) than in non‐Black participants (0.5% and 7.8%, respectively). Further, 14.5% lost a job and 15.9% reported food shortages during the pandemic. Most participants complied with stay‐at‐home orders (98.3%), social distancing (97.8%), and always wearing a mask outside their home (74.6%). Participants also reported high access to needed healthcare (94.7%) and prescription medications (97.6%). Further, 95.7% of respondents reported that they continued to take their regular dosage of antihypertensive medications. Among the 44.5% of participants receiving a healthcare appointment by telehealth, 96.6% got the help they needed, and 80.8% reported that the appointment quality was as good as or better than in‐person visits. Finally, 88.9% were willing to return to their primary care clinic. Conclusions These data suggest that low‐income patients, especially Black patients, were negatively impacted by COVID‐19. However, most patients were able to access needed healthcare services and were willing to return to their primary care clinic for hypertension management.

Determinants of adherence to antihypertensive treatment among patients attending a primary care clinic with limited medical armamentarium in Delhi, India: A qualitative study

2020 ◽  
pp. 174239532095941
Author(s):  
Saurav Basu ◽  
Kajok Engtipi ◽  
Rajesh Kumar
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Care Center ◽  
Primary Care Clinic ◽  
Care Facility ◽  
Pressure Control ◽  
Organ Damage ◽  
Uncontrolled Hypertension ◽  
Primary Care Center ◽  
Care Clinic

Objective To determine perspectives on reasons for non-adherence to antihypertensive therapy and its socioeconomic determinants among patients attending a primary care center in a low-income area in Delhi, India. Methods We conducted in-depth interviews with a total of 30 patients having hypertension at a primary care facility located in a low-income urban area in Delhi. Results All the participants were aware that hypertension was a serious illness, and medication intake was necessary throughout life to prevent uncontrolled hypertension. All participants in varying quantities practiced salt restriction, but the consumption of fresh fruit and vegetables was low primarily due to economic reasons. The participants were unable to differentiate the concept of exercise from physical activity. Medication adherence was suboptimal, and significant reasons for non-adherence were forgetfulness, carelessness and running out of drug stocks. Blood pressure control was also suboptimal in a majority of the participants, but combination therapy was restricted due to limited medical armamentarium at the clinic. Laboratory investigations for monitoring target end-organ damage were either delayed or not conducted in most participants. Discussion Hypertensive patients undergoing treatment at primary care facilities often report suboptimal medical adherence and treatment outcomes, with socioeconomic causes being a major driver of non-adherence.

scholarly journals Is the Association between Herbal Use and Blood-Pressure Control Mediated by Medication Adherence? A Cross-Sectional Study in Primary Care

2021 ◽  
Vol 18 (24) ◽  
pp. 12916
Author(s):  
Phaviga Thangsuk ◽  
Kanokporn Pinyopornpanish ◽  
Wichuda Jiraporncharoen ◽  
Nida Buawangpong ◽  
Chaisiri Angkurawaranon
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Medication Adherence ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Clinic ◽  
The Past

Herbs have been used worldwide for many health conditions as an alternative treatment, including hypertension. Their use might affect the use of conventional medications, as well as blood-pressure control. This study aims to determine whether the potential associations between herb use and high blood pressure in hypertensive patients was mediated by medication adherence. A cross-sectional study was conducted using questionnaires and available medical databases at a primary care clinic of a tertiary hospital in Chiang Mai, Thailand. The data were collected from 450 patients with essential hypertension. Drug adherence was assessed by the Morisky Green Levine Medication Adherence Scale. The history of herbs used in the past three months was obtained. The goal of controlled blood pressure was defined in accordance with the Thai guidelines on the treatment of hypertension. Of the total 450 patients, 42% had high adherence. Nearly 18% reported herb use in the past three months. High medication adherence was strongly associated with blood-pressure control when adjusted for age, gender, education, the presence of comorbidities, and herb use (aOR 26.73; 95% CI 8.58–83.23; p < 0.001). The association between herb use and blood-pressure control did not achieve statistical significance (p = 0.143). However, the adjusted odds ratio of the association between herb use and blood-pressure control was diluted from 0.67 to 0.83 when adding the factor of medication adherence to the model. In conclusion, herb use was associated with poor medication adherence, which was in turn associated with poor blood-pressure control. Assessing this information contributes to appropriate exploration and counseling.

scholarly journals SAT-558 A Dedicated Endocrine Hypertension Service Increases the Timely Diagnosis of Primary Aldosteronism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jun Yang ◽  
Yin Y Lim ◽  
Renata Libianto ◽  
Jimmy Shen ◽  
Morag Jennifer Young ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Primary Aldosteronism ◽  
Pressure Control ◽  
Organ Damage ◽  
Antihypertensive Medications ◽  
Endocrine Hypertension ◽  
Treatment Naïve ◽  
Hypertension Diagnosis ◽  
The Impact

Abstract Background: Primary aldosteronism (PA) accounts for 3.2-12.7% of hypertension in primary care but is often diagnosed late, if at all. A delayed or missed diagnosis leads to poor blood pressure control and greater cardiovascular risk that could be averted with targeted treatment. An Endocrine Hypertension Service (EHS), encompassing an education program, streamlined diagnostic tests and dedicated PA clinic, was developed to address this issue. Aims: To analyse the impact of Victoria’s first dedicated EHS on the pattern of PA diagnoses. Methods: Socio-demographic and clinical data from all patients who attended the EHS since July 2016 (N=267) was collected prospectively. Patients were divided into Year 1 (Y1), Year 2 (Y2), and Year 3 (Y3), based on their first visit. Results: The proportion of referrals from primary care increased (20% in Y1 to 52% in Y3) with more referrals being made for treatment-naive hypertension (3% in Y1 to 19% in Y3). Patients with a hypertension diagnosis of 5 years or less at the time of referral to EHS increased from 34% in Y1 to 45% in Y3 whilst the percentage of patients with a hypertension diagnosis of more than 10 years decreased from 50% in Y1 to 35% in Y3. Consistent with an earlier presentation, the proportion of patients with end-organ damage at the time of referral decreased from 44% in Y1 to 29% in Y3. Almost a third of the PA patients had unilateral disease; all of those who underwent adrenalectomy had biochemical cure. Patients with bilateral PA were treated with spironolactone. Their systolic/diastolic blood pressure decreased by 15/12 mmHg in Y1, 17/13 mmHg in Y2 and 23/11 mmHg in Y3; while the mean number of antihypertensive medications decreased from 2.9 to 1.8 in Y1, 2.7 to 2.0 in Y2 and 2.2 to 1.6 in Y3 Conclusion: The EHS has facilitated an increase in referrals for PA screening from primary care, resulting in the earlier diagnosis of PA, when less complications are present, and optimised patient outcomes. A broader uptake of such a clinical service, integrated with education outreach, will bridge the gap between the reported high prevalence of PA and the actual low diagnostic rates.

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