Drug utilization pattern of antihypertensive agents in patients of hypertensive nephropathy in a tertiary care hospital: a cross sectional study
Keywords:Drug utilization, Hypertensive, Monotherapy, Prescriptions
Background: Objective of the study was to determine the drug utilization pattern of antihypertensive agents in patients of hypertensive nephropathy in a tertiary care teaching hospital.
Methods: This was a prospective observational study carried out in Index medical college and Hospital, Indore over a period of three 4 months. A total of 60 patients aged 40-79 years taking treatment for hypertension with associated nephropathy were enrolled in the study. All the relevant data were collected and drug utilization pattern of antihypertensive agents was determined. The study evaluated the percentage of use of multidrug therapy, drugs prescribed from Essential Drug List (EDL) and prescriptions with generic name. The cost of antihypertensive drugs used per day was calculated and linked with socioeconomic status of the patients.
Results: Evaluation of the prescriptions demonstrates that a total of 63.3% males and 36.7% females with mean age of 58.9±11.9 years were enrolled out of which 70% patients were on multidrug therapy while only 30% were on monotherapy. Though only 16.67% patients were prescribed generic drugs but it did not affect the economic condition of the patient as most of enrolled patients belong to upper middle class.
Conclusions: The prescriptions analysed were in accordance to guidelines of JNC-8 (Joint National Committee - 8) and most of the prescriptions were found to be rational and it also shows that management of hypertensive nephropathy needs combination therapy.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. The lancet. 2005 Jan 15;365(9455):217-23.
Yusuf S, Reddy S, Ounpuu S. Global burden of cardiovascular disease:part I: general considerations, the epidemiologic transition, risk factor, and impact of urbanisation. Circulation 2001;104(22):2746-53.
Hannedouche T, Chauveau P, Kalou F, Albouze G, Lacour B, Jungers P. Factors affecting progression in advanced chronic renal failure. Clinical nephrology. 1993 Jun;39(6):312-20.
Stojceva-Taneva O, Selim G, Stojkovski L, Lvanovski N. Hypertension and progression of nephropathy in diabetic and non-diabetic chronic kidney disease patients. Hippokratia 2007 Apr-Jun;11(2):72-6.
Vibert GC, Earle K. Predisposition to essential hypertension and the development of diabetic nephropathy. J Am Soc Nephrol. 1992;3:S27-33.
Alan H, Gradman MD, Celso Acevedo MD. Evolving strategies for the use of combination therapy in hypertension. Current hypertension reports. 2002;4(5):343-9.
Kalra S, Kalra B, Agarwal N. Combination therapy in hypertension:An update. Diabetology and metabolic Syndrome. 2010;2:44.
Datta S, Sharma C. Prescribing patterns of antihypertensives in patients having comorbid ischemic heart disease: study in a tertiary care hospital. J Pharm Res. 2010;3:2142-4.
Datta S. Use of antihypertensive 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.
Almas A, Salik RI, Ehtamsm A, Khan AH. Spectrum of antihypertensive therapy in south Asians at a tertiary care hospital in Pakiustan. BMC Res Notes. 2011;4:318.
Pepine CJ, Handberg EM, Cooper-DeHoff RM, Marks RG, Kowey P, Messerli FH, et al. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease: the International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA. 2003 Dec 3;290(21):2805-16.