Previously submitted to: JMIR Cardio (no longer under consideration since Mar 04, 2020)
Date Submitted: Nov 1, 2019
Open Peer Review Period: Nov 1, 2019 - Dec 27, 2019
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medical prescription pattern and extent of control of essential hypertension in hypertensive patients attending Ndola Central Hospital outpatient clinic:cross sectional study
Medical prescription pattern of essential hypertension is very important because it helps to observe the prescribing attitude of physicians with the aim of rational use of drugs based on the WHO guidelines. Antihypertensive drugs in the treatment of essential hypertension is classified as monotherapy or (polypharmacy). Single therapy are mostly used as the initial therapy. Recognition of adverse drug reactions, drug - disease interactions, cautions and contra-indications are all important when prescribing antihypertensive therapy. High blood pressure is the leading health problem and the most common cardiovascular disease such as ischemic heart disease, heart failure, stroke, chronic renal insufficiency which results in high morbidity and mortality worldwide if poorly controlled.
To determine the prevalence of controlled hypertension to uncontrolled hypertension Determine the most prescribed therapy between monotherapy and polypharmacy. Determine percentage usage of different categories antihypertensive drug Determine the prevalence of awareness of complications of poor control of essential hypertension
The cross section study was conducted at Ndola central hospital. The study is designed to have a sample size of 160 participants at an estimated cost of K1, 300. The study will be conducted within 6 month
In all the patient N=160, the blood pressure was well controlled in N=138 (86.3%), while in N=22 (13.8%) it was not well controlled. In all the participants were N=160, most of the participants N=111 (69.45%) were prescribed polypharmacy were N=49 (30.6%) of the patient were prescribed monotherapy. Amongst hypertensive drugs the most prescribed monotherapy was Nifedipine N=30 (18.8%). Which is calcium bloker. Followed by enalapril N=13 (8.1%) which is angiotensin converting enzyme inhibitor. The least was Lasix N=3 (1.9%). On the polypharmacy the most prescribed was Nifedipine plus Analopril N=36 (22.5%) which is calcium channel bloker plus angiotensin converting enzyme Inhibitors. Then nifedipine plus atenolol N=16 (10.0%). The least being Nifedipine plus Moduretics plus amylodipine plus analopril plus atenolol pus losartan N=6 (3.8%). Which is CCB+ACEIs+ARB+Diuretics. In all the participants were N=160, of which 117 (73.1%) participants were aware of complications associated to poor control of essential hypertension. Only 43(26.9%) were not aware of complications associated to poor control of essential hypertension.
This study reviewed the prevalence of controlled was 86%. In which both sex had good BP control. However there was increase in incidence of BP with age. Poly pharmacy was the frequently prescribed medication in this study with prevalence of 69% of which the most prescribed poly pharmacy was CCB+ACEIs specifically Nifedipine +Enalapril (22%). While the frequently prescribed monotherapy was CCB specifically Nifedipine. Followed by ACEIs Enalapril. In relation to age Nifedipine was commonly used in older patients while Enalapril was commonly prescribed in young adults. The prevalence of awareness of complication associated to poor control of essential hypertension was 73% of which the most know complication was stroke and heart failure With all this done, the objectives of this study can therefore be said to have been met as the study succeeded in determining the prescription pattern and extent control of essential hypertension at Ndola Teaching Hospital outpatient clinic.
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