A study evaluating knowledge, attitude and practices of practitioners in the medicine department of tertiary care teaching rural hospital with respect to antihypertensives

Jatin Patel, Andrew Mark, Sanjay K. Date

Abstract


Background: The aim of this study was to evaluate knowledge, attitude and practices of practitioners in the medicine department of tertiary care teaching rural hospital with respect to antihypertensives and find out the disparity between the recommended and actual practices for pharmacological management.

Methods: It was survey type of study, carried out using feedback questionnaire related to use of antihypertensives. Total 25 consultants were included in the study.

Results: It was found that in mild hypertension single drug and two drugs in combination were preferred by 15 and 10 practitioners respectively. In moderate hypertension single drug, two drugs in combination, and greater than two drugs were preferred by 3, 13, and 7 practitioners respectively. In severe hypertension two drugs in combination and greater than two drugs were preferred by 16 and 9 practitioners respectively; none preferred single drug. Angiotensin converting enzyme inhibitors /angiotensin receptor blockers, beta blockers, Calcium channel blockers, diuretics were preferred as first line drug by 7, 4, 8, and 16 practitioners respectively. Most commonly preferred combination was Losartan and amlodipine by 16 practitioners. In pregnancy nifedipine was preferred as the first line drug while in elderly diuretics were preferred. In hypertensive patients with age less than 40 years all practitioners preferred ACEIs/ARBs. In diabetics ACEIs/ARBs was preferred by all practitioners. Each practitioner claimed to follow Joint National Committee (JNC) 7 criteria. Cost of drug was an important consideration in all their prescribing patterns.

Conclusion: The knowledge, attitudes and practices followed by the practitioners of Dhiraj hospital were satisfactory and guidelines oriented.

 


Keywords


Hypertension, Antihypertensives, JNC 7, Tertiary care practitioners

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References


Johnston A, Stafylas P, Stergiou GS. Effectiveness, safety and cost of drug. Br J Clin Pharmacol. 2010:70(1);320-34.

Tripathi KD. Antihypertensive drugs. In: Tripathi KD, eds. Essentials of Medical Pharmacology, 6th ed. New Delhi: Jaypee Brothers Medical Publishers; 2009: 539-573.

Kearney PM, Whelton M, Reyonolds K. Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-23.

Khan NA, Hemmelgarn B, Herman RJ, Rabkin SW, McAlister FA, Bell CM, et al. Canadian hypertension education program. Can J Cardiol. 2008;24(6):465-75.

Kale A, Maniyar YA. Prescribing patterns of antihypertensive drugs in a tertiary care hospital. Sch Acad J Pharm. 2013;2(5):416-8.

Kaur S, Gupta S, Kumar D, Lal M, Gilani Z. Prescribing pattern of antihypertensive drugs in a tertiary care hospital in Jammu: a descriptive study. JK-Practitioner. 2012;17(4):38-41.

Johnson ML, Singh H. Patterns of antihypertensive therapy among patients with diabetes. J Gen Intern Med. 2005;20:842-6.

Stokes GS. Management of hypertension in the elderly patient. Clinical interventions in aging. Dove Press. 2009;7:379-89.

NHLBI Hypertension Guidelines. JNC VIII guidance, 2014. Available at: http://www.nhlbi.nih.gov/guidelines/hypertension/jnc8full.htm.

Clinical Pharmacology Unit. Guidelines for the management of hypertension. University of Cambridge. Available at: http://www.clinpharm.medschl.cam.ac.uk/public/BPGuidelines.pdf. Accessed 7 November 2014.