An assessment of antihypertensive drug prescription patterns and adherence to joint national committee-8 hypertension treatment guidelines among hypertensive patients attending a tertiary care teaching hospital

Rakesh Romday, Ajay Kumar Gupta, Pawan Bhambani


Background: The new guidelines issued by the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC-8) emphasize that aggressive blood pressure (BP) control is essential to reducing morbidity and mortality. Patient non-adherence is a serious obstacle to the effective treatment of many acute and chronic disorders. Successful treatment and outcome of a chronic disease such as hypertension depend on many factors, including resources (e.g., funds, space, and people), avoidance of serious adverse events, patient adherence with treatment plans, and the availability of effective therapies. The aim of this study is to assess the antihypertensive drug prescription patterns and adherence to joint national committee (JNC-8) hypertension (HT) treatment recommendations among hypertensive patients attending a tertiary care teaching hospital.

Methods: An observational and cross-sectional prospective prescription audit study was carried over a period of 1 year in ambulatory patients attending medicine OPD. A total of 500 prescriptions prescribed to diagnose HT were analyzed. Drug prescription patterns, and their adherence to JNC-8 report was assessed.

Results: Out of 500 patients, 299 (59.8%) were male and 201 (40.2%) were female. Mean age of male and female patients were found to be 57.68±15.32 and 61.29±12.65 years respectively. As per present study, most of the physicians prescribed single drug (monotherapy, 34.6%) to control BP followed by two-drug combination (18.4%), three-drug combination (11.8%) and four-drug combination (3%). Two drugs regimen was prescribed in 18.4% of the hypertensive patients. Angiotensin receptor blocker + diuretic combination (4.4%) was mostly used in two drug combination therapy followed by Angiotensin receptor blockers + Diuretics (3.6%) and Calcium channel blocker + ACEIs combination (2.6%). No combination of ACEIs + ARBs was prescribed in any prescription. The overall rate of adherence was 16.5 % (Pre-hypertension); 87.90% (Stage 1 hypertension); and 68.20% (Stage 2 hypertension).

Conclusions: In conclusion, present study demonstrated that physicians are not completely adhering to standard guidelines while treating hypertension with comorbid conditions.



Adherence, Anti-hypertensive drugs, Hypertension, Joint national committee-8 guidelines, Prescription patterns

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