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Prescription Pattern and Potential Drug-Drug Interactions of Antihypertensive Drugs in a General Hospital, South Ethiopia

Year 2015, , 698 - 706, 02.10.2015
https://doi.org/10.17826/cutf.44400

Abstract

Purpose: Selection and use of anti-hypertensive agents are not usually compliant with international guidelines. A prescription based survey is the most effective method to assess and evaluate the prescribing pattern of physicians and dispensing practice of pharmacists; hence, the aim of this study was to assess the prescription pattern of antihypertensive drugs in Durame General Hospital. Material and Methods: A retrospective study was carried out from January to February, 2013 on one year patient cards. Records of 250 patients were selected by simple random sampling technique. However, since some of prescriptions are illegible and incomplete, 205 patient records were included in the study. Results: Out of 205 patients, 46 (22.44%) of them were on mono-therapy and 159 (77.56%) on combination therapy. Among patients on combination therapy, 120 (75.5%) and 39(24.5%) were on two and three drugs combination, respectively. Diuretic was the most frequently prescribed drug both as a single agent (65.22%) and as combination therapy (86.8%). Combination therapy significantly reduced blood pressure as compared to mono-therapy. The majority of co-prescribed drugs which have a potential drug interaction with anti-hypertensive agents were NSAIDs (98.21%). Conclusion: Combination therapy was the most prescribed pattern to treat hypertensive patients which is in line with international guidelines. However, majority of patients in pre-hypertensive stage were treated by combination therapy which is not recommended. Hence, physicians should consider when the combination drugs are to be prescribed for hypertensive patients.

References

  • Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, Hea J. Global burdenof hypertension: analysis of worldwide data. Lancet. 2005;365:217-23.
  • Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F. Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovasc Disord. 2013;13:54. doi: 10.1186/1471- 2261-13-54.
  • Opie LH, Seedat YK. Hypertension in sub-Saharan African populations. Circulation. 2005; 112:3562- 3568.
  • Kearney PM, Wheltona M, Reynoldsa K, Muntner P. Whelton PK and Hea J. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004;22:11-9.
  • Seedat YK. Recommendations for hypertension in sub-Saharan Africa. Cardiovasc J S Afr. 2004;15:157–8.
  • Addo J, Smeeth L, Leon DA. Hypertension in sub- Saharan Africa: a systematic review. Hypertension. 2007;50:1012-8.
  • Njelekela M, Sato T, Nara Y, Miki T, Kuga S, Noguchi T, et al., Nutritional variation and cardiovascular risk factors in Tanzania–rural-urban difference. S Afr Med J. 2003;93:295-9.
  • Twagirumukiza M, De Bacquer D, Kips JG, De Backer G, Stichele RV, Van Bortel LM. Current and projected prevalence of arterial hypertension in sub- Saharan Africa by sex, age and habitat: an estimate from population studies. J Hypertens. 2011;29:1243- 52.
  • Opie LH, Seedat YK. Hypertension in sub-Saharan African populations. Circulation. 2005;112:3562-8.
  • The World Health Report 1999: The double burden: emerging epidemics and persistent problems. Geneva: WHO; 1999. Available from: http://www.who.org/, accessed on January 2, 2013.
  • Lester FT, Oli K. Epidemiology and ecology of health and disease in Ethiopia: in chronic non-infectious diseases in Ethiopian adults, 1st Edition. Shama Books, Addis Ababa; 2006:702-19.
  • Isthma AC. Department of epidemiology and population health: Keppel Street, London school of Hygiene and topical medicine. Hypotension. 2007;50:1004-5.
  • Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 report. JAMA. 2003;289:2560-72.
  • Mancia G, De Backer G, Dominiczak A , Cifkova R, Fagard R , Germano G, et al.Guidelines for the management of arterial hypertension. Eur Heart J. 2007;28:1462-1536.
  • Yuen YH, Chang S, Chong CK, Lee SC, Critchley JA, Chan JC. Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs. J Clin Pharm Ther. 1998;23:287-94.
  • Olanrewaju TO, Aderibigbe A, Busari OA, Sanya EO. Antihypertensive drug utilization and conformity to guidelines in a sub-Saharan African hypertensive population. Int J Clin Pharmacol Ther. 2010;48:68-73.
  • Nnaemeka RO, Kingsley CN. Assessment of patient’s antihypertensive medication adherence level in non-comorbid hypertension in a tertiary hospital in Nigeria. Int J Pharm Biomed Sci. 2012;3:47-54.
  • Al-Drabah1 E, Irshaid Y, Yasein N, Zmeili S. Prescription pattern of antihypertensive drugs in Family Practice Clinics at Jordan University Hospital. Med-Science. 2013;2:469-88.
  • James SA, Delonel BJ. Types of hypertension and cause of hypertension, Texas. J Pharmacol Exp Therapeut. 2005;71:306-15.
  • Yusuff KB and Blogun O. Physician prescription of antihypertensive combination in the tertiary care setting in the south western Nigeria, Ibadan Nigeria. J Pharm Pharmaceut Sc. 2005;8:235-42.
  • Isezuo AS, Njoku CH. Blood pressure control among hypertensive managed in a specialized health care setting in Nigeria. Afr J Med Med Sci. 2003;32:65- 70.35-242.
  • Gavras I, Rosenthal T. Combination therapy as first- line treatment for hypertension. Curr Hypertens Rep. 2004;6:267-72.
  • Martin J. Hypertension Guidelines: Revisiting the JNC 7 Recommendations. J Lanc Gen Hosp. 2008;3:91-7.
  • Etuk E, Isezuo SA, Chika A, Akuche J and Ali M. Prescription pattern of anti-hypertensive drugs in a tertiary health institution in Nigeria. Ann Afr Med. 2008;7:128-132.
  • Douglas JG, Bakris GL, Epstein M, Ferdinand KC, Ferrario C, Flack JM, et al. Management of high blood pressure in African Americans: consensus statement of the Hypertension in African Americans. Working Group of the International Society on Hypertension in Blacks. Arch Intern Med. 2003;163:525-41.
  • Report of the Joint National Committee on detection, Evaluation, and Treatment of High Blood Pressure: a cooperative study. JAMA. 1977;237:255-61.
  • ShahS U, Anjum S,Littler WA. Use of diuretics in cardiovascular disease: hypertension: A Review. Postgrad Med J. 2004;80:271-6.
  • Walley T, Duggan AK, Haycox AR, Niziol CJ. Treatment for newly diagnose hypertension: patterns of prescribing and antihypertensive effectiveness in the UK. J R Soc Med. 2003;96:525-31.
  • Polónia J. Interaction of antihypertensive drugs with anti-inflammatory drugs. Cardiology. 1997;88:47-51.
  • Fournier JP, Sommet A, Durrieu G, Poutrain JC, Lapeyre-Mestre M, Montastruc JL. Drug interactions between antihypertensive drugs and non-steroidal anti-inflammatory agents: a descriptive study using the French Pharmacovigilance database. Fundam Clin Pharmacol. 2014;28:230-5.
  • Morgan T, Anderson A. The effect of non steroidal anti-inflammatory drugs on blood pressure in patients treated with different antihypertensive drugs. J Clin Hypertens. 2003;5:53-7.
  • Harper R, Atkinson AB and Bell PM. Should we use thiazide diuretics in hypertensive patients with non- insulin-dependent diabetes mellitus? QJ Med. 1996;89:477-82.
  • Gugler R, Allgayer H. Effects of antacids on the clinical pharmacokinetics of drugs. Clin Pharmacokin. 1990;18:210-9.

Bir Güney Etiyopya Devlet Hastanesinde Antihipertansif İlaçların Potansiyel İlaç-İlaç Etkileşimi ve Reçete Yazma Modelleri

Year 2015, , 698 - 706, 02.10.2015
https://doi.org/10.17826/cutf.44400

Abstract

Amaç: Antihipertensif ajanların seçimi ve kullanımı genellikle uluslararası yönergeler ile uyumludur. araştırmaya dayalı ilaç yazma, hekimlerin ilaç yazma şeklini ve eczacıların ilaç hazırlama çalışmasını değerlendirme ve belirlemek için en etkili metoddur, böylece bu çalışmanın amacı, Durame Devlet hastanesinde anti-hipertensif ilaçların ilaç yazma şeklini belirlemekti. Materyal ve Metod: Geriye yönelik bir çalışma yıllık hasta dosyaları üzerinde 2013 ocak ayından şubat ayına kadar yapıldı. 250 hastanın kaydı basit rastgele örneklem tekniği ile seçildi. ancak bazı reçeteler okunaksız ve eksik olduğu için, 205 hasta kaydı çalışmaya dahil edildi. Bulgular: 205 hastanın 46'sı (%22.44) mono terapi altındayken, 159'u (%77.56) birleşik tedavi altındaydı. birleşik tedavi altında olanlar arasında 120'si (%75.5) ve 39'u (%24.5) sırasıyla 2 ve 3 ilacı birlikte almaktaydı. diüretik hem tekli ajan tedavisinde (%65.22) hem de birleşik tedavide (%86.8) en sık reçetelenen ilaçtı. birleşik terapi, tekli terapi ile karşılaştırıldığında kan basıncını önemli derecede azalttı. antihipersensitif ajanlar ile ilaç etkileşiminde olan birlikte yazılan ilaçların büyük çoğunluğu NSAID'lardı.( %98.21). Sonuç: Yüksek tansiyonlu hastaları tedavi etmek için, birleşik tedavi uluslararası yönerge ile uyumlu olan en çok yazılan reçete şeklidir. ancak, ön hipertensif aşamadaki hastaların çoğu, tavsiye edilmeyen birleşik terapi ile tedavi edildi. böylece doktorlar birleşik ilaçların yüksek tansiyonlu hastalar için yazmak üzerinde olduklarında göz önünde bulundurmalılar.

References

  • Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, Hea J. Global burdenof hypertension: analysis of worldwide data. Lancet. 2005;365:217-23.
  • Kayima J, Wanyenze RK, Katamba A, Leontsini E, Nuwaha F. Hypertension awareness, treatment and control in Africa: a systematic review. BMC Cardiovasc Disord. 2013;13:54. doi: 10.1186/1471- 2261-13-54.
  • Opie LH, Seedat YK. Hypertension in sub-Saharan African populations. Circulation. 2005; 112:3562- 3568.
  • Kearney PM, Wheltona M, Reynoldsa K, Muntner P. Whelton PK and Hea J. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004;22:11-9.
  • Seedat YK. Recommendations for hypertension in sub-Saharan Africa. Cardiovasc J S Afr. 2004;15:157–8.
  • Addo J, Smeeth L, Leon DA. Hypertension in sub- Saharan Africa: a systematic review. Hypertension. 2007;50:1012-8.
  • Njelekela M, Sato T, Nara Y, Miki T, Kuga S, Noguchi T, et al., Nutritional variation and cardiovascular risk factors in Tanzania–rural-urban difference. S Afr Med J. 2003;93:295-9.
  • Twagirumukiza M, De Bacquer D, Kips JG, De Backer G, Stichele RV, Van Bortel LM. Current and projected prevalence of arterial hypertension in sub- Saharan Africa by sex, age and habitat: an estimate from population studies. J Hypertens. 2011;29:1243- 52.
  • Opie LH, Seedat YK. Hypertension in sub-Saharan African populations. Circulation. 2005;112:3562-8.
  • The World Health Report 1999: The double burden: emerging epidemics and persistent problems. Geneva: WHO; 1999. Available from: http://www.who.org/, accessed on January 2, 2013.
  • Lester FT, Oli K. Epidemiology and ecology of health and disease in Ethiopia: in chronic non-infectious diseases in Ethiopian adults, 1st Edition. Shama Books, Addis Ababa; 2006:702-19.
  • Isthma AC. Department of epidemiology and population health: Keppel Street, London school of Hygiene and topical medicine. Hypotension. 2007;50:1004-5.
  • Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 report. JAMA. 2003;289:2560-72.
  • Mancia G, De Backer G, Dominiczak A , Cifkova R, Fagard R , Germano G, et al.Guidelines for the management of arterial hypertension. Eur Heart J. 2007;28:1462-1536.
  • Yuen YH, Chang S, Chong CK, Lee SC, Critchley JA, Chan JC. Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs. J Clin Pharm Ther. 1998;23:287-94.
  • Olanrewaju TO, Aderibigbe A, Busari OA, Sanya EO. Antihypertensive drug utilization and conformity to guidelines in a sub-Saharan African hypertensive population. Int J Clin Pharmacol Ther. 2010;48:68-73.
  • Nnaemeka RO, Kingsley CN. Assessment of patient’s antihypertensive medication adherence level in non-comorbid hypertension in a tertiary hospital in Nigeria. Int J Pharm Biomed Sci. 2012;3:47-54.
  • Al-Drabah1 E, Irshaid Y, Yasein N, Zmeili S. Prescription pattern of antihypertensive drugs in Family Practice Clinics at Jordan University Hospital. Med-Science. 2013;2:469-88.
  • James SA, Delonel BJ. Types of hypertension and cause of hypertension, Texas. J Pharmacol Exp Therapeut. 2005;71:306-15.
  • Yusuff KB and Blogun O. Physician prescription of antihypertensive combination in the tertiary care setting in the south western Nigeria, Ibadan Nigeria. J Pharm Pharmaceut Sc. 2005;8:235-42.
  • Isezuo AS, Njoku CH. Blood pressure control among hypertensive managed in a specialized health care setting in Nigeria. Afr J Med Med Sci. 2003;32:65- 70.35-242.
  • Gavras I, Rosenthal T. Combination therapy as first- line treatment for hypertension. Curr Hypertens Rep. 2004;6:267-72.
  • Martin J. Hypertension Guidelines: Revisiting the JNC 7 Recommendations. J Lanc Gen Hosp. 2008;3:91-7.
  • Etuk E, Isezuo SA, Chika A, Akuche J and Ali M. Prescription pattern of anti-hypertensive drugs in a tertiary health institution in Nigeria. Ann Afr Med. 2008;7:128-132.
  • Douglas JG, Bakris GL, Epstein M, Ferdinand KC, Ferrario C, Flack JM, et al. Management of high blood pressure in African Americans: consensus statement of the Hypertension in African Americans. Working Group of the International Society on Hypertension in Blacks. Arch Intern Med. 2003;163:525-41.
  • Report of the Joint National Committee on detection, Evaluation, and Treatment of High Blood Pressure: a cooperative study. JAMA. 1977;237:255-61.
  • ShahS U, Anjum S,Littler WA. Use of diuretics in cardiovascular disease: hypertension: A Review. Postgrad Med J. 2004;80:271-6.
  • Walley T, Duggan AK, Haycox AR, Niziol CJ. Treatment for newly diagnose hypertension: patterns of prescribing and antihypertensive effectiveness in the UK. J R Soc Med. 2003;96:525-31.
  • Polónia J. Interaction of antihypertensive drugs with anti-inflammatory drugs. Cardiology. 1997;88:47-51.
  • Fournier JP, Sommet A, Durrieu G, Poutrain JC, Lapeyre-Mestre M, Montastruc JL. Drug interactions between antihypertensive drugs and non-steroidal anti-inflammatory agents: a descriptive study using the French Pharmacovigilance database. Fundam Clin Pharmacol. 2014;28:230-5.
  • Morgan T, Anderson A. The effect of non steroidal anti-inflammatory drugs on blood pressure in patients treated with different antihypertensive drugs. J Clin Hypertens. 2003;5:53-7.
  • Harper R, Atkinson AB and Bell PM. Should we use thiazide diuretics in hypertensive patients with non- insulin-dependent diabetes mellitus? QJ Med. 1996;89:477-82.
  • Gugler R, Allgayer H. Effects of antacids on the clinical pharmacokinetics of drugs. Clin Pharmacokin. 1990;18:210-9.
There are 33 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Fanta Fufa This is me

Dereje Mirkano This is me

Ramenjiredi Tipathi This is me

Publication Date October 2, 2015
Published in Issue Year 2015

Cite

MLA Fufa, Fanta et al. “Prescription Pattern and Potential Drug-Drug Interactions of Antihypertensive Drugs in a General Hospital, South Ethiopia”. Cukurova Medical Journal, vol. 40, no. 4, 2015, pp. 698-06, doi:10.17826/cutf.44400.