Patterns of Antihypertensive Drug Utilization in a West Indies University Teaching Hospital

Abstract

Objective of this study was to determine the prescribing patterns of antihypertensive medications in specialty outpatient clinics in a tertiary care hospital of a Caribbean developing country. A retrospective prescription-based survey was conducted in the renal and cardiac outpatient clinics during the period September to December 2006. Data recorded included demographic data, antihypertensive and other drugs prescribed, duration of prescription, adverse drug reactions and side effects. A total of 285 patients were included in the study. Diuretics (30%) were the most commonly prescribed antihypertensive agents followed by angiotensin converting enzyme inhibitors (ACEIs) (26%), beta-adrenoceptor blocking agents (16.6%) and calcium channel blocking agents (CCBs) (14.8%). Overall, 74 patients (26%) had a good control of their blood pressure. 154 patients (54%) had diabetes mellitus along with hypertension, of which, 36 patients (12.6%) had an adequate control. Forty patients (14%) were on monotherapy and 245 patients (86%) were on two or more drugs. Thirteen patients were on two-drug, 21 on three-drug, 15 on four-drug, seven on five-drug, four on six-drug antihypertensive combinations. The most common two-drug combination was an ACEI and a diuretic, followed by an ACEI and beta-adrenoceptor blocking agent. Majority of the hypertensive patients in Trinidad were on combination therapy which shows that the prescription patterns in Trinidad are adhering to the Joint National Committee (JNC VII) report of the United States.

Keywords: prescribing pattern of antihypertensive agents, combination therapy of hypertension, drug utilization, guideline adherence