DRUG UTILISATION STUDY IN THE TREATMENT OF HYPERTENSION IN A TERTIARY CARE HOSPITAL

BACKGROUND Hypertension, a common clinical problem is considered as an ‘iceberg disease’ because its unknown morbidity far exceeds the known morbidity. In terms of attributable deaths, it is one of the leading behavioural and physiological risk factors amounting to 13% of global deaths. Drug selection is based on efficacy in lowering BP (blood pressure) and in reducing Cardiovascular (CV) endpoints like stroke, myocardial infarction and heart failure. This study was carried out to evaluate the pattern, extent, rationality and frequency of the use of antihypertensive drugs in the treatment of hypertension. The aim of the study is to analyse drug utilisation in the treatment of hypertension in a tertiary care hospital. MATERIALS AND METHODS This study was conducted during January 2014 to December 2015 in Medicine OPD (Outpatient Department) in a tertiary care hospital. The sample size was selected as per the WHO recommendations on conducting Drug Utilisation Studies (DUS). Statistical Analysis- The collected data was numerically coded and entered in Microsoft Excel 2007 and analysed by SPSS version 16. Settings and Design- Prospective, cross-sectional, observational study. RESULTS Out of 612 patients, 262 (42.81%) were in the age group of 60 and above. Considering gender distribution, 328 (53.59%) were males and 284 (46.41%) were females. Of these, 274 (44.78%) were prescribed monotherapy, 256 (41.83%) were prescribed two-drug therapy, 72 (11.76%) were prescribed three-drug therapy and 10 (1.63%) were prescribed four-drug therapy. Among 274 (44.78%) patients prescribed with monotherapy, 112 (40.87%) were prescribed with CCB (calcium channel blocker), 76 (27.73%) were given BB (B-blocker), 45 (16.42%) were prescribed ACEI (angiotensin converting enzyme inhibitor), 35 (12.77%) were prescribed with ARB (angiotensin receptor blocker) and 6 (2.18%) were prescribed with Diuretics (D). Of the total antihypertensive drugs prescribed, 68.30% were prescribed by generic name, while 25.98% were prescribed as FDCs (fixed drug combination) and 39.05% of antihypertensive drugs were from NLEM (national list of essential medicine). Average number of drugs prescribed per encounter in our study was 2.42, while number of antihypertensive drugs per encounter were 1.34. CONCLUSION The findings of our study suggest that majority of prescriptions had generic names of the drugs. Improving practitioners’ knowledge and attitude in rational prescribing can prove to be a cornerstone in achieving rational use of antihypertensive drugs