Medication use practices and inspection of returned pills during follow-up attendance at a tertiary care hypertension clinic in Nigeria

Background: Medication use practices in the treatment of hypertension (HTN) have been shown to determine outcomes. This study characterizes the profile of medication practices by hypertensive patients attending a tertiary health-care facility in Nigeria. Materials and Methods: This was a cross-sectional study in the outpatient HTN clinic of a tertiary hospital in southern Nigeria. Hypertensive patients seen during routine clinic visits were given the usual clinic instructions and requested to come with all medicines including herbal medications in their possession at their subsequent visits. A semi-structured observer-administered questionnaire was used to document all information sought and on medicines inspected. Data collected were analyzed and presented descriptively. Results: A total of 509 patients were recruited into the study (M:F ratio 1:2.2) aged 22–97 years. The mean(SD) number of all medicines used by the patients was 5.5 ± 2.While the mean(SD) number of antihypertensive medicines was 2.9 ± 1.3 with 75 patients (14.8%), 135 (26.6%), 144 (28.3%) and 154 (30.3%) on 1, 2, 3, and 4 or more antihypertensive medicines respectively. Calcium channel blocker was the most used antihypertensive medicine, 350 (68.8%). Of interest, was the use in 68 (13.4%) patients of unprescribed herbal medicines. A number of patients, i.e., 205 (40.2%) had discrepancy between their prescribed medicines and that presented to the clinic. This included the use of nonprescribed medicines, including analgesics (35%), vitamins (28.1%), nonsteroidal anti-inflammatory drugs (17.1%), and food supplements (6.8%). Conclusion: This study highlights the profile of antihypertensive medication use, revealing the significant use of nonprescribed medicines and factors likely to influence outcomes of therapy. It further underscores the importance of careful inspection during clinic attendance of all medication being taken by the patient