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Demographics And Comorbidities Associated With Hypertension And Prescription Practices By Junior House Officers For Disease Management In Relation To Clinical Guidelines

Authors

Saqib Khan
Lecturer & Research Officer, HBS College of Pharmacy, HBS Instituteof Healthcare & Allied Health Sciences, Islamabad. Department of DME, HBS Medical & Dental College, Islamabad
Muhammad Ahsan
Assistant Professor HBS College ofPharmacy, HBS Institute of Healthcare & Allied Health Sciences, Islamabad
Aysha Mushtaq
Assistant Professor Department of Physiology, HBS Medical & Dental College, Islamabad

Keywords

Comorbidity, Drug prescriptions, Guideline Adherence, Hypertension.

Abstract

Objective:
To identify the demographics and most common comorbidities associated with hypertension and evaluate the prescription practices of Junior house officers for pharmacotherapy of hypertension, focusing on standard guideline adherence.
Study Design:
Descriptive, Cross-Sectional Study.
Place and Duration of Study:
Abbottabad, 03 months( Feburary to April 2021).
Methodology:
This study was conducted on 120 hypertensive patients from the in-patient department. Demographic data, comorbidities, treatment regimens, and adherence to Joint National Committee (JNC-8) guidelines were extracted from patient charts. Descriptive statistics were used to assess associated comorbidities and adherence to guidelines.
Results:
: In our study population, hypertension is found slightly more common in males (52.5%) and in those aged 51-60 years (30%). Diabetes was the most prevalent comorbidity (41.7%) followed by Ischemic heart disease (40%). Vasodilators (66.67%), diuretics (42.50%), and beta blockers (40.83%) were the most frequently prescribed antihypertensive drugs, whereas statins (65.83%) and antiplatelets (56.67%) represented the predominant combination therapies. Only 47.5% of prescriptions complied with JNC-8 guidelines.
Conclusion:
Hypertension was commonly reported in male and old age patients. Diabetes mellitus and ischemic heart disease were the most common comorbidities. The majority of junior house officer’s prescriptions for hypertensive patients were inconsistent with the established guidelines. This highlights the necessity for targeted educational interventions and enhanced support to improve guideline adherence and treatment outcomes.

How to cite this article

Khan S, Ahsan M, Mushtaq A. Demographics and Comorbidities associated with hypertension and Prescription Practices by Junior House Officers for Disease Management in Relation to Clinical Guidelines. HMDJ. 2024 Dec; 04(02): 60-64. https://doi.org/10.69884/hmdj.4.2.9273.
DOI: https://doi.org/10.69884/hmdj.4.2.9273

References

  1. Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med. 2020 Apr;30(3):160-164. https://doi.org/10.1016/j.tcm.2019.05.003.
  2. An J, Luong T, Qian L, Wei R, Liu R, Muntner P, et al. Treatment patterns and blood pressure control with initiation of combination versus monotherapy antihypertensive regimens. Hypertension. 2021 Jan;77(1):103-113. https://doi.org/10.1161/HYPERTENSIONAHA.120.15462.
  3. Ahmad N, Khan AH, Khan I, Khan A, Atif M. Doctors' knowledge of hypertension guidelines recommendations reflected in their practice. Int J Hypertens. 2018 Mar 12;2018:8524063. https://doi.org/10.1155/2018/8524063.
  4. Ataro BA, Mulatu G, Mengistu D. Compliance with guidelines of hypertension management, and associated factors among the health practitioners. Inquiry. 2023 Jan-Dec;60:469580231216400. https://doi.org/10.1177/00469580231216400.
  5. Qureshi NN, Hatcher J, Chaturvedi N, Jafar TH. Effect of general practitioner education on adherence to antihypertensive drugs: cluster randomised controlled trial. BMJ. 2007 Nov 17;335(7628):1030-1037. https://doi.org/10.1136/bmj.39360.617986.AE.
  6. Philip R, Beaney T, Appelbaum N, Gonzalvez CR, Koldeweij C, Golestaneh AK, et al. Variation in hypertension clinical practice guidelines: a global comparison. BMC Med. 2021 May 12;19(1):117. https://doi.org/10.1186/s12916-021-01963-0.
  7. Mehta SS, Wilcox CS, Schulman KA. Treatment of hypertension in patients with comorbidities: results from the study of hypertensive prescribing practices (SHyPP). Am J Hypertens. Apr1999; 12(4):333-340. https://doi.org/10.1016/S0895-7061(98)00270-2.
  8. Sohn IS, Kim CJ, Yoo BS, Kim BJ, Choi JW, Kim DI, et al. Clinical impact of guideline-based practice and patients' adherence in uncontrolled hypertension. Clin Hypertens. 2021 Dec 15;27(1):26-32. https://doi.org/10.1186/s40885-021-00183-1.
  9. Judd E, Calhoun DA. Management of hypertension in CKD: beyond the guidelines. Adv Chronic Kidney Dis. 2015 Mar;22(2):116-122. https://doi.org/10.1053/j.ackd.2014.12.001.
  10. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M,et al. ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. https://doi.org/10.1093/eurheartj/ehy339.
  11. Tavakoly Sany SB, Peyman N, Behzhad F, Esmaeily H, Taghipoor A, Ferns G. Health providers' communication skills training affects hypertension outcomes. Med Teach. 2018 Feb;40(2):154-163. https://doi.org/10.1080/0142159X.2017.1395002.
  12. World Health Organization. Hypertension{internet}. 2023 Mar 16[cited 2024 Jun 3]. Available from: https://www.who.int/news-room/factsheets/detail/hypertension.
  13. Santosa A, Zhang Y, Weinehall L, Zhao G, Wang N, Zhao Q, et al. Gender differences and determinants of prevalence, awareness, treatment and control of hypertension among adults in China and Sweden. BMC Public Health. 2020; 20: 1763. https://doi.org/10.1186/s12889-020-09862-4.
  14. Mannan A, Akter KM, Akter F, Chy NU, Alam N, Pinky SD, et al. Association between comorbidity and health-related quality of life in a hypertensive population: a hospital-based study in Bangladesh. BMC Public Health. 2022; 22:181. https://doi.org/10.1186/s12889-022-12562-w.
  15. Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005 Aug 10;294(6):716-724. https://doi.org/10.1001/jama.294.6.716.
  16. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024 Oct 7;45(38):3912- 4018. doi: 10.1093/eurheartj/ehae178. Erratum in: Eur Heart J. 2025 Feb 11:ehaf031. https://doi.org/10.1093/eurheartj/ehaf031.
  17. Kwakye AO, Kretchy IA, Oppong KG. Polypharmacy and its associated factors among patients with co-morbid hypertension and diabetes in a municipal hospital in Ghana. Sci Afr. 2024 Mar 23: e02028. https://doi.org/10.1016/j.sciaf.2023.e02028.
  18. Alsanosi SM, Mousa AH, Ahmadini HA, Qadhi RS, Ikram N, Felemban AH, et al. Polypharmacy among patients with hypertension attending primary healthcare centres. Ann Med Surg (Lond). 2023 May 10;85(6):2545-2549. https://doi.org/10.1097/MS9.0000000000000818.
  19. Mahmood S, Jalal Z, Hadi MA, Orooj H, Shah KU. Non-adherence to prescribed antihypertensives in primary, secondary and tertiary healthcare settings in Islamabad, Pakistan: a cross-sectional study. Patient Prefer Adherence. 2020 Jan 14;14:73-85. https://doi.org/10.2147/PPA.S235517.

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