PRESCRIBING PATTERN AND COST EFFECTIVE ANALYSIS OF ANTI HYPERTENSIVE MEDICATIONS IN PATIENTS ATTENDING THE HYPERTENSION CLINIC AT TERTIARY CARE HOSPITAL

Abstract

OBJECTIVE - To evaluate the prescribing
pattern of anti hypertensive medications in
patients attending the hypertension clinic
at Rajiv Gandhi Government General Hospital
and also to analyse cost effectiveness.
METHODS - This descriptive study,
evaluated the prescription of patients of
either sex, aged between 30-80 years with
stage 1 and 2 hypertension, being treated
at the hypertension clinic, Rajiv Gandhi
Govt General Hospital. Prescriptions containing
anti hypertensive medications for
more than 6 months were included in the
study. RESULTS - Of the 578 prescriptions
evaluated, following drugs were commonly
precribed- T.Atenolol 50mg,
T.Propranolol 10mg, T.Amlodipine 2.5mg,
T.Nifedipine 5mg, T.Enalapril 2.5mg,
T.Furosemide 40mg, T.Spironolactone
25mg and T.Methyl dopa 10mg, either as
monotherapy (n167) or as combination
therapy (n411) with 2 or more drugs. Prescriptions
had 49.1 males and 50.9 females.
86.3 of
the prescriptions represented stage 1 and
13.7 were stage 2 hypertension. 50 prescriptions
had 2 drug combination therapy
followed by monotherapy, which was 29.
3 drug and 4 drug combination therapy
were 18 and 3 respectively. A total of
65.92 of prescriptions contained
T.Amlodipine in both the single and combination
therapy followed by T.Atenolol
(64.36) and T.Enalapril (50.69).
T.Nifedipine (0.34), T. Spironolactone
(0.34) and T.Propranolol (0.34) were least
prescribed drug in monotherapy and combination
therapy. Total annual drug expentiture
for all groups of antihypertensives
was Rs.63,334.80, of which around
50 was spent on T.Amlodipine and
T.Atenolol.CONCLUSION -Although
CCBs, beta-blockers and ACEIs were the
most frequently prescribed antihypertensive
agents, alpha-blockers and diuretics
were prescribed sparingly. Among different
classes of antihypertensive agents
specific drugs like amlodipine, atenolol
and enalapril occupied large proportion of
the prescription. Cost is an important consideration
for therapy

of a chronic disease like hypertension, often
requiring lifelong medication.