Evaluation of Prescription Pattern of Antihypertensives and Its Compliance with Joint National Committee 8 Guidelines in Hospital Setting.

Journal: The Journal Of The Association Of Physicians Of India
Published:
Abstract

Globally, hypertension is a major noncommunicable disease that contributes to significant fatalities and morbidity. Evaluation of trends in the prescription of antihypertensives and their adherence to the Joint National Commission 8 (JNC 8) recommendations can provide perspective on the dissemination of local and international guidelines in real-world clinical practice. An ambispective observational study was conducted over a duration of 6 months. Among the three-drug combinations, angiotensin receptor blockers (ARB) + beta-blocker (BB) + calcium channel blocker (CCB) (10%), followed by ARB + CCB + diuretic (DU) (8%), were primarily prescribed. BB + diuretic (DU) (20%) was the most prescribed in two-drug combination therapy, followed by ARB + BB (19%). BB (46%) were the most prescribed drugs, followed by diuretics (25%) as monotherapy. Combination therapy is as efficient as single-drug therapy. Among patients with hypertension and heart failure with reduced ejection fraction (HFrEF), the ARNI/ARB combination is effective in HFrEF patients. ARNI/ARB + antihypertensives were most commonly prescribed (40%), followed by ARNI/ARB + ivabradine + antihypertensives (35%). Adherence to the JNC 8 guidelines varied between 71 and 92%. Ninety-two percent of the prescriptions were adherent to initiating pharmacological treatment in patients aged over 60 years with a BP goal of <140/90, with thiazide/loop diuretics, CCB, and ACEI/ARB as first-line therapy. The pattern of prescribed drugs was in accordance with clinical guidelines. Compliance with JNC 8 guidelines was optimal. However, studies including larger patient populations, drug dosages used, and physician perspectives on prescribing need to be studied further.

Authors
Himani Damania, Damini Kolhe, Shubhangi Kadam, Jyoti Rajput, Shraddha Devarshi, Amir Shaikh, Rajesh Badani
Relevant Conditions

Hypertension