Drug utilization among hypertensive patients in the outpatient department of medicine in a tertiary care hospital: A cross-sectional study

Background: Hypertension is one of the leading risk factors for cardiovascular, cerebrovascular, and renal disease. Its increasing prevalence and treatment costs influence the prescribing pattern among physicians. Drug utilization studies provide insights into the current prescribing practices and help us facilitate the rational use of drugs. We carried out the present study to assess the pattern of drug utilization in hypertensive patients. Method: Adults seeking treatment for hypertension were recruited. Prescriptions were studied for demographic and drug-use details. The World Health Organization indices for drug utilization were evaluated. The percentage of prescriptions adhering to the recent guidelines was determined. Results: Enalapril was the most commonly prescribed drug. Monotherapy was used in 71.8% of the cases. However, 42% of the cases were newly diagnosed. The ratio of prescribed daily dose and defined daily dose showed underutilization of enalapril and atenolol and overutilization of amlodipine. About 87.5% of the prescriptions adhered to Eighth Joint National Committee guidelines. Most of the medications were available at the hospital pharmacy store and were prescribed by their generic names. Total 65.3% of the concomitant medications were not listed in the World Health Organization essential list of medicines. The average number of drugs prescribed was six. A median cost of 14.6 and 94.5 rupees was spent, respectively, on anti-hypertensive and concomitant medications per encounter. Conclusion: The adherence to the guideline was good. Polypharmacy can be reduced by avoiding the prescription of unnecessary medications and promoting the use of fixed-dose combinations.