Prescribing Patterns of Antihypertensive Drugs in Patients Attending Tertiary Care Hospitals in Pakistan

The current study was aimed at examining the prescribing patterns of antihypertensive medications, dispensing time, generic prescribing, drug-drug interactions and to determining whether or not prescriptions are consistent with the recommendations of the Joint National Committee (JNC-8) guidelines. A cross-sectional study was conducted in three tertiary care hospitals among patients of 30 years and more who visited the outpatient departments (OPDs) from January 2018 to September 2018. Prescription patterns were assessed by reviewing the patient’s prescriptions, who were attending the OPDs of targeted hospitals during the study duration. Drug interactions in prescriptions were checked by using Micromedex® database to detect incompatible drug combinations. A total of 500 prescriptions were collected that met the criteria for inclusion. The sample data consisted of 57% of males with an average age of 54 years. The average time spent by the patients at the dispensing area was barely 1 min, and no proper counselling had provided them how and when to take medicine. One hundred one drug interactions have been identified in prescriptions. The most frequently first line prescribed drug class was found to be calcium channel blockers 27.8%, followed by 26.1% angiotensin-converting enzyme inhibitor, and 16% vasodilators. The trend observed in double combinations was calcium channel blockers + angiotensin receptor blockers (18.6%) followed by vasodilator + Beta-blockers 14.1%, and Beta-blockers + angiotensin-converting enzyme inhibitor 7.1%. The study findings demonstrated average compliance with the JNC-8 guidelines; none of the drug was prescribed by generic name and had very short dispensing time without counselling; approximately 101 minor and major drug-drug interactions were identified. This multi-factorial phenomenon of average compliance with the guidelines must be addressed in order to ensure the rational and quality use of medicines to improve the quality of life of patients.