Blood pressure-lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department.
Ghana
blood pressure control
blood pressure‐lowering medication
family medicine
guideline adherence
hypertension treatment
Journal
Health science reports
ISSN: 2398-8835
Titre abrégé: Health Sci Rep
Pays: United States
ID NLM: 101728855
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
18
12
2022
revised:
06
03
2023
accepted:
13
03
2023
medline:
7
4
2023
entrez:
6
4
2023
pubmed:
7
4
2023
Statut:
epublish
Résumé
In many resource-constrained countries, control of blood pressure (BP) is low. Antihypertensive drug prescribing practices may influence BP control. However, adherence of prescribing to treatment guidelines may not be optimal in resource-constrained settings. The aim of this study was to evaluate the pattern of blood pressure-lowering medication prescribing, and how it adheres to treatment guidelines, and to identify the relationship between medication prescriptions and BP control. It was a cross-sectional study of hypertensive outpatients at the Korle Bu Teaching Hospital (KBTH) Family Medicine department (FMD)/Polyclinic. Data was collected with a validated structured form. Adherence of "prescribing" to recommendations of the 2017 Standard Treatment Guidelines of Ghana and 2018 European Society of Cardiology guidelines was assessed using a composite measure. We analyzed data with SPSS. About 81% (247/304) of patients received two or more antihypertensive drugs. Most patients (41%; 267/651) received calcium channel blockers (CCB), and 21.8% (142/651), 15.7% (102/651) and 12.7% (83/651) were on diuretics, angiotensin-receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors respectively. CCB plus RAS inhibitor (50%) was the most prescribed two-drug combination. Number of BP drugs per patient had a statistically significant inverse relationship with BP control (beta Coefficient = -0.402; 95% Cl: 1.252-2.470; Most patients received multiple-pill combination treatment, and overall adherence to guidelines was suboptimal, largely owing to complex drug therapy. Number of drugs predicted BP control. Our findings suggest a need to prioritize simplified treatment, and implement other strategies to improve hypertension guideline adherence. Further research on the influence of SPC on BP control may inform future hypertension guidelines in Ghana and elsewhere in Africa.
Sections du résumé
Background
UNASSIGNED
In many resource-constrained countries, control of blood pressure (BP) is low. Antihypertensive drug prescribing practices may influence BP control. However, adherence of prescribing to treatment guidelines may not be optimal in resource-constrained settings. The aim of this study was to evaluate the pattern of blood pressure-lowering medication prescribing, and how it adheres to treatment guidelines, and to identify the relationship between medication prescriptions and BP control.
Methods
UNASSIGNED
It was a cross-sectional study of hypertensive outpatients at the Korle Bu Teaching Hospital (KBTH) Family Medicine department (FMD)/Polyclinic. Data was collected with a validated structured form. Adherence of "prescribing" to recommendations of the 2017 Standard Treatment Guidelines of Ghana and 2018 European Society of Cardiology guidelines was assessed using a composite measure. We analyzed data with SPSS.
Results
UNASSIGNED
About 81% (247/304) of patients received two or more antihypertensive drugs. Most patients (41%; 267/651) received calcium channel blockers (CCB), and 21.8% (142/651), 15.7% (102/651) and 12.7% (83/651) were on diuretics, angiotensin-receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors respectively. CCB plus RAS inhibitor (50%) was the most prescribed two-drug combination. Number of BP drugs per patient had a statistically significant inverse relationship with BP control (beta Coefficient = -0.402; 95% Cl: 1.252-2.470;
Conclusion
UNASSIGNED
Most patients received multiple-pill combination treatment, and overall adherence to guidelines was suboptimal, largely owing to complex drug therapy. Number of drugs predicted BP control. Our findings suggest a need to prioritize simplified treatment, and implement other strategies to improve hypertension guideline adherence. Further research on the influence of SPC on BP control may inform future hypertension guidelines in Ghana and elsewhere in Africa.
Identifiants
pubmed: 37021012
doi: 10.1002/hsr2.1185
pii: HSR21185
pmc: PMC10069237
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e1185Informations de copyright
© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Lancet. 2016 Mar 5;387(10022):957-967
pubmed: 26724178
J Am Heart Assoc. 2013 Feb 01;2(1):e004473
pubmed: 23525435
Int J Hypertens. 2018 Mar 12;2018:8524063
pubmed: 29721335
J Hypertens. 2011 Aug;29(8):1649-59
pubmed: 21610513
Hypertension. 2010 Feb;55(2):399-407
pubmed: 20026768
Eur Heart J. 2011 Sep;32(17):2143-52
pubmed: 21471134
BMC Med. 2015 Apr 09;13:78
pubmed: 25880068
Afr J Prim Health Care Fam Med. 2015 Apr 13;7(1):
pubmed: 26245596
Lancet Public Health. 2017 Sep;2(9):e411-e419
pubmed: 29253412
J Am Coll Cardiol. 2018 May 15;71(19):e127-e248
pubmed: 29146535
Pharm Pract (Granada). 2014 Apr;12(2):419
pubmed: 25035720
J Eval Clin Pract. 2013 Oct;19(5):798-804
pubmed: 22583820
Card Fail Rev. 2017 Nov;3(2):130-133
pubmed: 29387466
Heart. 2014 Jun;100(11):855-61
pubmed: 24694797
Am J Med. 2009 Mar;122(3):290-300
pubmed: 19272490
N Engl J Med. 2016 May 26;374(21):2032-43
pubmed: 27039945
Arch Intern Med. 2008 Jan 28;168(2):207-17
pubmed: 18227370
BMC Health Serv Res. 2019 May 14;19(1):309
pubmed: 31088467
JAMA. 2016 Jun 28;315(24):2673-82
pubmed: 27195814
BMC Cardiovasc Disord. 2010 Jun 09;10:25
pubmed: 20534118
Medicine (Baltimore). 2020 Apr;99(17):e19873
pubmed: 32332654
N Engl J Med. 2019 Jun 20;380(25):2429-2439
pubmed: 30883050
PLoS Med. 2018 Jun 11;15(6):e1002584
pubmed: 29889841
J Clin Hypertens (Greenwich). 2008 Jan;10(1 Suppl 1):20-6
pubmed: 18174780
J Hum Hypertens. 2006 Jun;20(6):426-33
pubmed: 16543909
S Afr Med J. 2003 Mar;93(3):206-7
pubmed: 12768945
Ethn Dis. 2014 Autumn;24(4):431-7
pubmed: 25417425
Int J Clin Pharmacol Ther. 2010 Jan;48(1):68-75
pubmed: 20040341
Patient Prefer Adherence. 2012;6:101-8
pubmed: 22346346
Hypertension. 2017 Nov;70(5):1042-1048
pubmed: 28847892
Int J Hypertens. 2015;2015:498074
pubmed: 26550489
BMC Med. 2020 Mar 27;18(1):75
pubmed: 32216794
PLoS One. 2021 Mar 5;16(3):e0248137
pubmed: 33667277
J Am Heart Assoc. 2017 Nov 18;6(11):
pubmed: 29151036
Malawi Med J. 2017 Jun;29(2):113-117
pubmed: 28955417
Hypertens Res. 2015 Jan;38(1):89-96
pubmed: 25253583
JAMA. 2013 Sep 4;310(9):959-68
pubmed: 24002282
JAMA. 2002 Dec 18;288(23):2998-3007
pubmed: 12479764
Annu Rev Public Health. 2015 Mar 18;36:109-30
pubmed: 25594330
Eur Heart J. 2018 Sep 1;39(33):3021-3104
pubmed: 30165516
J Hypertens. 2007 Dec;25(12):2463-70
pubmed: 17984668
J Hypertens. 2011 Jan;29(1):4-16
pubmed: 20881867
Cardiol Ther. 2015 Dec;4(2):179-90
pubmed: 26253777
Int J Hypertens. 2012;2012:503821
pubmed: 23251788
J Clin Hypertens (Greenwich). 2021 Apr;23(4):702-712
pubmed: 33501760
Ethn Dis. 2013 Autumn;23(4):480-3
pubmed: 24392612
BMC Public Health. 2017 Apr 28;17(1):368
pubmed: 28454523
Arch Intern Med. 2001 May 28;161(10):1329-35
pubmed: 11371262
Br J Clin Pharmacol. 2016 Oct;82(4):1134-45
pubmed: 27302475
BMC Health Serv Res. 2019 Jun 13;19(1):373
pubmed: 31196079
J Hypertens. 2011 Mar;29(3):610-8
pubmed: 21157368
Lancet. 2008 May 3;371(9623):1513-8
pubmed: 18456100
Med J Malaysia. 2017 Feb;72(1):18-25
pubmed: 28255135
Expert Rev Clin Pharmacol. 2017 Nov;10(11):1263-1271
pubmed: 28831829
BMJ Open. 2016 Nov 22;6(11):e011650
pubmed: 27881519
J Gen Intern Med. 2017 Jun;32(6):619-625
pubmed: 28050754
N Engl J Med. 2015 Nov 26;373(22):2103-16
pubmed: 26551272