Appraising the compliance to Joint National Committee-8 Guidelines for antihypertensives in a teaching hospital by drug utilization evaluation method and impact of patient counselling

Abstract

Abstract Objectives To evaluate the prescribing pattern of antihypertensive drugs and its compliance to the recommendations of Joint National Committee 8 (JNC 8) guidelines and assess the impact of pharmacist led patient counselling on hypertension management. Methods A prospective study was carried out for a period of one year (September 2020–October 2021) among 150 hypertensive patients of various departments in a tertiary care hospital, Kerala, India. All the cases were prospectively analysed to study the pattern of antihypertensive use and patients were counselled with a patient information leaflet. Key findings Out of 150 patients, 53% were women and 47% were men. Majority of patients were aged 60 years and above (66.0%). Diabetes mellitus (26%) was the most common co-morbidity associated with hypertension. About half of the patients had received dual therapy (49%) followed by monotherapy (31.3%), triple therapy (18%) and quadruple therapy (2%). Calcium channel blockers (59.8%) were the most frequently prescribed drug class followed by angiotensin II receptor blockers (30.5%) either alone or in combination for effective control of blood pressure. Cilnidipine (8.7%) was the most commonly used antihypertensive drug followed by telmisartan (8%). It was observed that 80% of prescriptions were adherent to JNC 8 hypertension treatment recommendations. There was a significant difference (P < 0.001) in the knowledge-awareness scores before (18%) and after (52%) patient counselling. Conclusion The study represents the utilisation pattern of antihypertensive drugs. The adherence of antihypertensive medication use to JNC 8 guidelines was high level at the study site but needs to improve further. The study concludes that pharmacist-led counselling plays a vital role in improving patients’ knowledge and awareness towards hypertension management.