Abstract
Introduction: Hypertension is a public health problem with a high prevalence in Nigeria. The cost of prescription medications is thought to be a barrier for many patients to access the healthcare they need. This study was aimed at identifying associated co-morbid conditions, the prescribing patterns and cost of prescription for the treatment of hypertension in an outpatient clinic at Lagos University Teaching Hospital. Materials and Methods: A cross sectional study was carried out. A total of 147 prescriptions were obtained from the case notes of patients treated at the LUTH outpatient department between February 2012 and August 2012. For each prescription, the number of drugs, the class and combinations of antihypertensives were recorded. The monthly cost of a 30-day anti-hypertensive supply based on the recommended daily dose was calculated. Results: The mean age of the patients was 54(+/-14) years and of the 147 prescriptions, 77(52.4%) was for females and 70(47.6%) was for males. The mean systolic blood pressure was 141.6 mmHg (+/-20.5SD) and mean diastolic blood pressure was 86.5 mmHg (+/-13.3SD). Of the 147 prescriptions, 112(76.2%) were for patients with co-morbidities. The frequency of prescription of the various classes of anti hypertensives are; diuretics 117(79.6%), angiotensin receptor blockers 78(53.1%), angiotensin converting enzyme inhibitors 65(44.2%), calcium channel blockers 65 (44.2%) beta blockers 54(36.7%) and centrally acting agents 12(8.2%). Average cost per month was =N=6611.47 (US$44). There was a statistically significant association between co morbid conditions and high cost of prescriptions with 73.7% of those with diabetes and 63.2% of those with renal disease having cost of prescriptions within the high cost group (p
Highlights
Hypertension is a public health problem with a high prevalence in Nigeria
In looking at the association between co-morbidity and cost of prescription per month, it was found that the highest proportion of prescriptions for patients with co-morbidity was in the high cost per month group this was significant (p < 0.05) (Table 2)
The anti hypertensives prescribed belonged to the following classes; diuretics, angiotensin receptor blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, beta receptor blockers and centrally acting agents
Summary
Hypertension is a public health problem with a high prevalence in Nigeria. Hypertension is a public health problem and in the year 2000 hypertension was estimated to affect almost one billion patients worldwide and the prevalence is predicted to increase by approximately 60% by 2025 representing an increase from 26.4% in 2000 to 29.2% in 2025 worldwide [1]. In Nigeria, there is a high incidence of hypertension and hypertension-associated diseases with a consequent heavy burden on the public healthcare system. Uncontrolled hypertension leads to severe long-term consequences such as stroke, heart failure, coronary heart disease and end-stage kidney disease. It is important that once hypertension is diagnosed, a rational anti-hypertensive therapy on a long term basis along with regular follow up is instituted
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