Assessment of Rational Prescribing of Antihypertensive Drug combinations in Lagos University Teaching Hospital

Abstract

Purpose: The study aimed to assess prescribing trends of antihypertensives and proportion of prescriptions containing irrational combinations of antihypertensives and co-prescribed drugs. Methods: Five hundred and fifty four prescriptions, containing antihypertensives, were collected prospectively over a period of twelve months, from the internal medicine clinic of the Lagos University Teaching Hospital, and evaluated. Results: The average number of drugs prescribed per encounter was 2.9. Encounters with injections were 0.5%. The percentage of drugs prescribed by generic name was 31.6%. All the drugs prescribed were from the National Essential Drugs List. Calcium antagonists were the most frequently used group of drugs (41.3%), followed by Diuretics (33.0%) and Angiotensin-Converting Enzyme inhibitors (ACEIs) (22.4%). Nifedipine (31.9%), Methyldopa (22.4%) and Propranolol (20.2%) were the most frequently used individual drugs. Beta-blockers with Calcium antagonists (13.3%), Methyldopa with Diuretics (10.6%), Calcium antagonists with ACEIs (10.3%) were the most frequently prescribed drug combinations. Irrational drug combinations with NSAIDs were observed in 21.8% of the prescriptions. Also beta-blockers were prescribed in 22% of prescriptions for hypertensive / diabetic patients. Conclusion: There is need to educate prescribers on appropriate therapeutic combinations that would provide optimal management of hypertension and associated clinical conditions. KEY WORDS: Antithypertensive, rational, drug combination. Nig. Jnl Health & Biomed. Sciences Vol.3(1) 2004: 8-11