Prescribing adherence of antihypertensive agents in Chronic Kidney Disease (CKD) patients and its relationship with clinical outcomes

Abstract

Objectives This study was conducted to evaluate the utilisation of antihypertensive agents, assess prescribing adherence and determine the relationship between guideline adherence indicator (GAI) and clinical outcomes among hypertensive CKD patients. Methods This was a retrospective cohort study involving newly diagnosed CKD patients undergoing follow-up between January to December 2018 at a tertiary Malaysian hospital. The study subjects were screened and recruited using simple random sampling according to inclusion and exclusion criteria. Clinical data was retrieved from the online medical record (eHis system) using a pre-prepared data collection form. Results A total of 74 patients were included in this study with mean (SD) age of 66.86 (10.86) years old. The majority were male (n= 39, 52.7%) and Malay (n= 34, 45.9%). The study results showed that CCB was the drug of choice prescribed, while the most commonly prescribed combination therapy was ACEI + beta-blocker + CCB and ACEI + CCB. The overall adherence to the guideline was moderate (mean (SD) GAI score of 76.25 (17.56) %). There was a significant difference in mean GAI score between subjects with controlled and uncontrolled BP (92.86 (11.11) vs 69.23 (14.88), P <0.05).