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Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department
BACKGROUND: 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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069237/ https://www.ncbi.nlm.nih.gov/pubmed/37021012 http://dx.doi.org/10.1002/hsr2.1185 |
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author | Harrison, Mark Amankwa Marfo, Afia F. A. Buabeng, Kwame O. Annan, Augustine Nelson, Frempomaa Boateng, Dorcas P. Nkansah, Florence A. Owusu Aboagye, Grace Ankrah, Daniel |
author_facet | Harrison, Mark Amankwa Marfo, Afia F. A. Buabeng, Kwame O. Annan, Augustine Nelson, Frempomaa Boateng, Dorcas P. Nkansah, Florence A. Owusu Aboagye, Grace Ankrah, Daniel |
author_sort | Harrison, Mark Amankwa |
collection | PubMed |
description | BACKGROUND: 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: 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: 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; p = 0.015). The composite adherence score was 0.73 (moderate adherence) but Single‐pill combination (SPC) was poor (3.2%; n = 8). CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-10069237 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100692372023-04-04 Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department Harrison, Mark Amankwa Marfo, Afia F. A. Buabeng, Kwame O. Annan, Augustine Nelson, Frempomaa Boateng, Dorcas P. Nkansah, Florence A. Owusu Aboagye, Grace Ankrah, Daniel Health Sci Rep Original Research BACKGROUND: 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: 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: 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; p = 0.015). The composite adherence score was 0.73 (moderate adherence) but Single‐pill combination (SPC) was poor (3.2%; n = 8). CONCLUSION: 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. John Wiley and Sons Inc. 2023-04-03 /pmc/articles/PMC10069237/ /pubmed/37021012 http://dx.doi.org/10.1002/hsr2.1185 Text en © 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Harrison, Mark Amankwa Marfo, Afia F. A. Buabeng, Kwame O. Annan, Augustine Nelson, Frempomaa Boateng, Dorcas P. Nkansah, Florence A. Owusu Aboagye, Grace Ankrah, Daniel Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department |
title | Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department |
title_full | Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department |
title_fullStr | Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department |
title_full_unstemmed | Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department |
title_short | Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department |
title_sort | blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069237/ https://www.ncbi.nlm.nih.gov/pubmed/37021012 http://dx.doi.org/10.1002/hsr2.1185 |
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