Pattern of use and pharmacoeconomic impact of antihypertensive drugs in a north Indian referral hospital.
OBJECTIVE
The current study was designed to investigate drug utilisation and the pharmacoeconomics of hypertension in the hypertension clinic of a tertiary-care hospital.


METHODS
The study was conducted in patients attending the hypertension clinic of Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India. A survey of prescriptions was carried out, and the information obtained was further corroborated by seeing the medical records as well as patient interviews.


RESULTS
A total of 1,076 prescriptions were evaluated. Beta-adrenoceptor-blocking agents (51%), calcium antagonists (47%) and angiotensin-converting enzyme inhibitors (46%) were the most popular drugs. The utilisation of thiazides was less than expected. Combination therapy was used more commonly than monotherapy (53.8% vs 46.7%). Oral hypoglycaemic agents and lipid-lowering agents were commonly co-prescribed along with antihypertensive medications. About 30% of drugs were prescribed by generic name and 90% were from the national essential drugs list. Of the per capita income, 10.6% was spent on the treatment of hypertension. The mean monthly cost of various drugs ranged between US $0.8 and US $6.6. A total of 91 adverse drug reaction (ADRs) were encountered in the study; the added cost of treatment of these ADRs was US $211.


CONCLUSIONS
In general, the treatment guidelines for hypertension were followed in our hospital. The utilisation of thiazides was an area requiring improvement. The cost of treatment of hypertension was substantial and imparted a significant economic burden on the patients.
Malhotra
S
S
Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Karan
R S
RS
Pandhi
P
P
Jain
S
S
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003625:Data Collection / Q000191:economics / Q000706:statistics & numerical data; D016527:Drug Costs / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006784:Hospitals, Teaching / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007194:India; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers