Irrational prescribing of calcium channel blockers for the elderly in health facilities: a qualitative study in four hospitals in Benin City, Nigeria.
BACKGROUND
Calcium channel blockers (CCBs) can further depress a failing heart and are not recommended for elderly patients with systolic heart failure (HF).


OBJECTIVE
This study conducted in four hospitals in Benin City was undertaken to evaluate rational prescribing of CCBs in hypertensive elderly outpatients.


METHODS
Self-administered questionnaire was administered to 161 medical doctors to detect the proportion of physicians who prescribe CCBs to elderly outpatients with systolic HF with or without evaluating the heart status and/or counseling them on the possibility of recognizing the dangerous effect on heart while taking the CCBs. The association between inappropriate prescription of CCBs and sociodemographic variables was determined using logistic regression analysis.


RESULTS
Majority (98.7%) of the 150 respondents reported ever treating hypertension in 48.5 +/- 42.3 (range: 2-250) elderly outpatients per month with most evaluating the patients' heart status. CCBs (nifedipine and amlodipine) were often prescribed for systolic HF for the elderly by 34.3% of participants but only 4.7% of them properly counseled the patients. Area of specialization (odds ratio = 1.076), hospital where the doctors worked (OD = 1.080) and status of the doctors were good predictors of CCBs prescription in systolic HF.


CONCLUSIONS
It is concluded that irrational prescribing of CCBs for elderly outpatients is common in the four hospitals studied. This calls for appropriate educational intervention that will improve the knowledge of physicians in Benin City in rational prescribing of drugs for the elderly.
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria. p_erah@yahoo.com
Patrick O
PO
Erah
Obiajulu
O
Onwurah
Penaere T
PT
Osahon
Paul J C
PJ
Nwosu
D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006761:Hospitals; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D057970:Inappropriate Prescribing / Q000009:adverse effects* / Q000706:statistics & numerical data; D009543:Nifedipine / Q000627:therapeutic use; D009549:Nigeria; D010820:Physicians; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D036301:Qualitative Research
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D017311:Amlodipine; D009543:Nifedipine