title: Drug utilization and blood pressure control in a population where antihypertensives are given free: effect of policy change.
abstract: OBJECTIVE
  To assess the current utilization pattern of antihypertensive drugs and blood pressure (BP) control among treated hypertensives where there is a change in payment policy for antihypertensive drugs and to compare with a previous study when drugs were given free in the same setting.
  
  
  METHODS
  A cross sectional study of hypertensive subjects being followed-up in the medical clinic of International Institute for Tropical Agriculture.
  
  
  RESULTS
  One hundred and sixteen consecutive hypertensive subjects aged 50.9+/-8.6 years were studied. Eighty two (70.7%) of the subjects were fully controlled on the treatment, while 15 (12.9%) were not controlled at all. Systolic BP alone was controlled in 14 (12.1%) while in 5 (4.3%) subjects the Diastolic BP alone was controlled. Systolic BP was 133.4+/-14.0 (106-186) mmHg, while diastolic was 83.5+/-9.1 (59-110) mmHg. Salt use correlated with and was predictive of BP control, r = 0.336 and r2 = 3.383, p=0.001. Frequency of drug use: Diuretics 79.8%, calcium channel blockers (CCB) 51.8%, alpha-methyldopa 21.9%, angiotensin converting enzyme inhibitors 17.5%, beta-blockers 15.8%, vasodilator 1.8%, and prazosin 0.9%.
  
  
  CONCLUSIONS
  In this study, twice as many patients as in the previous study had fully controlled blood pressure in spite of the new policy of co-payment. Health education and patient counselling along with availability of free drug could have contributed to improve adherence to antihypertensive drugs. Physicians managing hypertensive patients should pay attention not only to adequate dosing and appropriate combination of drugs but also to health education and patient counselling.
authors.affiliation: Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria. debyee1965@yahoo.co.uk
authors.forename: A D A
authors.initials: AD
authors.lastname: Adedapo
authors.forename: O
authors.initials: O
authors.lastname: Sikuade
authors.forename: S
authors.initials: S
authors.lastname: Adeleke
authors.forename: R
authors.initials: R
authors.lastname: Okechukwu
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D017723:Drug Utilization Review; D005260:Female; D006291:Health Policy / Q000191:economics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence; D008750:Methyldopa / Q000627:therapeutic use; D008875:Middle Aged; D009549:Nigeria; D011224:Prazosin / Q000627:therapeutic use; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D017673:Sodium Chloride, Dietary; D014665:Vasodilator Agents; D008750:Methyldopa; D011224:Prazosin