title: Antihypertensive drug prescription patterns, rationality, and adherence to Joint National Committee-7 hypertension treatment guidelines among Indian postmenopausal women.
abstract: OBJECTIVE
  The aim of this study is to evaluate antihypertensive drug prescription patterns, rationality and adherence to Joint National Committee (JNC-7) hypertension (HT) treatment recommendations among Indian postmenopausal women (PMW).
  
  
  METHODS
  An observational and cross-sectional prospective prescription audit study was carried over a period of 1 year. A total of 500 prescriptions prescribed to PMW for diagnosed HT, were identified for one point analysis. Drug prescription patterns/trends, and their adherence to JNC-7 report as well as rationality using WHO guide to good prescribing was assessed.
  
  
  RESULTS
  In the monotherapy, category angiotensin receptor blockers (ARBs) accounted (24.8%), calcium channel blockers (CCBs) (19.4%), angiotensin converting enzyme inhibitors (ACEIs) (11%), beta blockers (BBs) (2.8%), and diuretics (2%) of the total prescription. Individually, amlodipine was maximally prescribed in 16.4%. 31.6% had double combination, whereas 2.2% and 1% had triple and four drug combinations, respectively. About 3.6% of the prescription contained antihypertensive combination along with other class of drug. ARBs + diuretic were observed in 11%, CCBs + BB 10% and ACEI + diuretic in 2.6% of the total prescriptions. Among the combination therapy amlodipine + atenolol (8.4%), telmisartan + hydrochlorothiazide (6%) and losartan + hydrochlorothiazide (4.4%) were maximally prescribed. 84.21% (P < 0.001) of the prescription showed nonadherence as per recommendations for pre-HT. 100% and 43.25% adherence rates were noticed for Stage 1 HT (P < 0.001) and Stage 2 HT (P > 0.05) patients.
  
  
  CONCLUSIONS
  Antihypertensive prescription trends largely adhere to existing guidelines and are rational except polypharmacy, generic and fixed dose combinations prescribing, were some of the common pharmacologically considered irrationality noticed.
authors: Department of Pharmacology and Therapeutics, Govt. Medical College, Jammu, Jammu and Kashmir, India.
authors: Vishal R
authors: VR
authors: Tandon
authors: Department of Obstetrics and Gyanecology, Govt. Medical College, Jammu, Jammu and Kashmir, India.
authors: Sudhaa
authors: S
authors: Sharma
authors: Department of Nephrology-Superspecialty Hospital, Govt. Medical College, Jammu, Jammu and Kashmir, India.
authors: Shagun
authors: S
authors: Mahajan
authors: Department of Internal Medicine, Govt. Medical College, Jammu, Jammu and Kashmir, India.
authors: Annil
authors: A
authors: Mahajan
authors: Department of Pharmacology and Therapeutics, Govt. Medical College, Jammu, Jammu and Kashmir, India.
authors: Vijay
authors: V
authors: Khajuria
authors: Department of Pharmacology and Therapeutics, Govt. Medical College, Jammu, Jammu and Kashmir, India.
authors: Vivek
authors: V
authors: Mahajan
authors: Department of Pharmacology and Therapeutics, Govt. Medical College, Jammu, Jammu and Kashmir, India.
authors: Chander
authors: C
authors: Prakash
keywords: Elderly; Joint National Committee-7; hypertension; postmenopausal women; prescription trends; rationality