title: Assessment of prescribing, dispensing, and patient use pattern of antihypertensive drugs for patients attending outpatient department of Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia.
abstract: BACKGROUND
  Hypertension is a global concern and is one of the key preventable risk factors for cardiovascular events, resulting in unnecessary morbidity and mortality. The aim of this study was to assess the prescribing, dispensing and patient use pattern of antihypertensive drugs among patients attending Hiwot Fana Specialized University Hospital outpatient department.
  
  
  METHODS
  A hospital-based cross-sectional study was conducted in Hiwot Fana Specialized University Hospital on assessment of the prescribing, dispensing, and patient use pattern of antihypertensive drugs among patients who were above the age of 18 years and attending outpatient department from April 1-May 31, 2013. Data collection was conducted by reviewing the record of patients and direct observation of the dispensing process of randomly selected patients to measure average dispensing time, and direct interview with the patients.
  
  
  RESULTS
  A total of 400 patients met the inclusion criteria; out of the 400 patients studied, 63.5% were females. Most of the patients had Stage 1 hypertension (69%), followed by Stage 2 hypertension (31%). Out of the total number of patients, 264 were with different comorbid conditions: diabetes mellitus (64.3%), followed by congestive heart failure (15.1%) and ischemic heart disease (2.3%). The most frequently prescribed class of antihypertensive drugs was diuretics, of which hydrochlorothiazide was the most frequently prescribed drug, both in single (55%), followed by enalapril (22.3%), methyl dopa (11.2%), atenolol (6.9%), and nifedipine (4.6%), and in combination with other antihypertensive drugs. The average dispensing time was 1.2 minutes, and 75% of the patients left the counter with inadequate information about the dosage.
  
  
  CONCLUSIONS
  All antihypertensive drugs prescribed were in compliance with the Ethiopian Standard Treatment Guidelines. This study showed that most outpatients with hypertension in our hospital received monotherapy. Diuretics and angiotensin converting enzyme inhibitors were the most frequently prescribed classes of antihypertensive drugs in both monotherapy and combination therapy.
authors: Dil Chora Referral Hospital, Dire Dawa, Ethiopia.
authors: Fedila
authors: F
authors: Shukrala
authors: Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
authors: Tesfaye
authors: T
authors: Gabriel
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000145:classification / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics
keywords: antihypertensive drugs; combination therapy; compliance; fixed dose combination; hypertension; monotherapy
references: N Engl J Med. 2001 Aug 16;345(7):479-86
references: 11519501
references: Lancet. 2005 Jan 15-21;365(9455):217-23
references: 15652604
references: Hypertension. 2008 Jun;51(6):1403-19
references: 18391085
references: Hypertension. 2003 Dec;42(6):1206-52
references: 14656957
references: Singapore Med J. 2004 Mar;45(3):117-20
references: 15029413
references: J Pharm Pharm Sci. 2005;8(2):235-42
references: 16124935
references: J R Soc Med. 2003 Nov;96(11):525-31
references: 14594958
references: Ann Afr Med. 2008 Sep;7(3):128-32
references: 19253522
references: J Pharmacol Pharmacother. 2012 Apr;3(2):190-1
references: 22629098
references: JAMA. 1996 May 22-29;275(20):1571-6
references: 8622248
references: Pharmacoepidemiol Drug Saf. 2001 May;10(3):219-27
references: 11501335
references: JAMA. 2003 May 21;289(19):2560-72
references: 12748199
references: Hypertension. 2004 May;43(5):1017-22
references: 15037552