Assessment of Medication Adherence to JNC-7 Guidelines and Risk Factors for Hypertension in a South Indian Tertiary Care Hospital
Uday Bhaskar Narra1, Ravindrababu Pingili1,2, Sri Varsha Reddy Chinnam1, Prardhana Devi Datla1, Sree Varsha Potluri1, Naveen Babu Kilaru1★★ Corresponding author
- 1Department of Pharmacy Practice, KVSR Siddhartha College of Pharmaceutical Sciences, Vijayawada, Andhra Pradesh, INDIA.
- 2Department of Pharmacology, KVSR Siddhartha College of Pharmaceutical Sciences, Vijayawada, Andhra Pradesh, INDIA.
CORRESPONDENCE
Naveen Babu Kilaru
Department of Pharmacy Practice, KVSR Siddhartha College of Pharmaceutical Sciences, Vijayawada, Andhra Pradesh, INDIA.
Volume 10, Issue 2 · pp. 78–89 · PUBLISHED · DOI: 10.5530/ijopp.10.2.17
ABSTRACT
Objective: The objective of the study was to assess the drug utilization pattern, medication adherence to Joint National Committee (JNC-7) treatment guidelines and risk factors for hypertension (HTN) in a south Indian tertiary care teaching hospital. Methods:A prospective study was conducted on 1000 subjects (with or without hypertension) from November 2015 to April 2016 in a general medicine department. Drug utilization pattern, medication adherence was assessed by comparing with the JNC-7 guidelines and the odds ratios were calculated in univariate regression analysis for risk factors. Results:Stage 1 hypertension (47.30%) was most predominant than stage 2 hypertension (24.28%) and hypertension emergency (12.23%) according to the SBP of JNC-7 guidelines. Hypertension was significantly higher in the subjects of age above 40 years (92.6%, P<0.0001), married (99.6%, P<0.0001), educated (59.5%, P=0.066), known family history (father, P=0.009; mother, P<0.0001; father and mother, P<0.0001), physical inactivity (74.8%, P<0.001), monthly income above Rs. 10,000 (34.5%, P<0.0001), co-morbidities (diabetes, P<0.0001; history of cardiovascular diseases, P<0.0001; chronic kidney disease, P<0.0001), alcohol consumption (19.2%, P=0.007), smoking (23%, P=0.0005), tea consumption (twice or more per day, P=0.027), and intake of junk foods (thrice or more in a week, P<0.0001) than normotensive subjects. Angiotensin receptor blockers (17.98%) are most widely prescribed drugs followed by calcium channel blockers (10.07%) and ß-blockers (6.29%) in monotherapy (38.63%). Angiotensin receptor blocker + diuretic combination (24.64%) was mostly used in two drug combination therapy (36.11%). The overall rate of adherence was 24.9% (Pre hypertension, P<0.01); 80.3% (Stage 1 hypertension, P<0.001); 73.93% (Stage 2 hypertension, P<0.001) and 50% (Hypertension emergency, P<0.05). Univariate regression analysis showed that age (above 40 years), female gender, married, widowed, generalized obesity, moderate to high economic status (Above 10, 000/month), family history, diabetes, history of cardiovascular diseases, chronic kidney disease, physical inactivity, smoking, alcohol consumption and junk food (weekly thrice or more, odds ratio: 17.69, 95% confidence interval: 2.373-131.8, P<0.0001) intake were significantly associated with HTN. Conclusion: The present study results suggested that medication adherence to JNC-7 was optimal. Junk foods, age (above 60 years), diabetes, alcohol, smoking, marital status and high economic status are the main risk factors for hypertension.
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Narra, U. B., Pingili, R., Chinnam, S. V. R., Datla, P. D., Potluri, S. V., & Kilaru, N. B. (). Assessment of Medication Adherence to JNC-7 Guidelines and Risk Factors for Hypertension in a South Indian Tertiary Care Hospital. Indian Journal of Pharmacy Practice, 10(2), 78–89. https://doi.org/10.5530/ijopp.10.2.17