An Observational Study of Drug Prescription Pattern in Outdoor Patients of Hypertension in Department of Medicine at Sms Hospital, Jaipur

Abstract

Background: Hypertension represents a leading contributor to global morbidity and mortality, with an estimated 1.28 billion adults affected worldwide. In India, prevalence exceeds 30% among adults aged ≥18 years, imposing substantial economic and clinical burdens. Rational pharmacotherapy guided by prescribing indicators can optimize therapeutic outcomes and resource utilization. This study aimed to characterize antihypertensive prescription patterns among outpatients in the Department of Medicine at SMS Hospital, Jaipur, using WHO prescribing indicators and national treatment guidelines.

Methods: A study design (descriptive study) was to recruit 400 consecutive outpatients with a diagnosis of hypertension (systolic blood pressure values in excess of 160mmHg, or diastolic values greater or equal to 100mmHg). Demographic, comorbidities and prescribed medications information were obtained after ethical approval. The indicators that were measured based on prescriptions are the average number of drugs per encounter, the percentage of drugs prescribed by generic name, encounters with antibiotics or injections, and the percentage of the drugs in the Rajasthan Essential Drugs List of 2022. The comparisons of the patterns were done against the Standard Treatment Guidelines (6th Ed). The mean (SD) of continuous variables and percentages of categorical variables were reported and compared using a Student t-test or 2-way anova and 2-sample and 2-way 2-sample chi2 tests, respectively; p < 0.05 the level of significance.

Results: The average age was 54.3 years +- 10.2, male to female ratio was 1.2:1. The mean encounter drugs were 2.4 0.7. Generics comprised 78.5% of prescriptions, antibiotics in 12.0%, injections in 4.5%, and 85.2% from the Essential Drugs List. Monotherapy prevailed in 38%, dual therapy in 46%, and ≥3 drugs in 16% of encounters. ACE inhibitors (35%), calcium channel blockers (28%), and diuretics (22%) were most frequently prescribed. Overall adherence to national guidelines was 72.5%.

Conclusion: Prescription patterns at our center demonstrate moderate adherence to WHO indicators and national guidelines; however, scope exists for improved generic use and guideline conformity. Continuous prescriber education and periodic audit are recommended to promote rational antihypertensive therapy.