Assessment of drug utilisation and patient knowledge on management of hypertension

Abstract

Hypertension is a common cause of morbidity and mortality. It is a chronic disease and hence requires long-term management. Inadequate control leads to complications that may be fatal if not treated. 5-10 % of the general population is hypertensive. Unfortunately, most victims are not aware of their status and diagnosis is usually accidental especially after complications have set in. Objective The overall objective of this study was to assess patient's knowledge on proper management of hypertension and the types of antihypertensive drugs used at KNH. Aspects covered included types of drugs used, lifestyle issues such as salt intake, exercise, weight loss, use of alcohol and smoking status. Methods The study was conducted at KNH in the department of internal medicine. A cross sectional study design was used and the target population was hypertensive patients. Data was collected using a questionnaire that was filled after interviewing the patients and looking at their hospital records. Fifty patients were selected using systematic random sampling. Data was analyzed using descriptive statistics such as frequency distribution tables, charts and graphs. Statistical techniques used included percentages, figures and mean, standard deviation and confidence intervals. Relationship between variables was evaluated using chi-square. Results All the patients were adults with a mean age of 56.16 years and majority were females (76%). Majority of the respondents were overweight with a mean body mass index of 27.9Kg/m2 • Minority (12.2%) had no formal education and majority (53.2%) was not aware of the normal blood pressure reading. Most patients were unaware of the fact that hypertension can cause complications such as heart failure ( 56%), kidney damage (64%), visual damage (60%) and disturbance of circulation to lower limbs (70%). On average, patients were aware of four out of six non pharmacological measures in the management of hypertension had mixed. All the respondents were either on two (28%), 11 three (50%) or four (22%) antihypertensive drugs. The drugs that were mainly prescribed included Hydrochlorthiazide (58%), Losartan (38%), Amlodipine (34%), Nifedipine (32%), Enalapril (30%) and Atenolol (30%). The association between education level and awareness of complications was statistically significant but that between education level and awareness of non pharmacological management had mixed results. Conclusion A significant proportion of the respondents were not aware of complications and non pharmacological measures of managing hypertension. Antihypertensive drugs were not rationally prescribed. Recommendation Patient education regarding non-pharmacological methods of management and awareness of complications of hypertension should be intensified and rational prescribing should be practiced at KNH.