Resum
Objectives: To assess the current utilization pattern of antihypertensive drugs and blood pressure (BP) control among treated hypertensives where there is a change in payment policy for antihypertensive drugs and to compare with a previous study when drugs were given free in the same setting.
Methods: A cross sectional study of hypertensive subjects being followed-up in the medical clinic of International Institute for Tropical Agriculture.
Results: One hundred and sixteen consecutive hypertensive subjects aged 50.9±8.6 years were studied. Eighty two (70.7%) of the subjects were fully controlled on the treatment, while 15 (12.9%) were not controlled at all. Systolic BP alone was controlled in 14 (12.1%) while in 5 (4.3%) subjects the Diastolic BP alone was controlled. Systolic BP was 133.4±14.0 (106-186) mmHg, while diastolic was 83.5±9.1 (59 -110) mmHg. Salt use correlated with and was predictive of BP control, r = 0.336 and r2 = 3.383, p=0.001. Frequency of drug use: Diuretics 79.8%, calcium channel blockers (CCB) 51.8%, alpha-methyldopa 21.9%, angiotensin converting enzyme inhibitors 17.5%, beta-blockers 15.8%, vasodilator 1.8%, and prazosin 0.9%.
Conclusion: In this study, twice as many patients as in the previous study had fully controlled blood pressure in spite of the new policy of co-payment. Health education and patient counselling along with availability of free drug could have contributed to improve adherence to antihypertensive drugs. Physicians managing hypertensive patients should pay attention not only to adequate dosing and appropriate combination of drugs but also to health education and patient counselling.
Keywords: Drug utilization - blood pressure control - policy change.
Resume
Objectifs: Pour évaluer la tendance actuelle d’utilisation des médicaments anti-hypertensifs et le contrôle de la Pression Artérielle (PA) chez les hypertensifs lorsqu’il y a un changement dans la hypertensifs lorsqu’il y a un changement dans la politique de paiement des médicaments anti-hypertensifs et de comparer cela à une étude antérieure où les médicaments étaient offerts gratuitement dans le même cadre.
Méthodes: Une étude à caractère d’échantillon de sujets hypertensifs qui sont suivis au Service de Soins de l’International Institute for Tropical Agriculture. (Institut Internationale pour l’Agriculture Tropicale)
Résultats: Cent seize sujets d’hypertension consécutive âgés de 50,9±8,6 ans ont été étudiés. Quatre-vingt-deux (70,7%) des sujets étaient contrôlés au cours du traitement, tandis que 15 (12,9%) n’étaient pas du tout contrôlés. La PA systolique a été contrôlée chez 14 (12,1%) tandis que chez 5 (4,3%) sujets, seul la PA diastolique a été contrôlée. La PA systolique BP était de 133,4±14,0 (106-186) mmHg, tandis que la diastolique était de 83,5±9,1 (59 -110) mmHg. L’usage de sel correspondait et était prédictif du contrôle de la PA, r = 0,336 and r2= 3,383, p=0,001. Fréquence de consommation de médicaments: Diurétiques 79,8%, inhibiteurs du canal calcique (ICC)51,8%, alpha-methyldopa 21,9%, inhibiteurs de l’enzyme de conversion de l’angiotensine 17,5%, beta-bloquants 15,8%, vasodilatateur 1,8%, and prazosine 0,9%.
Conclusion: Dans cette étude, deux fois plus le nombre de patients dans l’étude antérieure ont totalement maîtrisé la pression artérielle en dépit de la nouvelle politique de paiement conjoint. L’éducation à la santé et les conseils psychologiques aux patients ajouté à la disponibilité de médicaments gratuits auraient pu contribué à améliorer l’adhésion aux médicaments anti-hypertensifs. Les médecins qui s’occupent des hypertensifs doivent faire attention pas seulement au dosage approprié et à la combinaison appropriée des médicaments mais aussi à l’éducation à la santé et aux conseils psychologiques aux patients.
Correspondence: Dr. Aduragbenro Adedapo, Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria. E-mail: debyee1965@yahoo.co.uk
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