Jennifer M Mbui1, Margaret N Oluka1, Eric M Guantai1, Kipruto A Sinei1, Loice Achieng2, Amanj Baker3, Mary Jande4, Amos Massele5, Brian Godman3,6,7. 1. a Department of Pharmacology and Pharmacognosy, School of Pharmacy , University of Nairobi , Nairobi , Kenya. 2. b Department of Clinical Medicine and Therapeutics, School of Medicine , University of Nairobi , Nairobi , Kenya. 3. c Strathclyde Institute of Pharmacy and Biomedical Sciences , Strathclyde University , Glasgow , UK. 4. d School of Pharmacy , Catholic University of Health and Allied Science , Mwanza , Tanzania. 5. e Department of Clinical Pharmacology, School of Medicine , University of Botswana , Gaborone , Botswana. 6. f Department of Laboratory Medicine, Division of Clinical Pharmacology , Karolinska Institutet, Karolinska University Hospital Huddinge , Stockholm , Sweden. 7. g Health Economics Centre , Liverpool University Management School, Liverpool University , Liverpool , UK.
Abstract
BACKGROUND: Hypertension is a major cause of global morbidity and mortality, with high prevalence rates in Africa including Kenya. Consequently, it is imperative to understand current treatment approaches and their effectiveness in practice. Currently, there is paucity of such data in Kenya, which is a concern. The aim is to describe prescribing patterns and adequacy of blood pressure (BP) control in adult hypertensive patients to guide future practice. METHOD: Retrospective study of patients attending a sub-county outpatient clinic combined with qualitative interviews. RESULTS: 247 hypertensive patients, predominantly female, mean age 55.8 years on antihypertensive therapy for 1-5 years, were analyzed. ACEIs and thiazide diuretics were the most commonly prescribed drugs, mainly as combination therapy. Treatment typically complied with guidelines, mainly for stage 2 hypertension (75%). BP control was observed in 46% of patients, with a significant reduction in mean systolic (155 to 144 mmHg) and diastolic (91 to 83 mmHg) BP (P < 0.001). Patients on ≥2 antihypertensive drugs were more likely to have uncontrolled BP (OR:1.9, p = 0.021). CONCLUSION: Encouragingly good adherence to guidelines was helped by training. Poor blood pressure control in the majority needs to be addressed. Additional training of prescribers and follow-up of measures to improve BP control will be introduced and followed up.
BACKGROUND:Hypertension is a major cause of global morbidity and mortality, with high prevalence rates in Africa including Kenya. Consequently, it is imperative to understand current treatment approaches and their effectiveness in practice. Currently, there is paucity of such data in Kenya, which is a concern. The aim is to describe prescribing patterns and adequacy of blood pressure (BP) control in adult hypertensivepatients to guide future practice. METHOD: Retrospective study of patients attending a sub-county outpatient clinic combined with qualitative interviews. RESULTS: 247 hypertensivepatients, predominantly female, mean age 55.8 years on antihypertensive therapy for 1-5 years, were analyzed. ACEIs and thiazide diuretics were the most commonly prescribed drugs, mainly as combination therapy. Treatment typically complied with guidelines, mainly for stage 2 hypertension (75%). BP control was observed in 46% of patients, with a significant reduction in mean systolic (155 to 144 mmHg) and diastolic (91 to 83 mmHg) BP (P < 0.001). Patients on ≥2 antihypertensive drugs were more likely to have uncontrolled BP (OR:1.9, p = 0.021). CONCLUSION: Encouragingly good adherence to guidelines was helped by training. Poor blood pressure control in the majority needs to be addressed. Additional training of prescribers and follow-up of measures to improve BP control will be introduced and followed up.
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