Antihypertensive Medication Prescription Patterns and Cost Minimization Possibilities in Pakistan

The aim of this study was drug usage trends in stage I hypertensive patients without any compelling indications, deviations of current clinical practices from evidence based antihypertensive therapeutic guidelines, and cost minimization opportunities in District Bhakkar, Pakistan. The study consisted of two randomized stratified independent surveys (conducted in May 2017-July 2017) in doctors (N = 100) and patients (N = 400) using pretested questionnaires and collection of one year retrospective data of hypertensive patients (N = 1200) from different hospitals and clinics in Bhakkar. Statistical analysis was performed using IBM SPSS version 19.0. The study was approved by institutional Ethics Committee of District Headquarter Hospital (DHQ) Bhakkar. The study revealed that national and international therapeutic guidelines for treatment of hypertension were not followed by the doctors (working in clinics and hospitals) in Bhakkar. Instead of cheaper thiazide diuretics and ACE inhibitors, expensive calcium channel blockers were prescribed to hypertension patients that caused substantial increase in cost of therapy. Moreover, lack of life style and dietary modifications further caused poor control over hypertension. Regular patient education and doctors orientation for updated therapeutic guidelines to treat hypertension is highly recommended.