Drug utilization, adherence and occurrence of Resistant Hypertension among hypertensive patients visiting community based screening and management program in Eastern Nepal

  • Bhawesh Koirala BP Koirala Institute Of Health Sciences
  • Gajendra Prasad Rauniar Head of Department and Professor Department of Pharmacology BPKIHS,Dharan
  • Anup Ghimire Head of Department and Professor School of Public Health and community Medicine BPKIHS, Dharan
  • Sanjib Kumar Sharma Head of Department and Professor Department of Internal Medicine BPKIHS, Dharan
Keywords: Hypertension, Drug utilization, Drug adherence, Resistant Hypertension


Objectives: To access the drug utilization pattern, drug adherence and occurrence of resistant hypertension in hypertensive patients.

Methods:In this prospective crossover study, data was collected from 140 hypertensive patients visiting community program (KHDC) held on first Saturday of every month for follow-up. KHDC is a community based program for early detection and management of Kidney disease, Hypertension, Diabetes and Cardiovascular diseases, using structured self-constructed questionnaire (translated in Nepali also) which have been prepared after reviewing multiple literatures.For descriptive statistics, percentage, mean, Standard deviation was calculated along with graphical and tabular presentation.

Results:Out of 140 patients enrolled 52.1% were male. Majority of the patient were aged between 40-59 years of age 50.7 %. Most of them were Aryans 55.7 %( followed by Mongolians 44.3% . Mean of Systolic Blood Pressure was 131.48(SD± 16.57) and Mean of Diastolic Blood Pressure was 81.7(SD±9.57).The Mean Drug prescribed per patients was 2.16(1.321) with maximum number of drug prescribed to be 7 and minimum 1. Amlodipine was commonly prescribed antihypertensive 57.8%.  Metformin was the most common drug prescribed among non-antihypertensive drugs.Drug adherence was seen among 76.4% of patients. The common adverse seen among these patients was fatigue (Figure 3). The occurrence of other adverse effects was low. Resistant hypertension was seen in 2 out of 140 patients.

Conclusion: The common group of antihypertensive prescribed was CCB, ARB and Diuretics consistent with JNC VII.The adherence to the prescribed drugs was good amongst the patients. The occurrence of resistant hypertension was low.


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Author Biography

Bhawesh Koirala, BP Koirala Institute Of Health Sciences
Assistant Professor
Original Research Articles