Key result
Prescribing practices in Karachi deviated significantly from guidelines, with beta blockers most commonly prescribed as first-line therapy (33%) and thiazide diuretics not used.
Why the study?
Deviations from evidence-based antihypertensive therapeutic guidelines and cost minimization opportunities in treatment of Stage I hypertension without compelling indications in Karachi were not well characterized.
Cross-Sectional (n=500)
Deviant Karachi prescribing may raise costs; leaves open generalizability and outcome impact elsewhere.
OBJECTIVE: This study finds out drug usage trends in Stage I Hypertensive Patients without any compelling indications in Karachi, deviations of current practices from evidence based antihypertensive therapeutic guidelines and looks for cost minimization opportunities. METHODS: In the present study conducted during June 2012 to August 2012, two sets were used. Randomized stratified independent surveys were conducted in doctors and general population - including patients, using pretested questionnaires. Sample sizes for doctors and general population were 100 and 400 respectively. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Financial impact was also analyzed. RESULTS: On the basis of patients' doctors' feedback, Beta Blockers, and Angiotensin Converting Enzyme Inhibitors were used more frequently than other drugs. Thiazides and low-priced generics were hardly prescribed. Beta blockers were prescribed widely and considered cost effective. This trend increases cost by two to ten times. CONCLUSION: Feedbacks showed that therapeutic guidelines were not followed by the doctors practicing in the community and hospitals in Karachi. Thiazide diuretics were hardly used. Beta blockers were widely prescribed. High priced market leaders or expensive branded generics were commonly prescribed. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.
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Naqvi et al. (2015) conducted a cross-sectional in Stage I Hypertension (n=500). Current antihypertensive prescribing practices vs. Evidence-based therapeutic guidelines was evaluated on Drug usage trends and deviations from evidence-based guidelines in Stage I hypertension. Prescribing practices in Karachi deviated significantly from guidelines, with beta blockers most commonly prescribed as first-line therapy (33%) and thiazide diuretics not used.
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