QUALITY OF PRESCRIPTIONS RECEIVED BY PATIENTS WITH HYPERTENSIONATTENDING A SECONDARY HEALTH FACILITY IN IBADAN, OYO STATE

A B Ibraheem1, W.A Ibraheem2, I.O Ajayi3

  1. Department of Family Medicine, Jericho Specialist Hospital, Ibadan.
  2. Department of Opthamology and Vitereoretina Surgery, Federal Medical Centre, Abeokuta.
  3. IAMRAT, College of Medicine, University of Ibadan, Ibadan.

Abstract

Background: High-quality prescription (HQP) which is a key player in optimal blood pressure control reflects good prescribing process and thus quality health care.

Aims: To determine quality of prescription and its correlates in patients with hypertension attending a secondary health facility in Ibadan, Nigeria

Methodology: A cross-sectional hospital-based study among 347 known hypertensive patients attending the Medical Outpatient clinic of Jericho Specialist hospital, Ibadan. Quality of prescription was determined using prescription quality index (PQI) tool and it was categorized into high, mediumand low-quality prescriptions. The respondents were recruited using a simple random sampling technique (computer generated random number). Data was analyzed using SPSS version 2020. Mean, standard deviation, Chi-square and Spearman correlation were used for data analysis and level of significant was set at <0.05.

Results: The mean (PQI) was 31.4±5.6; less than half of the patients 163 (47.3%) had low PQI, while medium and high PQI was found in 41(11.8%) and 143 (41.2%) patients respectively. There was a significant difference in the quality of prescriptions between male and female hypertensive patients (? 2=15.85, pvalue<0.0001). Two-thirds of the patients, 229(66.0%) experienced associated health problems and this was significantly inversely correlated with prescription quality (r=-0.33, p<0.001).

Conclusion: The study revealed marginally low quality of prescription, statistically significant poor-quality prescription among the male patients and higher number of comorbidities significantly correlated negatively with prescribing quality. Thus, to comply with high quality prescriptions, combined medications among hypertensive patients with comorbidities should be used cautiously.

Keywords: Quality of prescriptions, Hypertension, Secondary health facility, Ibadan

Correspondence:

Dr. A.B. Ibraheem
Department of Family Medicine,
Jericho Specialist Hospital,
Ibadan.
Email: drmrsibrahim@gmail.com
Submission Date: 12th Oct., 2023
Date of Acceptance: 1st April, 2024
Publication Date: 30th April, 2024

Introduction

Optimal blood pressure control is critical in the management of hypertension prevent microvascular complications and life-threatening sequelae. However, the ability to achieve blood pressure control is based on several factors among which are quality prescribing through adherence to treatment protocol.1,2 Studies on quality prescription and its correlates are inconsistent and scarce, this is because while some reported poorquality prescriptions, others documented the reverse. World Health Organization (WHO) and other related bodies on prevention, diagnosis and treatment of hypertension have put up certain guidelines for effective and efficient control of hypertension in order to ensure uniformity in prescription quality. 1,2
Quality treatment of hypertension entails using multitherapy (>1 drug combination) in the right dosage and combining the right class of antihypertensive medications, using their generic names.1,2

Unfortunately, despite the availability of the guidelines and the well documented benefits of rational prescription, many health care facilities are still far from implementing this preferred practice.3-5 This may either be due to lack of awareness or poor understanding of the inherent benefit in this rational prescription and thus leading to uncontrolled hypertension and longterm complications.

It was on this background that this study was conceived and conducted to assess the quality of prescriptions among patients with hypertension in a secondary health-care facility. It is anticipated that the result of this study will reveal some useful information that may be used to assess care of patients with hypertension in our local domain. Also, the result will be used as a template for assessing trends in prescription practice in the study center in future.