Antihypertensive prescribing pattern, prescriber adherence to ISH 2020 guidelines, and implication of outpatient drug price on blood pressure control at selected hospitals in Southern Ethiopia

Abstract

Purpose To determine the impact of drug prescribing pattern, outpatient drug price of medicines, and level of adherence to evidence-based international guidelines on blood pressure (BP) control at selected hospitals in Southern Ethiopia. Methods Hospital-based cross-sectional study was conducted. The data entry and analysis were done by using SPSS version 21.0. Results A mean age of participants was 55.87 +/- 11.02 years. The rate of BP control was 17.5 based on International Society of Hypertension (ISH) guidelines 2020. In about two-thirds of patients, 270 (66.5) were taking combination therapy. Mean annual cost of drugs for hypertension was 11.39 +/- 3.98 US dollar (USD). Treatment was affordable for only 91 (22.4) of patients. There was considerable variation on prescriber's adherence to evidence-based guidelines. Body mass index (BMI) of 18-24.9 kg/m(2), adjusted odds ratio (AOR) = 3.63 (95 confidence interval (C.I), 1.169-11.251, p = 0.026), physically activity, AOR = 12.69 (95 C.I, 1.424-113.17, p = 0.023), presence of no comorbidity, AOR = 12.82 (95 C.I, 4.128-39.816, p = 0.000), and taking affordable antihypertensive regimen, AOR = 3.493 (95 C.I, 1.4242-9.826, p = 0.018), were positively associated BP control. Conclusion The level of BP control, affordability of drugs for the management of hypertension and related comorbidities, and the prescriber's adherence to evidence-based guidelines were inadequate. Therefore, addressing factors associated with good BP control including affordability and clinician adherence to evidence-based guidelines by responsible stakeholders could improve BP control and reduce associated complications.