Prescription patterns and adequacy of blood pressure control among adult hypertensive patients in Kenya; findings and implications

Mbui, Jennifer M. and Oluka, Margaret N. and Guantai, Eric M. and Sinei, Kipruto A. and Achieng, Loice and Baker, Amanj and Jande, Mary and Massele, Amos and Godman, Brian (2017) Prescription patterns and adequacy of blood pressure control among adult hypertensive patients in Kenya; findings and implications. Expert Review of Clinical Pharmacology, 10 (11). pp. 1263-1271. ISSN 1751-2441 (https://doi.org/10.1080/17512433.2017.1371590)

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Abstract

Introduction: Hypertension is a major cause of global morbidity and mortality, with high prevalence rates in Africa including Kenya. Consequently, it is imperative to understand current treatment approaches and their effectiveness in practice. Currently, there is paucity of such data in Kenya, which is a concern. The aim is to describe prescribing patterns and adequacy of blood pressure control in adult hypertensive patients to guide future practice. Method: Retrospective study of patients attending a sub-county outpatient clinic combined with qualitative interviews. Results: 247 hypertensive patients, predominantly female, mean age 55.8 years on antihypertensive therapy for 1-5 years, were analyzed. ACEIs and thiazide diuretics were the most commonly prescribed mainly as combination therapy. Treatment typically complied with guidelines, mainly for stage 2 hypertension (75%). BP control was observed in 46% of patients, with a significant reduction in mean systolic (155 to 144 mmHg) and diastolic (91 to 83 mmHg) BP (P<0.001). Patients on ≥2 antihypertensive drugs were more likely to have uncontrolled BP (OR:1.9, p=0.021). Conclusion: Encouragingly good adherence to guidelines helped by training. Poor blood pressure control in the majority needs to be addressed. Additional training of prescribers and follow-up of measures to improve BP control will be introduced and followed up

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