Pharmacological Management of Hypertensive Clients at Hypertension/Diabetes Clinic of KNUST Hospital

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The main aim of the study is to identify, describe and assess the pharmacological management of hypertensive clients at the Hypertension and Diabetes (HPT/DM) Clinic of the Kwame Nkrumah University of Science and Technology (KNUST) Hospital, Kumasi. HPT is a major public health issue because of its high prevalence and serious complications. Appropriate and timely management using pharmacological and non-pharmacological therapy is essential to minimize complications and death resulting from HPT. A cross sectional retrospective study involving 100 clients was employed in this study. Data was collected through the administration of semi structured questionnaires from 1st July to 31st October, 2011. Case notes of the clients were also reviewed to obtain additional information and also to confirm and validate the clients’ responses. The classes of Antihypertensive Agents (AHA) commonly used at the HPT/DM Clinic of the KNUST Hospital are calcium channel blockers (CCB), diuretics (DIU), angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), and beta blockers (BB). Centrally acting agents (CAA) and vasodilators (VAS) are used sparingly. Clients’ pharmacological management was frequently initiated with monotherapy (57.6%), of which CCB accounted for 77.2% of the prescriptions followed by DIU (10.5%). Dual- and three-drug therapies are also used in initiating management. Among the CCB, Nifedipine (71.4% / 57.303) is the most prescribed and bendrofluazide (94.1% / 83.78) is the most prescribed among the DIU. Aspirin 44 (46.8%) was the most prescribed non-AHA. The target or goal blood pressure (BP) for HPT clients from World Health Organization/International Society of Hypertension (WHO/ISH) and European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines is <130/85 mmHg and that of the Ghana Standard Treatment Guidelines (GSTG) of the Ministry of Health (MOH) of Ghana is < 140/ 90 mmHg. Based on these criteria BP control rates are 42% and 62% respectively. In conclusion, the AHA in use at the HPT/DM Clinic of the KNUST Hospital and prescription pattern are in accordance with that of the international and national guidelines.
A thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirement for the award of Master of Philosophy (Mphil) in Clinical Pharmacology, October-2012