Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Guidelines Adherence and Hypertension Control in an Outpatient Cardiology Clinic in Malaysia

Nafees Ahmad¹ , Yahaya Hassan², Balamurugan Tangiisuran³, Ong Loke Meng⁴, Noorizan Abd Aziz⁵, Amer Hayat Khan³

¹Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang; ²Department of Clinical Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Bandar Puncak Alam Selangor; ³Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang; ⁴Head of One Stop Centre Clinical Research Centre Ministry of Health, Malaysia Pulau Pinang; ⁵Department of Clinical Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Bandar Puncak Alam Selangor, Malaysia.

For correspondence:- Nafees Ahmad Email: nafeesuob@gmail.com Tel:0060142458913

Received: 14 July 2011 Accepted: 27 May 2012 Published: 16 August 2012

Citation: Ahmad N, Hassan Y, Tangiisuran B, Meng OL, Aziz NA, Khan AH. Guidelines Adherence and Hypertension Control in an Outpatient Cardiology Clinic in Malaysia. Trop J Pharm Res 2012; 11(4):665-672 doi: 10.4314/tjpr.v11i4.19

© 2012 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

Abstract

Purpose: To evaluate doctors’ adherence to Malaysian Clinical Practice Guideline (CPG) 2008 in established hypertensive patients with cardiovascular diseases and factors associated with guideline adherence and hypertension control in Pulau Pinang Hospital, Malaysia.

Methods: Prescriptions written by 13 doctors for 320 established hypertensive patients with cardiovascular diseases (25 patients per doctor) were noted on first visit. Two hundred and sixty (81%) of the enrolled 320 patients (20 patients per doctor) were followed up until the second visit. Blood pressure (BP) noted on the second visit was related to the prescription written on the first visit.

Results: One hundred and ninety one (73.5%) patients received guidelines-compliant pharmacotherapy. CPG adherence had statistically significant association with left ventricular hypertrophy (LVH) (j0; =-0.241, p < 0.01) and diabetes (j0; =-0.228, p < 0.01). One hundred and fifty four (59.2 %) patients were on goal BP. Hypertension control had statistically significant association with guidelines compliance (j0; = 0.175, p < 0.01), angiotensin converting enzyme (ACE) inhibitors (j0; = 0.195, p < 0.01), diabetes (j0; = -0.148, p = 0.017), LVH (j0; = -0.153, p = 0.017) and monotherapy (j0; = -0.168, p < 0.01).

Conclusion: Prescribing practices were fairly compliant with guidelines. Doctors poorly adhered to guidelines in hypertensive patients with diabetes and LVH. Significantly better hypertension control was seen in patients who were on ACE inhibitors and guidelines-adherent therapy.

Keywords: Guidelines, Adherence, Hypertension control, Diabetes, Cardiology