Drug prescribing for hypertension at primary healthcare facilities in Trinidad.

OBJECTIVE To describe the drug prescribing pattern for hypertension at primary healthcare facilities throughout Trinidad. METHODS A descriptive, cross-sectional survey was conducted at 22 primary healthcare facilities across Trinidad using a de novo, pilot-tested questionnaire during June to August 2006. RESULTS A total of 547 hypertensive patients were recruited into the study. There was a high prevalence of diabetes mellitus (57.6%). Information on the current drug prescribed was available for 442 patients (80.0%) and 26 of these patients (6.1%) were managed without drug intervention. On average, patients were prescribed 1.47 antihypertensive drugs. Angiotensin converting enzyme (ACE) inhibitors, particularly enalapril, were the most commonly prescribed class of antihypertensive drugs in 63.6% of patients. beta-blockers, thiazide diuretics and calcium channel blockers were prescribed in 29.2%, 25.8% and 12.0% of patients respectively. CONCLUSIONS There was significant use of ACE inhibitors, beta-blockers, thiazide diuretics and calcium channel blockers. Angiotensin converting enzyme inhibitors (as monotherapy or in combination with other drug classes) were more likely to be prescribed in diabetic hypertensive patients. Thiazide diuretics were not used as frequently as expected given the evidence which demonstrate similar efficacy with other classes of drugs and associated cost-saving. The observed prescribing pattern in the Trinidad public healthcare setting seems to point to an attempt to conform to recognized international and regional guidelines for the management of hypertension.