{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:16:50Z","timestamp":1767374210845,"version":"3.41.2"},"reference-count":65,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In many resource\u2010constrained countries, control of blood pressure (BP) is low. Antihypertensive drug prescribing practices may influence BP control. However, adherence of prescribing to treatment guidelines may not be optimal in resource\u2010constrained settings. The aim of this study was to evaluate the pattern of blood pressure\u2010lowering medication prescribing, and how it adheres to treatment guidelines, and to identify the relationship between medication prescriptions and BP control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>It was a cross\u2010sectional study of hypertensive outpatients at the Korle Bu Teaching Hospital (KBTH) Family Medicine department (FMD)\/Polyclinic. Data was collected with a validated structured form. Adherence of \u201cprescribing\u201d to recommendations of the 2017 Standard Treatment Guidelines of Ghana and 2018 European Society of Cardiology guidelines was assessed using a composite measure. We analyzed data with SPSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 81% (247\/304) of patients received two or more antihypertensive drugs. Most patients (41%; 267\/651) received calcium channel blockers (CCB), and 21.8% (142\/651), 15.7% (102\/651) and 12.7% (83\/651) were on diuretics, angiotensin\u2010receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors respectively. CCB plus RAS inhibitor (50%) was the most prescribed two\u2010drug combination. Number of BP drugs per patient had a statistically significant inverse relationship with BP control (beta Coefficient\u2009=\u2009\u20130.402; 95% Cl: 1.252\u20132.470; <jats:italic>p<\/jats:italic>\u2009=\u20090.015). The composite adherence score was 0.73 (moderate adherence) but Single\u2010pill combination (SPC) was poor (3.2%; <jats:italic>n<\/jats:italic>\u2009=\u20098).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Most patients received multiple\u2010pill combination treatment, and overall adherence to guidelines was suboptimal, largely owing to complex drug therapy. Number of drugs predicted BP control. Our findings suggest a need to prioritize simplified treatment, and implement other strategies to improve hypertension guideline adherence. Further research on the influence of SPC on BP control may inform future hypertension guidelines in Ghana and elsewhere in Africa.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.1185","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T12:34:15Z","timestamp":1680525255000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Blood pressure\u2014lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8774-1324","authenticated-orcid":false,"given":"Mark Amankwa","family":"Harrison","sequence":"first","affiliation":[{"name":"Pharmacy Department Korle Bu Teaching Hospital Accra Ghana"},{"name":"Department of Pharmacy Practice, College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afia F. A.","family":"Marfo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwame O.","family":"Buabeng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augustine","family":"Annan","sequence":"additional","affiliation":[{"name":"Pharmacy Department Korle Bu Teaching Hospital Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frempomaa","family":"Nelson","sequence":"additional","affiliation":[{"name":"Pharmacy Department Korle Bu Teaching Hospital Accra Ghana"},{"name":"Department of Pharmacy Practice, College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorcas P.","family":"Boateng","sequence":"additional","affiliation":[{"name":"Pharmacy Department Korle Bu Teaching Hospital Accra Ghana"},{"name":"Department of Pharmacy Practice, College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence A.","family":"Nkansah","sequence":"additional","affiliation":[{"name":"Pharmacy Department Korle Bu Teaching Hospital Accra Ghana"},{"name":"Department of Pharmacy Practice, College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Owusu Aboagye","sequence":"additional","affiliation":[{"name":"Pharmacy Department Korle Bu Teaching Hospital Accra Ghana"},{"name":"Department of Pharmacy Practice, College of Health Sciences, Faculty of Pharmacy and Pharmaceutical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Ankrah","sequence":"additional","affiliation":[{"name":"Pharmacy Department Korle Bu Teaching Hospital Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr080"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.184182"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60655-8"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031914-122949"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248137"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4260-5"},{"key":"e_1_2_12_8_1","unstructured":"Korle Bu Teaching Hospital. Annual Report.2016.http:\/\/kbth.gov.gh\/assets\/downloads\/pdf\/2016_Annual_Report.pdf"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.23.2998"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1901113"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.10.1329"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600177"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-015-0328-1"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.7050"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy339"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.006"},{"key":"e_1_2_12_18_1","first-page":"146","volume-title":"Standard Treatment Guidelines","author":"Ministry of Health","year":"2017"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.09.038"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/8524063"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/503821"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S27223"},{"issue":"4","key":"e_1_2_12_23_1","first-page":"480","article-title":"Pattern of prescription of anti\u2010hypertensive medications in a tertiary health care facility in Abuja, Nigeria","volume":"23","author":"Ojji DB","year":"2013","journal-title":"Ethn Dis"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2012.01852.x"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.4314\/tjpr.v7i2.14608"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4140-z"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v29i2.7"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1002005"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2017:13:1"},{"issue":"2","key":"e_1_2_12_30_1","first-page":"1","article-title":"Antihypertensive drug utilization and blood pressure control in a Nigerian hypertensive population","volume":"3","author":"Oke O","year":"2015","journal-title":"Gen Med (Los Angel)"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-019-4202-2"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01530-z"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.006986"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-10-25"},{"issue":"3","key":"e_1_2_12_35_1","first-page":"206","article-title":"Prescription patterns and utilisation of antihypertensive drugs in private practice in Umtata","volume":"93","author":"Dambisya YM","year":"2003","journal-title":"South African medical journal\u2009=\u2009Suid\u2010Afrikaanse tydskrif vir geneeskunde"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3972-z"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13043"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011650"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002584"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.139816"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2017.1371590"},{"issue":"325","key":"e_1_2_12_42_1","article-title":"Adequacy of blood pressure control and management patterns among hypertensive adult patients attending a sub\u2010county hospital in central Kenya: a cross\u2010sectional study","volume":"37","author":"Muthuki EW","year":"2020","journal-title":"Pan Afr Med J"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01225-8"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.66"},{"issue":"2","key":"e_1_2_12_45_1","article-title":"Anti\u2010hypertensive medicines prescribing for medical outpatients in a premier teaching hospital in Nigeria: a probable shift of paradigm","volume":"12","author":"Eshiet UI","year":"2014","journal-title":"Pharm Pract (Internet)"},{"issue":"4","key":"e_1_2_12_46_1","first-page":"431","article-title":"Prescribing patterns in the treatment of hypertension among underserved African American elderly","volume":"24","author":"Yazdanshenas H","year":"2014","journal-title":"Ethn Dis"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328348345d"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e32834000be"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3282f063d5"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2014.144"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09631"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328342ca97"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/498074"},{"issue":"2","key":"e_1_2_12_54_1","first-page":"93","article-title":"Evaluation of the management of hypertension among diabetic and non\u2010diabetic adult outpatients at a referral hospital in Kenya","volume":"5","author":"Mongi A","year":"2016","journal-title":"Afr. J. Pharmacol Ther"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.5414\/CPP48068"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.14193"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/20786190.2016.1272246"},{"issue":"1","key":"e_1_2_12_58_1","first-page":"18","article-title":"Patients' blood pressure control and doctors' adherence to hypertension clinical practice guideline in managing patients at health clinics in Kuala Muda district, Kedah","volume":"72","author":"Teoh SH","year":"2017","journal-title":"Med J Malaysia"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.9734\/jammr\/2022\/v34i1331379"},{"issue":"1","key":"e_1_2_12_60_1","first-page":"1","article-title":"Adherence of doctors to a clinical guideline for hypertension in Bojanala district, North\u2010West Province, South Africa","volume":"7","author":"Govender I","year":"2015","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019873"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(17)30141-X"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-305063"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.004473"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-6175.2007.08028.x"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40119-015-0045-z"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.1185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T21:02:01Z","timestamp":1692651721000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.1185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":65,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1002\/hsr2.1185"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.1185","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"type":"print","value":"2398-8835"},{"type":"electronic","value":"2398-8835"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"2022-12-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e1185"}}