Doctors’ Knowledge, Attitude and Objective Adherence with Hypertension Guidelines in Quetta, Pakistan: A Cross-sectional Analytical Study

Journal of Pharmacy Practice and Community Medicine,2020,6,4,57-63.
Published:January 2021
Type:Research Article
Author(s) affiliations:

Mirza Khan1,*, Nafees Ahmed1, Abdul Wahid1, Syed Liaquat Ali Khan1, Asad Khan2, Zarka Akbar1, Palwasha Bibi1

1Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Balochistan, PAKISTAN.

2Department of Pharmacy, Quaid-i-Azam University, Islamabad, PAKISTAN.


Background: There is scarcity of published information about doctors’ knowledge, attitude and adherence with hypertension guidelines from Pakistan. Objectives: To evaluate doctors’ knowledge, attitude and objective adherence with the recommendations of Clinical Practice Guidelines (CPG) developed by American Society of Hypertension/International Society of Hypertension. Methods: This cross-sectional questionnaire-based study included 95 doctors from various health care facilities in Quetta, Baluchistan to evaluate doctors’ knowledge of and attitude towards guidelines. Physicians’ endearment with ASH/ISH (2014) guidelines was evaluated by the prescriptions they wrote to 1900 hypertensive individuals (20 prescriptions of each enrolled doctor). Data was analysed using SPSS 20. Results: 58.9% doctors had sufficient knowledge of guidelines. Doctors’ with specialization and consultants, doctors of age >35 years and who were in clinical practice for >5 years had significantly (p-value<0.05) greater knowledge and more guidelines adherent practices than their counterparts. There was a significant association between doctors’ knowledge and practice scores. (rs=0.758, p-value <0.001). Overall, doctors had positive attitudes towards guidelines. A total of 1385 (72.9%) prescriptions were judged guidelines adherent. In multivariate analysis, guidelines adherence had statistically significant positive association with the presence of any comorbidity (OR=2.804, p-value<0.001), heart failure (OR=5.101, p-value<0.001), chronic kidney disease (OR=2.384, p-value<0.001) and benign prostatic hyperplasia (OR=3.137, p-value=0.009) and negative association with diabetes mellitus (OR=0.265, p-value<0.001). Conclusion: Only 58.9% doctors were adequately aware of guidelines recommendations. A fair number of patients (72.9%) received guidelines adherent prescriptions. Doctors’ poor knowledge of guidelines preferred antihypertensive agents in diabetic hypertensive patients reflected in their practices.