Abstract:

Aim: The objective of the study is to determine the availability of anti-hypertensive medications in primary care clinics in Kuwait, and the impact of such problem on the hypertensive patients, since hypertension is a major chronic illness with significant morbidity and mortality. Methods: This is a descriptive study conducted during January 2006. The study included almost all (71) primary care clinics in Kuwait; 19 (27%) family care centers and 52 (73%) non-family centers. A specially designed data form was developed containing all anti-hypertensive medications available in the Ministry of Health (M.O.H). Results: The results showed that none of the centers surveyed had potent Calcium channel blockers like felodipine, amlodipine or trimetazidine . In addition, none of the centers had Angiotensin II receptor antagonists . Less effective medications like propranolol, methyldopa and furosamide 40 mg were found in all centers. Potent Angiotensin converting enzyme inhibitors like lisinopril was available in all centers of Capital health area (HA), 12/13 centers in Ahmadi HA, 4/9 in Jahra HA and 9/17 in Farwania HA . Captopril 25 was available in almost all centers (70/71), captopril 50 was found in all centers of Hawalli, Jahra, and Ahmadi HA, while it was found in 14/20 centers in Capital HA and 7/9 centers in Jahra HA. potent Beta blockers like metoprolol & Diltiazem 60 mg were found in only 12 centers in the Capital HA . Verapamil 40 was found in only 9 centers. Amiloride/hydrochlorthiazide was available in 66 centers. Indapamide was found in 59 centers, mostly in Capital and Ahmadi HA. The test of proportion showed significant difference between the family and non-family centers in terms of the availability of some medications like metoprolol and lisinopril (p<0.001 & p<0.05 respectively). Conclusion: Most of primary care centers in Kuwait lack essential effective hypertension medications. This creates over-reliance on secondary and tertiary care departments. This problem has a significant impact on the hypertensive patients if these medications r not available, (medical ,social, financial problems)

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