Drug Utilization Patterns and WHO Prescribing Indicators Among Hypertensive Outpatients at Karnali Academy of Health Sciences, Nepal: A Cross‐Sectional Study

ABSTRACT

Hypertension is one of the most prevalent non‐communicable diseases (NCDs) worldwide. This descriptive cross‐sectional study evaluated drug utilization patterns and WHO core prescribing indicators among hypertensive patients attending the Outpatient Department of Karnali Academy of Health Sciences (KAHS), Jumla. A total of 197 hypertensive outpatients were systematically enrolled, and data were collected using a structured WHO‐aligned questionnaire and analyzed using descriptive statistics in SPSS version 26. The mean age of participants was 51.6 ± 13.2 years, with a slight male predominance (51.3%). Calcium channel blockers (32.8%) and angiotensin receptor blockers (24.6%) were the most frequently prescribed antihypertensive classes, while dual‐drug therapy was the predominant treatment regimen (43.7%). Assessment of WHO prescribing indicators showed an average of 4.05 drugs per prescription (WHO target < 2.0), generic prescribing of 34.4% (target 100%), adherence to the Essential Medicines List of 79.9% (target 100%), antibiotic prescribing of 14.2%, and injection prescribing of 7.6%. Although antihypertensive prescribing practices at KAHS reflected generally appropriate drug selection for hypertension management, substantial deviations from WHO rational medicine use standards were observed, particularly with regard to low generic prescribing and excessive polypharmacy. These findings highlight the need for urgent policy‐level interventions, including mandatory generic prescribing practices and regular prescription audits, to improve affordability, promote rational drug use, and enhance patient safety in this resource‐limited setting.