Changing patterns in health-seeking behaviour and prescription practices for treatment of hypertension in nine districts – insights from India Hypertension Control Initiative, 2018-19 and 2023-24

The India Hypertension Control Initiative (IHCI) aimed to strengthen public sector primary care for hypertension treatment and control. Our study describes changes in health-seeking behaviour, prescription practices, and key predictors influencing treatment adoption in the public sector using data from IHCI repeat cross-sectional surveys. We conducted baseline (2018-19) and follow-up (2023-24) surveys in nine districts across five Phase I states in India - two districts each from Punjab, Madhya Pradesh, Telangana, and Kerala, and one from Maharashtra. We conducted the survey among 3,900 adults (18-69 years) per district at two time points. We computed frequencies and proportions for socio-demographic variables, healthcare utilisation, blood pressure (BP) control, drug availability, medication costs, and prescription practices. We used a log-binomial model to estimate unadjusted and adjusted prevalence ratios (PRs, APRs) with 95% confidence intervals for factors influencing care-seeking for hypertension in government facilities. Among 2,873 baseline and 3,276 follow-up respondents, the proportion seeking treatment at government facilities increased from 20% to 32%. Individuals on treatment were 1.5 times more likely to use government facilities in 2023-24 than in 2018-19 (aPR 1.54, 95% CI: 1.4-1.7). BP control improved in government (37% to 48%) and non-government (35% to 47%) facilities. Drug availability (always available) in government facilities rose from 72% (425/588) to 81% (844/1041), with Amlodipine 5 mg remaining the most prescribed drug (18%). The proportion of individuals paying for medications dropped from 47% to 9%. There was increased public sector use, improved BP control, enhanced drug availability, and reduced costs, possibly due to IHCI interventions. We recommend using representative surveys for NCD surveillance to monitor healthcare utilisation patterns and assess the impact of interventions on hypertension outcomes. KeywordsBlood Pressure; Hypertension; Public Sector; Primary Health Care; Drug Prescriptions; Patient Acceptance of Health Care; India.

Authors

Institutions

Publication Details

Journal
BMC Public Health
Published
2025-10-27
DOI
https://doi.org/10.1186/s12889-025-24898-0
Citations
1
Primary Topic
Blood Pressure and Hypertension Studies
Type
article
Field-Weighted Citation Impact
1.39
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Changing patterns in health-seeking behaviour and prescription practices for treatment of hypertension in nine districts – insights from India Hypertension Control Initiative, 2018-19 and 2023-24

Bidisha Das, Pragati Pragya, Jayashree Kalva, Mosoniro Kriina et al.
1 citations
BMC Public Health
Blood Pressure and Hypertension Studies
1.39
article

Changing patterns in health-seeking behaviour and prescription practices for treatment of hypertension in nine districts – insights from India Hypertension Control Initiative, 2018-19 and 2023-24

Bidisha Das, Pragati Pragya, Jayashree Kalva, Mosoniro Kriina, Parasuraman Ganeshkumar, Sandeep Singh Gill, Namita Neelkanth, Branch Immanuvel A, Ashu Gupta, R. Maanasa, Sampada Dipak Bangar, Kannamkottapilly Chandrasekharan Prajitha, Subramanian Venkatesan, Navaneeth S. Krishna, Gagandeep Singh Grover, Yannick Poulose Puthussery, Vettrichelvan Venkatasamy, Rupali Bharadwaj, Sravan Kumar Reddy T, Meenakshi Sharma, Vishwajit Bharadwaj, Prabhdeep Kaur, Jayalakshmi Somasundaram, Anupam Khungar Pathni, Sailaja Bitragunta, Abhishek Kunwar, Roopa Shivashankar, Amol Wankhede, Deenadayalan Chandran, Lakshmi Krishnan, Navneet Kishore, J. M., Tapas Chakma, Bipin Gopal, A. Sugavathy, Kalyani Sailesh, Sarita Hazare, Sonie Sait, Ramakrishna Kodirekkala
article en
1 citations

Abstract

The India Hypertension Control Initiative (IHCI) aimed to strengthen public sector primary care for hypertension treatment and control. Our study describes changes in health-seeking behaviour, prescription practices, and key predictors influencing treatment adoption in the public sector using data from IHCI repeat cross-sectional surveys. We conducted baseline (2018-19) and follow-up (2023-24) surveys in nine districts across five Phase I states in India - two districts each from Punjab, Madhya Pradesh, Telangana, and Kerala, and one from Maharashtra. We conducted the survey among 3,900 adults (18-69 years) per district at two time points. We computed frequencies and proportions for socio-demographic variables, healthcare utilisation, blood pressure (BP) control, drug availability, medication costs, and prescription practices. We used a log-binomial model to estimate unadjusted and adjusted prevalence ratios (PRs, APRs) with 95% confidence intervals for factors influencing care-seeking for hypertension in government facilities. Among 2,873 baseline and 3,276 follow-up respondents, the proportion seeking treatment at government facilities increased from 20% to 32%. Individuals on treatment were 1.5 times more likely to use government facilities in 2023-24 than in 2018-19 (aPR 1.54, 95% CI: 1.4-1.7). BP control improved in government (37% to 48%) and non-government (35% to 47%) facilities. Drug availability (always available) in government facilities rose from 72% (425/588) to 81% (844/1041), with Amlodipine 5 mg remaining the most prescribed drug (18%). The proportion of individuals paying for medications dropped from 47% to 9%. There was increased public sector use, improved BP control, enhanced drug availability, and reduced costs, possibly due to IHCI interventions. We recommend using representative surveys for NCD surveillance to monitor healthcare utilisation patterns and assess the impact of interventions on hypertension outcomes. KeywordsBlood Pressure; Hypertension; Public Sector; Primary Health Care; Drug Prescriptions; Patient Acceptance of Health Care; India.

BMC Public HealthVol. 25(1)
Government of Maharashtra (IN), Government of India (IN), Government of Andhra Pradesh (IN), Government of Kerala (IN), Mahatma Gandhi Institute for Rural Industrialization (IN), Government of Karnataka (IN), Kerala University of Health Sciences (IN), Indian Council of Medical Research (IN), National Institute of Epidemiology (IN), National Institute for Research in Tribal Health (IN), Punjab State Council for Science & Technology (IN), National Institute of Indian Medical Heritage (IN), Save the Children (BD), Centre for Management Development (IN), National AIDS Research Institute (IN), World Health Organization - India (IN), Kannur University (IN), Ministry of Health and Family Welfare (BD), Indian Institute of Science Bangalore (IN)
Openalex Percentile: Top 14%
Blood Pressure and Hypertension Studies
1.39
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.