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Abstract
Introduction: Patients with type 2 diabetes mellitus with hypertension are at a higher risk
of drug related problems since they are often prescribed many medications due to
comorbidities. Many factors have been identified to contribute to the development of drug
related problems in type 2 diabetes mellitus patients with hypertension. These include comorbidity,
polypharmacy,
age,
medical
conditions.
Objective: The aim of this study was to assess the prevalence of drug related problems and
associated factors among patients with type 2 diabetes mellitus and hypertension in Southern
Ethiopia, 2013 E.C.
Methods: Hospital based cross-sectional study was conducted among adult patients
admitted to medical ward with the diagnosis of type 2 diabetes mellitus and hypertension. A
structured questionnaire and review of patients’ medical record was used during data
collection. Pharmaceutical Care Network Europe Foundation Classification System was
used to classify and evaluate drug related problems. The adherence in chronic diseases scale
was used to assess the adherence. Data was entered in to EPI Data version-4.6 and the
exported to Statistical Package for the social sciences version 25.0 for analysis. The results
were summarized using descriptive statistics including frequency, mean, and standard
deviation. Logistic regression analysis was conducted to identify the independent predicators
of drug therapy problem. P value <0.05 was considered significant.
Result: Out of 288 type 2 diabetes with hypertension patients included in the study, total of
281 drug related problems were identified, with a mean (±SD) of 1.91 (±0.5) problems per
patient. Drug choice problem 126 (44.8%) and dosing problem 65 (23.1%) were the most
commonly occurred types of drug related problems. Age >60 years (AOR= 23.567; 95% CI:
7.216, 76.973), comorbidity (AOR=3.786; 95% CI: (1.907, 7.519), polypharmacy (AOR
=2.747; 95% CI: (1.629, 3.717) and stage II hypertension (AOR=3.370; 95% CI: (1.656,
6.858), were independent factors of the drug therapy problems. 85% of study participants
were non-adherent for their medications. Among study participants, 85% of study
participants were non-adherent to their medications. 7.7% of patients were taking drugs with
potential drug-drug interaction. Frequently prescribed drug for Type 2 Diabetes Mellitus was
Metformin (41%) and frequent combination was Metformin + insulin (20.1%). Angiotensin
converting enzyme inhibitors (37.9%) was commonly prescribed anti-hypertensive drugs
and frequent anti-hypertensive combination was enalapril + amlodipine (34.5%)., Statins
(29.4%) were frequently prescribed class of drug among concurrently used agents.
Conclusion: Drug related problems are common among type 2 diabetics and hypertension
patients admitted to medical wards. Drug choice problem was the most frequent problems
while drug/dose selection was the main causes. Among drug classes used by T2DM with
hypertension patients in the hospital, anti-diabetic medications followed by Antihypertensive
and statin were found to be the most frequently involved drugs in overall
occurrence of drug related problems. 85% of study participants were non-adherent to their
medications.
Key words: Type 2 diabetes, Hypertension, Drug-related problems, Southern Ethiopia |
en_US |