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Risk factors for developing drug-related problems in patients with cardiovascular diseases attending Gondar
Ousman Abubeker Abdela1, Akshaya Srikanth Bhagavathula1, Henok Getachew1
1Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Insights
Patients with cardiovascular diseases (CVDs) often experience drug-related problems (DRPs). The primary risk factors identified were the need for additional drug therapy and insufficient therapeutic monitoring, highlighting the importance of clinical pharmacist involvement.
Area of Science:
- Pharmacology and Therapeutics
- Clinical Pharmacy
- Public Health
Background:
- Cardiovascular diseases (CVDs) frequently present with comorbidities, increasing the likelihood of polypharmacy and subsequent drug-related problems (DRPs).
- DRPs can manifest at any point in the medication management process, from initial prescription to ongoing patient care.
- Limited research exists on the specific risk factors for DRPs in CVD patients within the sub-Saharan African region.
Purpose of the Study:
- To identify and analyze the risk factors associated with the development of potential DRPs in patients diagnosed with CVDs.
- To investigate the prevalence and types of DRPs encountered in CVD patients at Gondar University Referral Hospital (GUH).
Main Methods:
- A cross-sectional study design was employed, involving a systematic review of patient data.
- Data were collected from adult outpatients and inpatients with CVDs at GUH between April and June 2015.
- DRPs were assessed using online resources (drugs.com, Medscape), and their causes were classified using the Pharmaceutical Care Network Europe version 6.2. Binary logistic regression was used to determine risk factors.
Main Results:
- A total of 227 CVD patients were analyzed; 63.4% experienced at least one DRP.
- The most frequent DRPs identified were inappropriate drug selection (36.1%) and incorrect dosage (24.8%).
- Key risk factors identified included the need for additional drug therapy and a lack of adequate therapeutic monitoring.
Conclusions:
- The need for additional drug therapy and insufficient therapeutic monitoring are significant risk factors for DRPs in CVD patients.
- Clinical pharmacist interventions are crucial for monitoring, preventing DRPs, and improving clinical outcomes in this patient population.
- The findings underscore the importance of integrated pharmaceutical care in managing complex CVD cases.
Background:
Cardiovascular diseases (CVDs) are often accompanied with comoribidities and complications leading to taking multiple drugs and thus are more liable to be exposed to drug-related problems (DRPs). DRPs can occur at any stages of medication process from prescription to follow-up treatment. However, a few studies have assessed the specific risk factors for occurrence of at least one potential DRP per patient with CVDs in sub-Saharan African region.
Aim:
We aim to assess the risk factors for developing potential DRPs in patients with CVDs attending Gondar University Referral Hospital (GUH).
Methodology:
This was a cross-sectional study. A structured systematic data review was designed focusing on patients with CVDs (both out and inpatients) with age >18 years of both genders attending GUH from April to June 2015. All DRPs were assessed using drugs.com and Medscape. The causes of DRPs were classified using Pharmaceutical Care Network Europe version 6.2. Risk factors that could cause DRPs were assessed using binary logistic regression showing odds ratio with 95% confidential interval. Statistical significance was set at P < 0.05.
Results:
A total of 227 patients with CVDs were reviewed with a mean age of 52.0 ± 1.7 years. Majority were females (143, 63%), outpatients (133, 58.6%), and diagnosed with heart failure (71, 31.3%). Diuretics (199, 29.5%) were the most commonly prescribed drugs. A total of 265 DRPs were identified, 63.4% of patients have at least one DRP (1.17 ± 1.1). The most common DRPs were found to be an inappropriate selection of drug (36.1%) and dose (24.8%). The most identified risk factors causing DRPs were: Need of additional drug therapy and lack of therapeutic monitoring.
Conclusion:
The most identified risk factors for developing DRPs were the need of additional drug therapy and lack of therapeutic monitoring. There is a need for clinical pharmacist interventions to monitor and prevent the risk of developing DRPs and contribute to improve the clinical outcome in patients with CVDs.