Evaluation Of Drug Therapy Problems Among Hypertensive Patients In a Nigerian Secondary Healthcare Centre

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Kosisochi Chinwendu Amorha Chinwendu Amorha
Chinyere Euphemia Anyanwu
Ebere Emilia Ayogu
Deborah Oyine Aluh

Abstract

Background: High blood pressure (HBP) is responsible for over 7.1 million deaths annually. Drug therapy problems (DTPs) interfere with the therapeutic control of HBP. This study aimed to evaluate drug therapy problems among hypertensive patients in a secondary healthcare centre in Lagos State.


Methods: This was a retrospective study carried out in a secondary health facility in Lagos State, Nigeria from 1st January 2017 through 31st December 2018. Data were extracted from the patients' folders using the Pharmaceutical Care Network Europe (PCNE) Classification tool Version 7.0, DRP-PCNE V 7.0 and analyzed with the IBM SPSS Version 25.0.


Results: 250 patient folders were assessed. Drug therapy problems were found in 181 of the 245 folders included in the study (73.9%). The mean + SD age of patients was 58.65 + 12.35 years. The mean + SD number of drug therapy problems per patient was 3.18 1 1.17. Treatment effectiveness was the most frequently encountered category of drug therapy problems (96.6%, n = 177). There was a moderate positive correlation between the total number of drug therapy problems encountered and the number of drugs taken by the patients (r = 0.546, P < 0.001). The number of drugs taken by a patient was a significant predictor of the number of drug therapy problems encountered (F [2, 134] = 37.205, P < 0.001).


Conclusion: There was a high prevalence of drug therapy problems among hypertensive patients. Patients with co- morbidities and those taking multiple medications should be monitored for potential or manifest drug therapy problems.

Article Details

How to Cite
Chinwendu Amorha, K. C. A., Euphemia Anyanwu, C. ., Emilia Ayogu, E. ., & Oyine Aluh, D. . (2020). Evaluation Of Drug Therapy Problems Among Hypertensive Patients In a Nigerian Secondary Healthcare Centre. The Nigerian Journal of Pharmacy, 54(2), 39–49 | https://doi.org/10.51412/psnnjp.2020.3. Retrieved from https://psnnjp.org/index.php/home/article/view/56
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Articles
Author Biographies

Kosisochi Chinwendu Amorha Chinwendu Amorha, Department of Clinical Pharmacy and Pharmacy Management,

Faculty of Pharmaceutical Sciences, University of Nigeria Nsukka, PMB 410001, Enugu State

Chinyere Euphemia Anyanwu, Department of Clinical Pharmacy and Pharmacy Management,

Faculty of Pharmaceutical Sciences, University of Nigeria Nsukka, PMB 410001, Enugu State

Ebere Emilia Ayogu, Department of Clinical Pharmacy and Pharmacy Management,

Faculty of Pharmaceutical Sciences, University of Nigeria Nsukka, PMB 410001, Enugu State

Deborah Oyine Aluh, Department of Pharmacy,

General Hospital, Gbagada, Lagos State

References

Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International Journal of Cancer. 127(12): 28932917.2.

Pessinaba S, Mbaye A, Yabeta G-A-D, Kane A, Ndao CT, Ndiaye MB, Harouna H, Bodian M, Diao M, Mbaye MN, Diagne MN, Diack B, Kane M, Niang K, Mathieu JS, Kane A (2013). Prevalence and determinants of hypertension and associated cardiovascular risk factors: Data from a population-based, cross- sectional survey in Saint Louis, Senegal. Cardiovascular Journal of Africa. 24(5): 180183. 3.

Awoke A, Awoke T, Alemu S, Megabiaw B (2012). Prevalence and associated factors of hypertension among adults in Gondar, Northwest Ethiopia: A community based cross- sectional study. BMC Cardiovascular Disorders. 12: 113.4.

Oliveras A, Schmieder RE (2013). Clinical situations associated with difficult-to-control hypertension. Journal of Hypertension. 31(Suppl 1): S3-8. 5.

van Mil F (2005). Drug-related problems: a cornerstone for pharmaceutical care. Journal of the Malta College of Pharmacy Practice. 10: 5-8. 6.

Pharmaceutical Care Network Europe (PCNE). Available from: https://www.pcne.org/ (Accessed 9th July 2019)

Cipolle RJ, Strand L, Morley P, Cipolle R (2004). Pharmaceutical Care Practice: The Clinicians Guide. 2nd ed. New York: McGraw-Hill.

Chua SS, Kok LC, Md Yusof FA, Tang GH, Lee SWH, Efendie B, Paraidathathu T (2012). Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension or hyperlipidaemia in primary care settings. BMC Health Services Research. 12: 388. 9.

Huri HZ, Wee HF (2013). Drug related problems in type 2 diabetes patients with hypertension: a cross- sectional retrospective study. BMC Endocrine Disorders. 13: 2.10.

Eichenberger PM, Lampert ML, Kahmann IV, Van Mil JWF, Hersberger KE (2010). Classification of drug-related problems with new prescriptions using a modified PCNE classification system.

Pharmacy World & Science. 32(3): 362372.

Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, Wu SC (2012). Drug-related problems (DRPs) identified from geriatric medication safety review clinics. Archives of Gerontology and Geriatrics. 54(1): 168174.

Ganiyu KA, Erah PO and Suleiman IA (2014). Drug therapy problems in patients on anti-hypertensives with antidiabetic drugs in two tertiary health institutions in Niger Delta region, Nigeria. Journal of Pharmaceutical and Allied Sciences. 11: 1.

Hussein M, Lenjisa JL, Woldu MA, Tegegne GT, Umeta GT and Dins H (2014). Assessment of drug related problems among hypertensive patients on follow up in Adama Hospital Medical College, East Ethiopia. Clinical Pharmacology and Biopharmaceutics. 3: 122

Raosoft sample size calculator. Available from:http://www.raosoft.com/samplesize.html (Accessed 2nd September 2020)

Pharmaceutical Care Network, Europe. The PCNE classification for drug-related problem V.7.0.2016. Available from: http://www.pcne.org/upload/files/1 47_DRP-form_ext_V7.pdf (Accessed 11th May 2017)

Ogbonna B, Amagba C (2017). Investigation of drug therapy problems in Type 2 diabetes outpatients with co-morbid hypertension in a tertiary hospital in Southeast Nigeria. Value in Health. 20(9): A859.

Koyra HC, Tuka SB, Tufa EG (2017). Epidemiology and predictors of drug therapy problems among type 2 diabetic patients at Wolaita Soddo University Teaching Hospital, Southern Ethiopia. American Journal of Pharmacological Sciences. 5(2): 40-

Redzuan AM, Ramli AR, Pheng MTH (2017). Drug-related problems in hypertensive patients with multiple co-morbidities. Open Access Journal of Pharmaceutical Research. 1(3): 000113.

Shukrala F, Gabriel T (2015). Assessment of prescribing, dispensing, and patient use pattern of anti- hypertensive drugs for patients attending outpatient department of Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. Drug Design, Development and Therapy. 9: 519-523.

Al-Azzam SI, Alzoubi KH, AbuRuz S, Alefan Q (2016). Drug- related problems in a sample of outpatients with chronic diseases: A cross-sectional study from Jordan. Therapeutics and Clinical Risk Management. 1 2: 233-239.

Ong KL, Cheung BMY, Man YB, Lau CP, Lam KSL (2007). Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 49(1): 69-75.

Choi HM, Kim HC, Kang DR (2017). Sex differences in hypertension prevalence and control: Analysis of the 2010-2014 Korea national health and nutrition examination survey. PLoS One. 12(5): e0178334.

Lu J, Lu Y, Wang X, Li X, Linderman GC, Wu C, Cheng X, Mu L, Zhang H, Liu J, Su M, Zhao H, Spatz ES, Spertus JA, Masoudi FA, Krumholz HM, Jiang L (2017). Prevalence, awareness, treatment, and control of hypertension in China: data from 1-7 million adults in a population-based screening study (China PEACE Million Persons Project). Lancet. 390(101 1 2): 2549- 2558.

Wang L, Wang X, Qu HY, Jiang S, Zhang J, Fu L, et al. (2017). Role of kidneys in sex differences in angiotensin II-induced hypertension. Hypertension. 70(6): 1219-1227.

Mirabito Colafella KM, Samuel CS and Denton KM (2017). Relaxin contributes to the regulation of arterial pressure in adult female mice. Clinical Science. 131(23): 2795-2805.

Dasinger JH and Alexander BT. Gender differences in developmental programming of cardiovascular diseases. Clinical Science. 130(5): 337-348.

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. (2016). Executive summary: heart disease and stroke statistics-2016 update: A Report from the American Heart Association. Circulation. 133: 447-454.

Chen JH, Hales CN, Ozanne SE (2007). DNA damage, cellular senescence and organismal ageing: Causal or correlative? Nucleic Acids Research. 35(22): 7417-7428.

Singh T, Newman AB (2011). Inflammatory markers in population studies of aging. Ageing Research Reviews. 10(3): 319-329.

Buford TW (2016). Hypertension and aging. Ageing Research Reviews. 26: 96-111.

Bretzel RG (2007). Co-morbidity of diabetes mellitus and hypertension in the clinical setting: A review of prevalence, pathophysiology, and treatment perspectives. Clinical Therapeutics. 29(2): S35-S43.

Jones DW, Hall JE (2004). Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 43(1): 1-3.

Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL (2000). Hypertension and anti-hypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. New England Journal of Medicine. 342(13): 905-912.

Shrout T, Rudy DW, Piascik MT (2017). Hypertension update, JNC8 and beyond. Current Opinion in Pharmacology. 33: 41-46.

Dreischulte T, Morales DR, Bell S, Guthrie B (2015). Combined use of nonsteroidal anti-inflammatory drugs with diuretics and/or renin- angiotensin system inhibitors in the community increases the risk of acute kidney injury. Kidney International. 88(2): 396403.

Fog AF, Kvalvaag G, Engedal K, Straand J (2017). Drug-related problems and changes in drug utilization after medication reviews in nursing homes in Oslo, Norway. Scandinavian Journal of Primary Health Care. 35(4): 329-335.

AI- Taani GM, Al-Azzam SI, Alzoubi KH, Elhajji FWD, Scott MG, Alfahel H, et al (2017). Prediction of drug-related problems in diabetic outpatients in a number of hospitals, using a modeling approach. Drug, Healthcare and Patient Safety. 9: 65-70.

Kaufmann CP, Stampfli D, Hersberger KE, Lampert ML (2015). Determination of risk factors for drug-related problems: A multidisciplinary triangulation process. BMJ Open. 5(3): e006376.

Niriayo YL, Kumela K, Kassa TD, Angamo MT (2018). Drug therapy problems and contributing factors in the management of heart failure patients in Jimma University Specialized Hospital, Southwest Ethiopia. PLoS One. 13(10): e0206120.

Khdour MR, Jarab AS, Adas HO, Samaro EZ, Mukattash TL, Hallak HO (2012). Identification of drug-related problems: A prospective study in two general hospitals. Current Clinical Pharmacology.7(4): 276-281.

Hussen A, Daba FB (2017). Drug therapy problems and their predictors among hypertensive patients on follow up in dil-chora referral hospital, dire-dawa, Ethiopia. International Journal of Pharmaceutical Sciences and Research. 8(6): 2712-2719.

Osemene KP, Elujoba AA, Ilori MO (2011). A comparative assessment of herbal and orthodox medicines in Nigeria. Research Journal of Medical Sciences. 5(5): 280-285.

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