Drug related problems in type 2 diabetes patients with hypertension: a cross-sectional retrospective study

Hasniza Zaman Huri,Hoo Fun Wee

doi:10.1186/1472-6823-13-2

Abstract

BackgroundType 2 diabetes (T2DM) patients with hypertension are at increased risk for experiencing drug-related problems (DRPs) since they often receive multiple medications and have multiple comorbidities. To date, there is a lack of studies conducted in T2DM patients with hypertension. This study aims to analyze the DRPs and identify factors affecting the DRPs in this patient population.MethodThis retrospective study involved T2DM patients with hypertension and was conducted at a tertiary hospital in Malaysia from January 2009 to December 2011. The assessment of DRPs was based on the Pharmaceutical Network Care Europe (PCNE) tool version 5.01.ResultsTwo hundred patients with a total of 387 DRPs were identified. Among these patients, 90.5% had at least one DRP, averaging 1.9 ± 1.2 problems per patient. The most common DRPs encountered were insufficient awareness of health and diseases (26%), drug choice problems (23%), dosing problems (16%) and drug interactions (16%). The most implicated drugs were aspirin, clopidogrel, simvastatin, amlodipine and metformin. The six domains of DRPs found to have statistically significant associations were renal impairment, polypharmacy, cardiovascular disease, elderly status, and duration of hospital stay.ConclusionsEarly identification of the types and patterns of DRPs and the factors associated to them may enhance the prevention and management of DRPs in T2DM patients with hypertension.

Highlights

Type 2 diabetes (T2DM) patients with hypertension are at increased risk for experiencing drug-related problems (DRPs) since they often receive multiple medications and have multiple comorbidities
Hypertension is a common comorbidity in T2DM patients, with a prevalence of up to two-thirds of the population, and it may be present by the time T2DM is diagnosed or even before the onset of hyperglycemia [4]
The study population consisted of T2DM patients with hypertension who fulfilled the requirements of the International Classification of Diseases Tenth Revision (ICD-10) code E11.0-11.9 for T2DM and who were admitted to the University of Malaya Medical Centre (UMMC) from January 2009 to December 2011

Summary

Introduction

Type 2 diabetes (T2DM) patients with hypertension are at increased risk for experiencing drug-related problems (DRPs) since they often receive multiple medications and have multiple comorbidities. Hypertension enhances the risk of cardiovascular disease in T2DM patients [4]. To minimize the risk of complications, many guidelines recommend a target blood pressure (BP) of ≤ 130/ 80 mmHg in all T2DM patients with hypertension [4,7,8]. Achieving this target BP remains a great challenge and the majority of the patients require one or more antihypertensive agents in order to achieve this optimal BP control [9]

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