Key result
Higher drug count linked to ~885% greater odds of drug-related problems in hypertensive and HF inpatients.
Why the study?
Hypertensive and heart failure patients frequently require multiple drug therapy, which may be associated with drug-related problems.
Cross-Sectional (n=134)
No
Odds Ratio: 9.85 (95% CI 2.04–47.5)
p-value: p=<0.001
Drug-related problems are highly prevalent among hospitalized heart failure and hypertensive patients, and clinical pharmacists can effectively identify and intervene to resolve these issues.
Polypharmacy was associated with drug-related problems in HF/hypertensive inpatients; hypothesis-generating and should not yet change practice.
Background Hypertensive and heart failure patients frequently require multiple drug therapy which may be associated with drug‐related problems (DRPs). Aim To determine the frequency, types, and predictors of DRPs, and acceptance of pharmacists' interventions among hospitalized hypertensive and heart failure patients. Method It was a prospective cross‐sectional study at the internal medicine department wards of Korle Bu Teaching Hospital (KBTH) between January and June 2019 using a validated form (the pharmaceutical care form used by clinical pharmacists at the medical department). DRPs were classified based on the Pharmaceutical Care Network Europe (PCNE) Classification scheme for DRPs V8.02. Descriptive and inferential statistics were used for data analysis. Results A total of 247 DRPs were identified in 134 patients. The mean number of DRPs was 1.84 (SD: 1.039) per patient. Most DRPs occurred during the prescribing process (40.5%; n(DRPs) = 100), and the highest prescribing problem was untreated indication (11.7%; n = 29). Other frequent DRPs were medication counseling need (25.1%; n = 62), administration errors 10.1%(n = 25), drug interaction (10.5%; n = 26), and “no” or inappropriate monitoring (10.5%; n = 26). The number of drugs received significantly predicted the number of DRPs (adjusted odds ratio [AOR]: 9.85; 95% CI: 2.04–47.50; p < 0.001). Clinical variables were significant predictors of number of DRPs (diabetic status: AOR: 0.41, 95% CI: 0.18–0.98, p < 0.05; statin use: AOR: 0.34, 95% CI: 0.14–0.81, p < 0.05; antiplatelet use: AOR: 5.95, 95% CI: 2.03–17.48, p < 0.01). Average acceptance of interventions by physicians was 71.6% (SD: 11.7). Most (70.6%; n = 48) accepted interventions were implemented by physicians (resolved). Conclusion DRPs frequently occur, with most problems identified in the prescribing process. Medication counseling was frequently needed. Patients' number of drugs and clinical factors predicted the occurrence of DRPs. Physicians accepted and implemented most interventions. Our findings suggest that clinical pharmacists have an important role in cardiovascular patient care, but this study should be replicated in other hospitals in Ghana to corroborate these findings.
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Harrison et al. (2022) conducted a cross-sectional in Hypertension and heart failure (n=134). Number of drugs received was evaluated on Occurrence of drug-related problems (DRPs) (AOR 9.85, 95% CI 2.04-47.50, p=<0.001). The number of drugs received significantly predicted the occurrence of drug-related problems among hospitalized hypertensive and heart failure patients (AOR 9.85; 95% CI 2.04-47.50; P<0.001).
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