Drug-related Problems Among Type 2 Diabetic Patients With Hypertension in a Tertiary Care Hospital in Lebanon: A Cross-sectional Study

Georges Hatem, Aya Awarkeh, Lynne H Jaffal, Dalia Khachman, Amal Al-Hajje, Salam Zein
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Abstract

Background: Patients with type 2 diabetes (T2D) often have other associated comorbidities, making them susceptible to drug-related problems (DRPs) which can adversely affect their quality of life. Understanding these problems can provide baseline data to allow informed health decisions and effective management of patients. Objectives: This study aims to investigate DRPs in T2D patients with hypertension and find the predictors of these problems. Methods: This cross-sectional study was conducted for six months in the internal medicine department of a tertiary care hospital in Lebanon. Participants were 135 adult T2D patients with hypertension who were receiving one or more anti-diabetes drugs, and at least one medication for hypertension. Pharmaceutical care network europe classification system was used to classify the DRPs. Data were collected by two clinical pharmacists using a self-report tool. Results: Most of patients were female. Most of them (94.1%) had at least one DRP (1.43±0.72 per patient). “Non-optimal drug treatment effect” was the most frequent problem (48.2%). Achieving the HbA1C target reduced the odds of this problem by 66.6%, while the increased serum creatinine level caused a two-fold increase in this problem. The use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers reduced the odds of DRPs by 86.2% and 83.3%, respectively, while lipid-lowering and anti-anginal drug use caused a four-fold increase in DRPs. Conclusion: Early identification of DRPs in diabetic patients with hypertension and their associated factors can help improve their management and reduce the associated mortality and morbidity rates.
黎巴嫩三级医院2型糖尿病合并高血压患者的药物相关问题:一项横断面研究
背景:2型糖尿病(T2D)患者通常有其他相关的合并症,使他们容易受到药物相关问题(DRPs)的影响,这可能会对他们的生活质量产生不利影响。了解这些问题可以提供基线数据,以便做出明智的健康决策并对患者进行有效管理。目的:本研究旨在探讨t2dm合并高血压患者的DRPs,并寻找这些问题的预测因素。方法:本横断面研究在黎巴嫩三级医院内科进行了六个月。研究对象为135名合并高血压的成年T2D患者,他们正在接受一种或多种抗糖尿病药物治疗,并至少接受一种高血压药物治疗。采用欧洲药学服务网络分类系统对drp进行分类。数据由两名临床药师使用自我报告工具收集。结果:患者以女性居多。大多数患者(94.1%)至少有一次DRP(1.43±0.72 /例)。“药物治疗效果不理想”是最常见的问题(48.2%)。达到HbA1C目标使该问题的发生率降低了66.6%,而血清肌酐水平的升高使该问题的发生率增加了两倍。血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂的使用分别使DRPs的发生率降低了86.2%和83.3%,而降脂和抗心绞痛药物的使用使DRPs的发生率增加了4倍。结论:早期发现糖尿病合并高血压患者的DRPs及其相关因素有助于改善其管理,降低相关病死率和发病率。
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