Drug-related problems (DRPs) in hypertensive patients at Karsa Husada Batu Hospital, East Java, Indonesia: Evaluation based on drug selection

Authors

  • Dhani Wijaya Department of Pharmacy, Faculty of Medicine and Health Science, UIN Maulana Malik Ibrahim Malang, Malang, Indonesia https://orcid.org/0000-0002-0073-4640
  • Sadli Syarifuddin Department of Pharmacy, Faculty of Medicine and Health Science, UIN Maulana Malik Ibrahim Malang, Malang, Indonesia
  • Atiqoh Nur Habibah Department of Pharmacy, Faculty of Medicine and Health Science, UIN Maulana Malik Ibrahim Malang, Malang, Indonesia
  • Fika Sayyidatun Nafisah Department of Pharmacy, Faculty of Medicine and Health Science, UIN Maulana Malik Ibrahim Malang, Malang, Indonesia
  • Fathia Faza Rahmadanita Department of Pharmacy, Faculty of Medicine and Health Science, UIN Maulana Malik Ibrahim Malang, Malang, Indonesia
  • Roihatul Mutiah Department of Pharmacy, Faculty of Medicine and Health Science, UIN Maulana Malik Ibrahim Malang, Malang, Indonesia
  • Siti Maimunah Department of Pharmacy, Faculty of Medicine and Health Science, UIN Maulana Malik Ibrahim Malang, Malang, Indonesia

DOI:

https://doi.org/10.46542/pe.2024.243.412417

Keywords:

Drug related problem, Drug selection, DRP, Hypertension

Abstract

Background: Hypertension significantly contributes to premature deaths globally. Drug selection has a vital role in the success of hypertension treatment, but incorrect selection could promote Drug-related problems (DRPs).

Objective: This study evaluates DRPs based on the drug selection of inpatient hypertensive patients at Karsa Husada Batu Hospital, which is located in East Java, Indonesia.

Method: This study was an observational study with a retrospective research design. The cases of DRPs were classified using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.1. This was total sampling research with the population of medical records of patients with hypertension without complications who were hospitalised at Karsa Husada Batu Hospital in 2018-2021.

Result: This study involved 66 patients’ medical records. The DRPs of the drug selection occurred in 47 patients (71.21%), including 15 cases of drug use that did not comply with guidelines, 34 cases without indication for the drug used, 51 cases of improper combination of drugs, nine cases of inexact duplication of the therapeutic group, and 31 cases of no adequate drug for existing indication.

Conclusion: Inappropriate drug combinations are the primary cause of DRPs based on drug selection, and there are no cases in which too many drugs are prescribed for an indication.

References

Appleton, S. L., Neo, C., Hill, C. L., Douglas, K. A., & Adams, R. J. (2013). Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample. Journal of human hypertension, 27(7), 453–462. https://doi.org/10.1038/jhh.2012.62

Blessing Onyinye, U. K., Maxwell, O. A., & Chinwe, V. U. (2020). Identifying and resolving drug therapy problems among hypertensive patients receiving care in a Nigerian-A pilot study. Annals of Clinical Hypertension, 4(1), 020–023. https://doi.org/10.29328/journal.ach.1001024

Cipolle, R. J., Strand, L. M., & Morley, P. C. (2015). Pharmaceutical care practice: the patient-centered approach to medication management. McGraw-Hill.

Denholm, L., & Gallagher, G. (2018). Physiology and pharmacology of nausea and vomiting. In Anaesthesia and Intensive Care Medicine, 19, 513–516. https://doi.org/10.1016/j.mpaic.2018.06.010

Drug Information Handbook. (2014). Drug information handbook 23rd edition with international trade names index. LexiComp for The American Pharmacists Association.

Garg, M., Vishwakarma, P., Sharma, M., Nehra, R., & Saxena, K. K. (2014). The impact of irrational practices: A wake-up call. Journal of Pharmacology and Pharmacotherapeutics, 5, 245–247. https://doi.org/10.4103/0976-500X.142434

Gonçalves, C., & Abreu, S. (2020). Sodium and potassium intake and cardiovascular disease in older people: A systematic review. Nutrients, 12(11), 1–16. https://doi.org/10.3390/nu12113447

Hussein, M. (2014). Assessment of drug related problems among hypertensive patients on follow up in Adama [ hospital medical college, east Ethiopia. Clinical Pharmacology & Biopharmaceutics, 3(2). https://doi.org/10.4172/2167-065x.1000122

Iorga, A., Cunningham, C. M., Moazeni, S., Ruffenach, G., Umar, S., & Eghbali, M. (2017). The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy. Biology of Sex Differences, 8, 33. https://doi.org/10.1186/s13293-017-0152-8

James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., Lackland, D. T., LeFevre, M. L., MacKenzie, T. D., Ogedegbe, O., Smith, S. C., Svetkey, L. P., Taler, S. J., Townsend, R. R., Wright, J. T., Narva, A. S., & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee (JNC 8). JAMA, 311, 507–520. https://doi.org/10.1001/jama.2013.284427

Krogager, M. L., Kragholm, K., Thomassen, J. Q., Søgaard, P., Lewis, B. S., Wassmann, S., Baumgartner, I., Ceconi, C., Schmidt, T. A., Kaski, J. C., Drexel, H., Semb, A. G., Agewall, S., Niessner, A., Savarese, G., Kjeldsen, K. P., Borghi, C., Tamargo, J., & Torp-Pedersen, C. (2021). Update on management of hypokalaemia and goals for the lower potassium level in patients with cardiovascular disease: a review in collaboration with the european society of cardiology working group on cardiovascular pharmacotherapy. European Heart Journal - Cardiovascular Pharmacotherapy, 7, 557–567. https://doi.org/10.1093/ehjcvp/pvab038

Krustev, T., Milushewa, P., & Tachkov, K. (2022). Impact of polypharmacy, drug-related problems, and potentially inappropriate medications in geriatric patients and its implications for bulgaria—narrative review and meta-analysis. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.743138

Kumar, M. V., Pasha, M. M., Varshith, G., Pravalika, B., & Shameela, M. (2022). Drug related problems identified by clinical pharmacist in a tertiary care hospital in south india: an observational study. Indian Journal of Pharmacy Practice, 15(3), 198–204. https://doi.org/10.5530/ijopp.15.3.37

Kusumawardani, L., Andrajati, R., & Nusaibah, A. (2020). Drug-related problems in hypertensive patients: a cross-sectional study from Indonesia. Journal of Research in Pharmacy Practice, 9(3), 140–140. https://doi.org/10.4103/jrpp.jrpp_20_16

Lee, H., Song, I., Shin, S. M., Jeong, H. E., Lee, E. K., & Shin, J. Y. (2019). Regulatory effect of decreasing therapeutic duplication of respiratory drugs using a prescription database between 2012 and 2015. Regulatory Toxicology and Pharmacology, 103, 218–228. https://doi.org/10.1016/j.yrtph.2019.02.003

Maxwell A, S. R. J. (2016). Rational prescribing: The principles of drug selection. Clinical Medicine, 16(5), 459–464. https://doi.org/10.7861/clinmedicine.16-5-459

Moriarty, F., Bennett, K., & Fahey, T. (2019). Fixed-dose combination antihypertensives and risk of medication errors. Heart, 105(3), 204–209. https://doi.org/10.1136/heartjnl-2018-313492

Pharmaceutical Care Network Europe. (2020). Classification for drug related problems. https://www.pcne.org/upload/files/417_PCNE_classification_V9-1_final.pdf

Rahmanzade, R., Cabrera Diaz, F., Zaugg, C., Schuetz, P., & Salili, A. R. (2020). Therapeutic duplication of anticoagulants: A retrospective study of frequency and consequences in a tertiary referral hospital. Thrombosis Journal, 18(1). https://doi.org/10.1186/s12959-020-00227-w

Reilly, R. F. & Jackson, E. K. (2011). Goodman and Gilman’s The Pharmacological Basic of Therapeutics 12th edition. The McGraw-Hill Companies.

Rochon, P. A. (2022). Drug prescribing for older adults. UpToDate. https://www.uptodate.com/contents/drug-prescribing-for-older-adults

Rodrigues, A. T., Stahlschmidt, R., Granja, S., Pilger, D., Falcão, A. L. E., & Mazzola, P. G. (2017). Prevalence of potential drug-drug interactions in the intensive care unit of a Brazilian teaching hospital. Brazilian Journal of Pharmaceutical Sciences, 53(1). https://doi.org/10.1590/s2175-97902017000116109

Sun, Z. (2015). Aging, arterial stiffness, and hypertension. Hypertension, 65(2), 252–256. https://doi.org/10.1161/HYPERTENSIONAHA.114.03617

Unger, T., Borghi, C., Charchar, F., Khan, N. A., Poulter, N. R., Prabhakaran, D., Ramirez, A., Schlaich, M., Stergiou, G. S., Tomaszewski, M., Wainford, R. D., Williams, B., & Schutte, A. E. (2020). 2020 international society of hypertension global hypertension practice guidelines. Hypertension, 75(6), 1334–1357. https://doi.org/10.1161/HYPERTENSIONAHA.120.15026

Vostinaru, O. (2017). Adverse effects and drug interactions of the non‐steroidal anti‐inflammatory drugs. Nonsteroidal Anti-Inflammatory Drugs. InTech. https://doi.org/10.5772/intechopen.68198

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., & Wright, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the american college of cardiology/american heart association task force on clinical practice guidelines. Journal of the American College of Cardiology, 71(19), e127–e248. https://doi.org/10.1016/j.jacc.2017.11.006

World Health Organization. (2022). The global health observatory: Hypertension. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3155

Zhao, D., Liu, H., & Dong, P. (2019). A meta-analysis of antihypertensive effect of telmisartan versus candesartan in patients with essential hypertension. Clinical and Experimental Hypertension, 41(1), 75–79. https://doi.org/10.1080/10641963.2018.1445750

Downloads

Published

27-09-2024

How to Cite

Wijaya, D., Syarifuddin, S., Habibah, A. N., Nafisah, F. S., Rahmadanita, F. F., Mutiah, R., & Maimunah, S. (2024). Drug-related problems (DRPs) in hypertensive patients at Karsa Husada Batu Hospital, East Java, Indonesia: Evaluation based on drug selection. Pharmacy Education, 24(3), p. 412–417. https://doi.org/10.46542/pe.2024.243.412417