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埃塞俄比亚贡德尔大学医院心血管疾病患者发生药物相关问题的危险因素。

Risk factors for developing drug-related problems in patients with cardiovascular diseases attending Gondar University Hospital, Ethiopia.

作者信息

Abdela Ousman Abubeker, Bhagavathula Akshaya Srikanth, Getachew Henok, Kelifa Yohannes

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

J Pharm Bioallied Sci. 2016 Oct-Dec;8(4):289-295. doi: 10.4103/0975-7406.199335.

Abstract

BACKGROUND

Cardiovascular diseases (CVDs) are often accompanied with comoribidities and complications leading to taking multiple drugs and thus are more liable to be exposed to drug-related problems (DRPs). DRPs can occur at any stages of medication process from prescription to follow-up treatment. However, a few studies have assessed the specific risk factors for occurrence of at least one potential DRP per patient with CVDs in sub-Saharan African region.

AIM

We aim to assess the risk factors for developing potential DRPs in patients with CVDs attending Gondar University Referral Hospital (GUH).

METHODOLOGY

This was a cross-sectional study. A structured systematic data review was designed focusing on patients with CVDs (both out and inpatients) with age >18 years of both genders attending GUH from April to June 2015. All DRPs were assessed using drugs.com and Medscape. The causes of DRPs were classified using Pharmaceutical Care Network Europe version 6.2. Risk factors that could cause DRPs were assessed using binary logistic regression showing odds ratio with 95% confidential interval. Statistical significance was set at < 0.05.

RESULTS

A total of 227 patients with CVDs were reviewed with a mean age of 52.0 ± 1.7 years. Majority were females (143, 63%), outpatients (133, 58.6%), and diagnosed with heart failure (71, 31.3%). Diuretics (199, 29.5%) were the most commonly prescribed drugs. A total of 265 DRPs were identified, 63.4% of patients have at least one DRP (1.17 ± 1.1). The most common DRPs were found to be an inappropriate selection of drug (36.1%) and dose (24.8%). The most identified risk factors causing DRPs were: Need of additional drug therapy and lack of therapeutic monitoring.

CONCLUSION

The most identified risk factors for developing DRPs were the need of additional drug therapy and lack of therapeutic monitoring. There is a need for clinical pharmacist interventions to monitor and prevent the risk of developing DRPs and contribute to improve the clinical outcome in patients with CVDs.

摘要

背景

心血管疾病(CVD)常伴有合并症和并发症,导致需服用多种药物,因此更容易出现药物相关问题(DRP)。DRP可发生在从处方到后续治疗的用药过程的任何阶段。然而,在撒哈拉以南非洲地区,很少有研究评估每位心血管疾病患者发生至少一种潜在DRP的具体风险因素。

目的

我们旨在评估贡德尔大学转诊医院(GUH)心血管疾病患者发生潜在DRP的风险因素。

方法

这是一项横断面研究。设计了一项结构化的系统数据回顾,重点关注2015年4月至6月在GUH就诊的年龄大于18岁的心血管疾病患者(包括门诊和住院患者)。所有DRP均使用drugs.com和Medscape进行评估。使用欧洲药学保健网络第6.2版对DRP的原因进行分类。使用二元逻辑回归评估可能导致DRP的风险因素,显示比值比及95%置信区间。设定统计学显著性为<0.05。

结果

共对227例心血管疾病患者进行了回顾,平均年龄为52.0±1.7岁。大多数为女性(143例,63%)、门诊患者(133例,58.6%),诊断为心力衰竭(71例,31.3%)。利尿剂(199例,29.5%)是最常用的药物。共识别出265个DRP,63.4%的患者至少有一个DRP(1.17±1.1)。最常见的DRP是药物选择不当(36.1%)和剂量不当(24.8%)。导致DRP的最常见风险因素是:需要额外的药物治疗和缺乏治疗监测。

结论

导致DRP的最常见风险因素是需要额外的药物治疗和缺乏治疗监测。需要临床药师进行干预,以监测和预防DRP的发生风险,并有助于改善心血管疾病患者的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f008/5314827/091fa8de1d2d/JPBS-8-289-g002.jpg

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