Kusumawardani Larasati Arrum, Andrajati Retnosari, Nusaibah Azizah
Clinical Pharmacy Laboratory, Faculty of Pharmacy, Universitas Indonesia, Depok, West Java, Indonesia.
J Res Pharm Pract. 2020 Oct 8;9(3):140-145. doi: 10.4103/jrpp.JRPP_20_16. eCollection 2020 Jul-Sep.
The treatment of hypertension requires special attention because of comorbidities and polypharmacy. In a previous study, polypharmacy has been associated with a high risk of drug-related problems (DRPs). This study aimed to analyze DRPs in Indonesian hypertensive patients focusing on drug therapy effectiveness and adverse drug reactions.
A cross-sectional study was conducted using medical records' data, prescriptions, and nursing records to observe DRPs that occurred in outpatients with hypertension from February to April 2019. A total of 114 outpatients aged ≥23 years with a primary diagnosis of primary hypertension were included in this study. DRPs were reviewed based on literature, recent guidelines, and drug interaction software. Classification DRPs were done using Indonesian-translated Pharmaceutical Care Network Europe V6.02. The data obtained were analyzed using univariate descriptive analysis.
Of all participants, 65 (57%) outpatients were found to have DRPs related to treatment effectiveness (54 cases) and adverse drug reactions (36 cases). The primary cause of the problems was an inappropriate drug (94.14%) and dose selection (2.86%). Potential drug interactions were found high (62.14%) in the combination of an antihypertensive agent with other drugs among patients. Overprescribing drugs without clear indications, untreated indications, and subtherapeutic dosage were also reported in this study.
A significant percentage of outpatients being treated for hypertension experienced DRPs. The role of clinical pharmacists and physicians in monitoring drug therapy needs to be prioritized to prevent and resolve DRPs in outpatients with hypertension.
由于合并症和联合用药，高血压的治疗需要特别关注。在之前的一项研究中，联合用药与药物相关问题（DRP）的高风险有关。本研究旨在分析印度尼西亚高血压患者中与药物治疗有效性和药物不良反应相关的DRP。
采用横断面研究，利用病历数据、处方和护理记录观察2019年2月至4月高血压门诊患者发生的DRP。本研究共纳入114名年龄≥23岁、初步诊断为原发性高血压的门诊患者。基于文献、最新指南和药物相互作用软件对DRP进行审查。使用印度尼西亚语翻译的欧洲药学保健网络V6.02进行DRP分类。对获得的数据进行单变量描述性分析。
在所有参与者中，65名（57%）门诊患者被发现存在与治疗有效性（54例）和药物不良反应（36例）相关的DRP。问题的主要原因是药物选择不当（94.14%）和剂量选择（2.86%）。在患者中，抗高血压药物与其他药物联合使用时，潜在药物相互作用的发生率较高（62.14%）。本研究还报告了无明确指征的过度用药、未治疗的指征和亚治疗剂量。
接受高血压治疗的门诊患者中，有相当比例经历了DRP。临床药师和医生在监测药物治疗方面的作用需要优先考虑，以预防和解决高血压门诊患者的DRP。
