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乌干达姆巴拉拉地区转诊医院高血压诊所高血压患者药物治疗问题的流行情况及相关因素:一项横断面研究。

Prevalence and factors associated with drug therapy problems among hypertensive patients at hypertension clinic of Mbarara Regional Referral Hospital, Uganda: a |cross-sectional study.

机构信息

Department of Pharmacy, Mbarara University of Science and Technology, P.O.Box 1410, Mbarara, Uganda.

Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda.

出版信息

Ther Adv Cardiovasc Dis. 2023 Jan-Dec;17:17539447231160319. doi: 10.1177/17539447231160319.

Abstract

BACKGROUND

Despite the use of safe and effective conventional drugs, drug therapy problems (DTPs) pose a threat to the successful management of hypertension. DTPs are of a great concern in health care because of their serious consequences such as poor quality of life, increased health care costs, morbidity and mortality. However, there is no published information regarding the prevalence of DTPs and associated factors among hypertensive patients in Uganda.

OBJECTIVE

The aim of the study was to determine the prevalence and factors associated with DTPs among hypertensive patients at the hypertension clinic of Mbarara Regional Referral Hospital (MRRH).

METHOD

A cross-sectional study was conducted at the hypertension clinic, MRRH, Uganda among 228 hypertensive patients. Data were collected from medical records using a data abstraction tool and patients were interviewed using a structured questionnaire. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 22.0. Descriptive analysis was used to determine the prevalence of DTPs. Logistic regression was used to determine the association between the independent and dependent variables. Variables were considered statistically significant at -value <0.05.

RESULTS

A total of 178 DTPs were identified among 141 hypertensive patients. The prevalence of antihypertensive-related DTPs was 61.8% (95% confidence interval [CI]: 55.3-67.5) with an average of 1.26 ± 0.52 DTPs per patient. Out of 141 participants with DTPs, 109 (77.3%) had one DTP, 27 (19.1%) had 2 DTPs, and 5 (3.5%) had 3 DTPs. The most common types of antihypertensive-related DTPs were 'dosage too low' which accounted for 53 (29.8%), followed by 'adverse drug reactions' which accounted for 48 (27%). Uncontrolled blood pressure (BP; adjusted odds ratio [AOR]: 4.17; 95% CI: 2.33-7.45,  < 0.001) and routine laboratory test results (AOR: 1.87; 95% CI: 1.04-3.36,  = 0.036) were significantly associated with antihypertensive-related DTPs among hypertensive patients.

CONCLUSION

Almost two-thirds of study participants had antihypertensive-related DTPs. The most common DTPs were 'dosage too low' and 'adverse drug reactions' which both accounted for almost a third of the total DTPs each. Uncontrolled BP and routine laboratory test results were significantly associated with antihypertensive-related DTPs among the study participants. Our study emphasizes the need for improved patient care by clinical pharmacists to identify and prevent DTPs among hypertensive patients.

摘要

背景

尽管使用了安全有效的常规药物,但药物治疗问题(DTPs)仍对高血压的成功管理构成威胁。DTPs 对医疗保健非常关注,因为它们会导致严重的后果,如生活质量下降、医疗保健成本增加、发病率和死亡率上升。然而,目前尚无关于乌干达高血压患者 DTPs 患病率及其相关因素的发表信息。

目的

本研究旨在确定 Mbarara 地区转诊医院(MRRH)高血压诊所高血压患者中 DTPs 的患病率及其相关因素。

方法

在乌干达 Mbarara 地区转诊医院(MRRH)的高血压诊所进行了一项横断面研究,共纳入 228 名高血压患者。使用数据提取工具从病历中收集数据,并使用结构化问卷对患者进行访谈。使用社会科学统计软件包(SPSS)版本 22.0 进行数据分析。描述性分析用于确定 DTPs 的患病率。使用逻辑回归确定独立和因变量之间的关联。变量的 - 值 <0.05 被认为具有统计学意义。

结果

在 141 名高血压患者中,共发现 178 个 DTP。抗高血压相关 DTPs 的患病率为 61.8%(95%置信区间[CI]:55.3-67.5),平均每个患者有 1.26±0.52 个 DTP。在患有 DTPs 的 141 名参与者中,有 109 名(77.3%)有一个 DTP,27 名(19.1%)有两个 DTP,5 名(3.5%)有三个 DTP。最常见的抗高血压相关 DTPs 是“剂量过低”,占 53 例(29.8%),其次是“药物不良反应”,占 48 例(27%)。未控制的血压(BP;调整后的优势比[OR]:4.17;95%CI:2.33-7.45, < 0.001)和常规实验室检查结果(OR:1.87;95%CI:1.04-3.36, = 0.036)与高血压患者的抗高血压相关 DTPs 显著相关。

结论

近三分之二的研究参与者存在抗高血压相关的 DTPs。最常见的 DTPs 是“剂量过低”和“药物不良反应”,各占总 DTPs 的近三分之一。未控制的血压和常规实验室检查结果与研究参与者的抗高血压相关 DTPs 显著相关。我们的研究强调了需要通过临床药师改善患者护理,以识别和预防高血压患者的 DTPs。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36a5/10101216/e7f7e3cf1315/10.1177_17539447231160319-fig1.jpg

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