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住院心血管疾病患者的药物治疗问题。

Drug therapy problems among hospitalized patients with cardiovascular disease.

机构信息

Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.

出版信息

BMC Cardiovasc Disord. 2024 Jan 15;24(1):50. doi: 10.1186/s12872-024-03710-8.

Abstract

BACKGROUND

Optimal utilization of cardiovascular drugs is crucial in reducing morbidity and mortality associated with cardiovascular diseases. However, the effectiveness of these drugs can be compromised by drug therapy problems. Hospitalized patients with cardiovascular diseases, particularly those with multiple comorbidities, polypharmacy, and advanced age, are more susceptible to experiencing drug therapy problems. However, little is known about drug therapy problems and their contributing factors among patients with cardiovascular disease in our setting. Therefore, our study aimed to investigate drug therapy problems and their contributing factors in patients with cardiovascular diseases.

METHOD

A prospective observational study was conducted among hospitalized patients with cardiovascular disease at Ayder Comprehensive Specialized Hospital in the Tigray region of Northern Ethiopia from December 2020 to May 2021. We collected the data through patient interviews and review of patients' medical records. We employed Cipolle's method to identify and categorize drug therapy problems and sought consensus from a panel of experts through review. Data analysis was performed using the Statistical Software Package SPSS version 22. Binary logistic regression analysis was performed to determine the contributing factors of drug therapy problems in patients with cardiovascular disease. Statistical significance was set at p < 0.05.

RESULTS

The study included a total of 222 patients, of whom 117 (52.7%) experienced one or more drug-related problems. We identified 177 drug therapy problems equating to 1.4 ± 0.7 drug therapy problems per patients. The most frequently identified DTP was the need for additional drug therapy (32.4%), followed by ineffective drug therapy (14%), and unnecessary drug therapy (13.1%). The predicting factors for drug therapy problems were old age (AOR: 3.97, 95%CI: 1.68-9.36) and number of medications ≥ 5 (AOR: 2.68, 95%CI: 1.47-5.11).

CONCLUSION

More than half of the patients experienced drug therapy problems in our study. Old age and number of medications were the predicting factors of drug therapy problems. Therefore, greater attention and focus should be given to patients who are at risk of developing drug therapy problems.

摘要

背景

优化心血管药物的使用对于降低与心血管疾病相关的发病率和死亡率至关重要。然而,药物治疗问题可能会影响这些药物的疗效。患有心血管疾病的住院患者,特别是那些患有多种合并症、多种药物治疗和高龄的患者,更容易出现药物治疗问题。然而,我们对当地心血管疾病患者的药物治疗问题及其相关因素知之甚少。因此,我们的研究旨在调查心血管疾病患者的药物治疗问题及其相关因素。

方法

2020 年 12 月至 2021 年 5 月,在埃塞俄比亚北部提格雷地区的阿耶德尔综合专科医院对住院心血管疾病患者进行了一项前瞻性观察研究。我们通过患者访谈和病历回顾收集数据。我们采用 Cipolle 方法识别和分类药物治疗问题,并通过专家审查寻求共识。使用 SPSS 版本 22 统计软件包进行数据分析。采用二元逻辑回归分析确定心血管疾病患者药物治疗问题的相关因素。以 p < 0.05 为统计学意义。

结果

该研究共纳入 222 例患者,其中 117 例(52.7%)出现 1 种或多种与药物相关的问题。我们共发现 177 种药物治疗问题,相当于每位患者有 1.4±0.7 种药物治疗问题。最常见的 DTP 是需要额外的药物治疗(32.4%),其次是无效的药物治疗(14%)和不必要的药物治疗(13.1%)。药物治疗问题的预测因素是年龄较大(AOR:3.97,95%CI:1.68-9.36)和药物数量≥5(AOR:2.68,95%CI:1.47-5.11)。

结论

在我们的研究中,超过一半的患者出现了药物治疗问题。年龄较大和药物数量是药物治疗问题的预测因素。因此,应更加关注有发生药物治疗问题风险的患者。

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