Drug Therapy Problems in Patients on Antihypertensives and Antidiabetic Drugs in Two Tertiary Health Institutions in Niger Delta Region, Nigeria

Abstract

Drug therapy problems (DTPs), with the associated risks inherent in antihypertensive and antidiabetic therapy require utmost attention. This present study was aimed at assessing the DTPs observed in the management of hypertension and diabetes mellitus (DM) in two tertiary health facilities in Niger Delta region. In this retrospective study, 531 randomly selected case notes of hypertensive and/or diabetic patients who attended the health facilities in 2011 and 2012 were evaluated for DTPs. The mean patients’ age was 55.70±12.23 years with the elderly patients constituting 70.2% of the population studied. Overall, average numbers of drugs per prescription in the first-month and the fourth–month of drug therapy considered were 4.91±1.96 and 4.92±1.70 (p>0.05), with associated mean DTP values of 1.54±1.08 and 1.46±1.20 (p>0.05) respectively. Using Beer’s/STOPP/START criteria, 21.5% and 22.8% of all DTPs at therapy initiation and last clinic visit were identified in older patients. Unnecessary drug therapy was the most observed DTP in the first month and fourth-month (23.6%, 29.4%) of drug therapy in all the patients and was closely followed by wrong drug therapy (23.4%, 22.9%), need for additional drug therapy (20.9%, 17.4%), non-adherence (15.4%, 13.8%), and drug interactions (12.9%, 9.6%). Other DTPs observed, though to lesser extents were dosage too low (1.5 %, 5.2 %), adverse drug reaction (1.4 %, 1.3 %) and dosage too high (0.9 %, 0.4 %) respectively. There was thus, high incidence of DTPs in the hypertensive and/or diabetic patients studied. Unnecessary drug therapy and wrong drug therapy were the most frequently observed DTPs.

Keywords: Antidiabetic medications, antihypertensive medications, diabetes mellitus, drug therapy problem, hypertension, Niger Delta, Nigeria