Assessment of Drug Therapy Problems Among Type 2 Diabetes Patients with Hypertension Comorbidity in Indonesia

Julaeha Julaeha (1) , Ery Fudjiati (2) , Aprilita Rina Yanti Eff (3)
(1) Universitas 17 Agustus 1945 Jakarta , Indonesia
(2) Universitas 17 Agustus 1945 Jakarta , Indonesia
(3) Universitas Esa Unggul , Indonesia

Abstract

Type 2 diabetes mellitus (T2DM) is a major chronic disease that affects a large number of people worldwide. Hypertension is a common disease comorbidity among T2DM patients, and often those patients received polypharmacy and complex treatment in long term duration. This condition may lead to an increased risk of drug therapy problems (DTPs). This study aimed to assess and determine potential drug therapy problems in type 2 diabetic patients with hypertension comorbidity. Retrospective cross-sectional design was conducted in a hospital setting, especially data sources from the prescription of ambulatory T2DM patients with hypertension. A total of 190 patients were studied. More than half of the participants were female (53.68%). The majority age range of participants was 50-59 years (46.84%). Almost all antidiabetic agents were prescribed as polypharmacy (73.16%). Metformin was the most antidiabetic agent prescribed as monotherapy and combination therapy (63.16%). Almost all antihypertensive agents were prescribed as polypharmacy (63.26%). Amlodipine was the most antihypertensive agent prescribed as monotherapy and combination therapy (34.74%). Among the study participants, 56.84% have at least one of DTPs. Adverse drug reaction was the most frequent (47.22%), followed by ineffective drug therapy (29.63%). Since the potential of DTPs in T2DM patients with hypertension comorbidity is relatively high, early identifying, resolving, and preventing drug therapy problems by the pharmacist is needed to achieve goals of treatment.

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References

Abdulmalik, H., Tadiwos, Y., & Legese, N. (2019). Assessment of drug-related problems among type 2 diabetic patients on follow up at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. BMC Research Notes, 12(771), 16. doi:10.1186/s13104-019-4760-8
American Diabetes Association. (2015). Standards of Medical Care in Diabetes—2015: Summary of Revisions. Diabetes Care, 38(Supplement 1), S4-S4. doi:10.2337/dc15-S003
Apicella, M., Campopiano, M.C., Mantuano, M., Mazoni, L., Coppelli, A., & Prato, S.D. (2020). COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The Lancet Diabetes & Endocrinology, [Epub ahead of print]. doi:10.1016/S2213-8587(20)30238-2
Argaw, A.M., Hiwet, T.T.G., & Derse, B.B. (2019). Drug Therapy Problems and Determinants among Ambulatory Type 2 Diabetes Mellitus Patients: Pharmacists’ Intervention in South-East Ethiopia. Endocrinology & Metabolic Syndrome, 8(4), 303. doi:10.35248/2161-1017.19.8.303
Atinga, R.A., Yarney, L., & Gavu, N.M. (2018). Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: A qualitative investigation. PLoS One, 13(3), e0193995. doi:10.1371/journal.pone.0193995
Ayele, Y., Melaku, K., Dechasa, M., Ayalew, M.B., & Horsa, B.A. (2018). Assessment of drug related problems among type 2 diabetes mellitus patients with hypertension in Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. BMC Research Notes, 11(1), 728. doi:10.1186/s13104-018-3838-z
Baxter, K. (2009). Stockley's Drug Interactions 2009 – Pocket Companion. London, United Kingdom: Pharmaceutical Press.
Benjamin, E.J., Blaha, M.J., Chive, S.E., Cushman, M., Das, S.R., Deo, R., de Ferranti, S.D., Floyd, J., Fornage, M., Gillespie, C., Isasi, C.R., Jiménez, M.C., Jordan, L.C., Judd, S.E., Lackland, D., Lichtman, J.H., Lisabeth, L., Liu, S., Longenecker, C.T., Mackey, R.H., Matsushita, K., Mozaffarian, D., Mussolino, M.E., Nasir, K., Neumar, R.W., Palaniappan, L., Pandey, D.K., Thiagarajan, R.R., Reeves, M.J., Ritchey, M., Rodriguez, C.J., Roth, G.A., Rosamond, W.D., Sasson, C., Towfighi, A., Tsao, C.W., Turner, M.B., Virani, S.S., Voeks, J.H., Willey, J.Z., Wilkins, J.T., Wu, J.H.Y., Alger, H.M., Wong, S.S., & Muntner, P. (2017). Heart Disease and Stroke Statistics—2017 Update: A Report from the American Heart Association. Circulation, 135(10), e146–e603. doi:10.1161/CIR.0000000000000485
de Boer, I.H., Bangalore, S., Benetos, A., Davis, A.M., Michos, E.D., Muntner, P., Rossing, P., Zoungas, S., & Bakris, G. (2017). Diabetes and Hypertension: A Position Statement by the American Diabetes Association. Diabetes Care, 40(9), 1273-1284. doi:10.2337/dci17-0026
Bolarinwa, O.A., Abdulahi, A., Sanya, E.O., Kolo, P.M., Ameen, H.A., Durowade, K.A., Uthman, M.M.B., Ogunmodede, J.A., Buliaminu, S.A., Odeigah, L.O., & Akande, T.M. (2018). Predictors of Cost of Follow-up Care among Patients with Hypertension and Diabetes Mellitus Attending a Teaching Hospital, North Central, Nigeria. Journal of Health Science Research, 3(2), 1-9. doi:10.18311/jhsr/2018/21335
Cade, W.T. (2008). Diabetes-Related Microvascular and Macrovascular Diseases in the Physical Therapy Setting. Physical Therapy, 88(11), 1322-1335. doi:10.2522/ptj.20080008
Chawla, A., Chawla, R., & Jaggi, S. (2016). Microvascular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian Journal of Endocrinology and Metabolism, 20(4), 546-551. doi:10.4103/2230-8210.183480
Cipolle, R.J., Strand, L.M., & Morley, P.C. (2012). Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management Services, third edition. New York, United States: McGraw-Hill Education, LLC.
Claydon-Platt, K., Manias, E., & Dunning, T. (2012). Medication-related problems occurring in people with diabetes during an admission to an adult teaching hospital: a retrospective cohort study. Diabetes Research and Clinical Practice, 97(2), 223-230. doi:10.1016/j.diabres.2012.03.003
Critchley, J.A., Carey, I.M., Harris, T., DeWilde, S., Hosking, F.J., & Cook, D.G. (2018). Glycemic Control and Risk of Infections Among People with Type 1 or Type 2 Diabetes in a Large Primary Care Cohort Study. Diabetes Care, 41(10), 2127-2135. doi:10.2337/dc18-0287
Dunning, T., Sinclair, A., & Colagiuri, S. (2014). New IDF Guideline for managing type 2 diabetes in older people. Diabetes Research and Clinical Practice, 103(3), 538-540. doi:10.1016/j.diabres.2014.03.005
Fang, L., Karakiulakis, G., & Roth, M. (2020). Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine, 8(4), e21. doi:10.1016/S2213-2600(20)30116-8
Farský, Š., Strišková, A., & Borčin, M. (2018). Hypertension Treatment in Patients with Metabolic Syndrome and/or Type 2 Diabetes Mellitus: Analysis of the Therapy Effectivity and the Therapeutic Inertia in Outpatient Study. Cardiology Research and Practice, 2018, 8387613. doi:10.1155/2018/8387613
Gangwar, S.S., Monisha, N., Nachiya, J., Narasingarao, K., Parimalakrishnan, S., & Singh, S.P. (2014). Impact of medication and psychological behaviour assessment by community pharmacists in type 2 diabetes mellitus patients after hospital stay. African Health Sciences, 14(3), 539-550. doi:10.4314/ahs.v14i3.7
Hartuti, S., Nasution, A., & Syafril, S. (2019). The Effect of Drug-Related Problems on Blood Glucose Level in the Treatment of Patients with Type 2 Diabetes Mellitus. Open Access Macedonian Journal of Medical Sciences, 7(11), 1798-1802. doi:10.3889/oamjms.2019.290
Huri, H.Z. & Wee, H.F. (2013). Drug related problems in type 2 diabetes patients with hypertension: a cross-sectional retrospective study. BMC Endocrine Disorders, 13, 2. doi:10.1186/1472-6823-13-2
Hussen, A. & Daba, F.B. (2017). Drug Therapy Problems and Their Predictors Among Hypertensive Patients on Follow Up in Dil-Chora Referral Hospital, Dire-Dawa, Ethiopia. International Journal of Pharmaceutical Sciences and Research, 8(6), 2712-2719. doi:10.13040/IJPSR.0975-8232.8(6).2712-19
James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison-Himmelfarb, C., Handler, J., Lackland, D.T., LeFevre, M.L., MacKenzie, T.D., Ogedegbe, O., Smith, S.C., Svetkey, L.P., Taler, S.J., Townsend, R.R., Wright, J.T., Narva, A.S., & Ortiz, E. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA, 311(5), 507-520. doi:10.1001/jama.2013.284427
Li, B., Yang, J., Zhao, F., Zhi, L., Wang, X., Liu, L., Bi, Z., & Zhao, Y. (2020). Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clinical Research in Cardiology, 109(5), 531-538. doi:10.1007/s00392-020-01626-9
Li, X.C., Zhang, J., & Zhuo, J.L. (2017). The vasoprotective axes of the renin-angiotensin system: physiological relevance and therapeutic implications in cardiovascular, hypertensive and kidney diseases. Pharmacological Research, 125(Pt A), 21-38. doi:10.1016/j.phrs.2017.06.005
Lira, C.P., Lolo, W.A., & Wewengkang, D.S. (2017). Potensi Drug Related Problems (DRPs) Penggunaan Obat Antidiabetes pada Pasien Diabetes Melitus Tipe 2 di Instalasi Rawat Inap Rumah Sakit Kalooran Gmim Amurang. Pharmacon, 6(4), 241-248. doi:10.35799/pha.6.2017.17775
Ministry of Health of the Republic of Indonesia. (2018). Riset Kesehatan Dasar 2018. Jakarta, Indonesia: Health Research and Development Agency, Ministry of Health of the Republic of Indonesia.
Nazilah, K., Rachmawati, E., & Subagijo, P.B. (2017). Identifikasi Drug Related Problems (DRPs) pada Terapi Diabetes Melitus Tipe 2 di Instalasi Rawat Inap RSD dr. Soebandi Jember Periode Tahun 2015. e-Journal Pustaka Kesehatan, 5(3), 413-419. doi:10.19184/pk.v5i3.5891
Nivya, K., Kiran, V.S.S., Rago, N., Jayaprakash, B., & Sekhar, M.S. (2015). Systemic review on drug related hospital admissions – A PubMed based search. Saudi Pharmaceutical Journal, 23(1), 1-8. doi:10.1016/j.jsps.2013.05.006
Ogbonna, B.O., Ezenduka, C.C., Opara, C.A., & Ahara, L.G. (2014). Drug Therapy Problems in Patients with Type-2 Diabetes in a Tertiary Hospital in Nigeria. International Journal of Innovative Research & Development, 3(1), 494-502.
Petrie, J.R., Guzik, T.J., & Touyz, R.M. (2018). Diabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms. The Canadian Journal of Cardiology, 34(5), 575-584. doi:10.1016/j.cjca.2017.12.005
Ruan, Q., Yang, K., Wang, W., Jiang, L., & Song, J. (2020). Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Medicine, 46(5), 846-848. doi:10.1007/s00134-020-05991-x
Shareef, J., Fernandes, J., & Samaga, L.N. (2020). Clinical pharmacist interventions in drug therapy in patients with diabetes mellitus and hypertension in a University Teaching Hospital. International Journal of Pharmaceutical Sciences and Research, 6(10), 4424-4432. doi:10.13040/IJPSR.0975-8232.6(10).4424-32
Singh, A.K., Gupta, R., & Misra, A. (2020). Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers. Diabetes and Metabolic Syndrome, 14(4), 283-287. doi:10.1016/j.dsx.2020.03.016
Wan, Y., Shang, J., Graham, R., Baric, R.S., & Li, F. (2020). Receptor Recognition by the Novel Coronavirus from Wuhan: An Analysis Based on Decade-Long Structural Studies of SARS Coronavirus. Journal of Virology, 94(7), e00127-20. doi:10.1128/JVI.00127-20
Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S., Huang, H., Zhang, L., Zhou, X., Du, C., Zhang, Y., Song, J., Wang, S., Chao, Y., Yang, Z., Xu, J., Zhou, X., Chen, D., Xiong, W., Xu, L., Zhou, F., Jiang, J., Bai, C., Zheng, J., & Song, Y. (2020). Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine, 180(7), 1-11. doi:10.1001/jamainternmed.2020.0994
Yang, X., Yu, Y., Xu, J., Shu, H., Xia, J., Liu, H., Wu, Y., Zhang, L., Yu, Z., Fang, M., Yu, T., Wang, Y., Pan, S., Zou, X., Yuan, S., & Shang, Y. (2020). Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine, 8(5), 475-481. doi:10.1016/S2213-2600(20)30079-5
Yimama, M., Jarso, H., & Desse, T.A. (2018). Determinants of drug-related problems among ambulatory type 2 diabetes patients with hypertension comorbidity in Southwest Ethiopia: a prospective cross sectional study. BMC Research Notes, 11, 679. doi:10.1186/s13104-018-3785-8
Zazuli, Z., Rohaya, A., & Adnyana, I.K. (2017). Drug-Related Problems in Type 2 Diabetic Patients with Hypertension: A Prospective Study. Journal of Basic and Clinical Pharmacy, 8, 251-254.

Authors

Julaeha Julaeha
julqoz87@gmail.com (Primary Contact)
Ery Fudjiati
Aprilita Rina Yanti Eff
1.
Julaeha J, Fudjiati E, Eff ARY. Assessment of Drug Therapy Problems Among Type 2 Diabetes Patients with Hypertension Comorbidity in Indonesia. Borneo J Pharm [Internet]. 2020Aug.31 [cited 2024Dec.21];3(3):190-8. Available from: https://journal.umpr.ac.id/index.php/bjop/article/view/1359

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