Medication Related-Problems and Associated Factors Among Patients with Hypertension at a Tertiary Care Hospital in Ethiopia: A Prospective Interventional Study

Abstract

Background

Hypertension affects more than 1.4 billion people worldwide currently, with that number anticipated to climb to 1.6 billion by 2025 with high mortality and morbidity effects. Medication related problems in cardiovascular disease patients, especially among hypertension patients were found to be high and a critical problem which is associated with high mortality, complication, prolonged hospital stay, compromised quality of life and increase health care cost.

Objective

To determine medication related problems and its predictors among hypertension patients on chronic follow-up at Jimma Medical Center.

Methods

A prospective interventional study was conducted among hypertension patients from November 28, 2021 to June 30, 2022 at Jimma Medical Center. Medication related problems were classified and identified based on Pharmaceutical care network Europe drug classification tool version 9.0. Interventions were done through discussion with individual prescriber and patients. Consecutive sampling technique was used. Binary Logistic regression was used to identify independent predictors of medication related problems. Variables having P-values < 0.05 were considered statistically significant.

Results

Among 384 hypertension patients included in the study, 219 (57.1%) were male. The mean (SD) age was 49.06+17.79. Two thirds of study participants had at least one medication related problem. A total of 483 MRPs were identified among 231 (60.15%) patients. Treatment effectiveness related problem (55.48%) was the most common observed medication related problems. Alcoholism (AOR; 3.15, 95% CI [1.46–7.23]), stage II hypertension (AOR=2.77, 95% CI= [3.53–4.66]); comorbidity (AOR=2.88, 95% CI= [1.47–5.66]) and polypharmacy (AOR=3.07, 95% CI= [1.57–5.99]) were the independent predictors of medication related problems.

Conclusion

The prevalence of medication related problems was high among hypertensive patients. Alcoholism, stage II hypertension, comorbidity and poly-pharmacy were the predictors of medication related problems. Therefore, to overcome the problems, clinical pharmacists, physicians and other health care professionals have to work in collaboration.

Keywords:

• medication related problems
• interventions
• hypertension
• Jimma

Abbreviations

ACEIs, Angiotensin converting enzyme inhibitors; ADR, Adverse drug reaction; AHA, American heart association; ARB, Angiotensin receptor blocker; BBs, Beta blockers; BMQ, Belief about medication questionnaire; CP, Clinical pharmacist; CVD, Cardiovascular disease; MRP, Medication related problems; ESC, European Society of Cardiology; ESTG, Ethiopian Standard treatment guideline; HF, Heart Failure; ICU, Intensive care unit; JMC, Jimma Medical Center; MRA, Mineralocorticoid receptor antagonist; NSAID, Non-steroidal anti-inflammatory drugs; PCNE, Pharmaceutical care Network Europe; TASH, UK, United Kingdom.

Data Sharing Statement

Readers who will require data and materials of the current study can communicate and get from the corresponding author with a reasonable request.

Acknowledgment

We would like to thank Jimma University, data collectors and all study participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors have no competing interests with the material presented in this manuscript.

Additional information

Funding

This research was funded by Jimma University Institute of health. The funding body had no any role in the design of the study, data collection, and analysis, interpretation of data and in writing the manuscript.