Assessment of Drug Therapy Problems and Medication Adherence among Ambulatory Hypertensive Patients on Follow up at Tikur Anbessa Specialized Hospital
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Date
2019-04
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Addis Ababa University
Abstract
Hypertensive patients are at high risk of drug therapy problems (DTPs), as there is multiple drug use for their comorbidities. To date, studies regarding DTPs in hypertensive patients are limited in Ethiopia. Thus, this study aimed to assess DTPs and medication adherence among ambulatory hypertensive patients on follow up at Tikur Anbessa Specialized Hospital (TASH). A hospital based cross sectional study was employed in 388 participants who fulfilled the inclusion criteria. Participants were interviewed and their medical chart was reviewed through a structured data collection formats. DTPs were assessed using Cipolle/Morely/Strand’s DTPs classification system. Data were reported as mean/percentage and multivariate logistic regression was performed to identify associated factors with DTPs. Out of 388 study participants, 283 of them had at least one DTP, of which 49.5% and 40.3% had drug interactions and adverse drug reactions (ADRs), respectively. Factors associated with DTPs, were old age (Adjusted Odds Ratio [AOR] =1.05, 5%CI:1.02-1.08), longer duration of treatment (AOR=1.06,95% CI:1.01-1.10), presence of complaints (AOR=2.23, 95%CI:1.06-4.71), ≥3 comorbidities (AOR=2.27, 95%CI:1.06-4.88), ≥5 drugs use (AOR=2.15, 95%CI:1.02-4.50), statins use (AOR=2.62, 95%CI:1.09-6.30) and aspirin use (AOR=3.79, 95%CI:1.11-12.87). About 45% of the study participants were non-adherent to their antihypertensives. Factors for non-adherence were monthly income of <500 Ethiopian birr (AOR=1.68, 95%CI: 1.03-2.72), ≥5 drugs use (AOR=2.36, 95%CI: 1.02-5.47), use of antidiabetics (AOR=1.95, 95%CI: 1.09-3.51) and non-steroidal anti-inflammatory drugs use (AOR=0.43, 95%CI: 0.20-0.91). DTPs were common among ambulatory hypertensive patients in TASH, indicating a need of multidisciplinary team that involved pharmaceutical care providers to identify and resolve DTPs in this setting.
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Hypertension, drug therapy problems, medication adherence, Ethiopia