Assessment of Drug Therapy Problems and Cardiovascular Disease Risk among Adult Hypertensive Patients at All Africa Leprosy and Tuberculosis Rehabilitation and Training Centre, Addis Ababa, Ethiopia
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Date
2019-07
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Addis Ababa University
Abstract
Hypertensive patients are at high risk of developing drug therapy problems (DTPs) and poor adherence due to different factors like: presence of comorbidities, polypharmacy and complexity of drug regimens. Occurrences of DTPs in hypertensive patients are associated with harmful health outcomes and unnecessary costs. Identifying types of DTPs and associated factors are very essential in DTPs prevention and reducing unnecessary health expenditures. Rise in each systolic blood pressure 20 millimeters of mercury and 10 mmHg diastolic blood pressure is associated with increasing risk of death from stroke and heart disease. This study was aimed to assess DTPs and cardiovascular disease risk among hypertensive patients on follow up at All Africa Leprosy and Tuberculosis Rehabilitation and Training Centre. A hospital based cross sectional study was conducted among 305 hypertensive patients. Data was collected through patient interview and medical charts review. DTPs were assessed based on Cipolle DTPs classification systems and cardiovascular disease risk was calculated by using American Heart Association pooled cohort Cardiovascular Risk Calculator. Descriptive statistics, binary logistic regressions were utilized and P< 0.05 was used to declare statistical significance. Out of 305 study participants, 223(73.1%) had at least one DTP. The commonest identified DTP was needs additional drug therapy (32.1%) followed by drug interaction (25.8%) and dosage too low (12.3%). Nonadherence was identified in 51.5% of study participants. The atherosclerotic cardiovascular disease (ASCVD) risk among 144 patients who had lipid profile was calculated and 40.3% of them had 20% or higher risk. Based on multivariate analysis alcohol use, number of medications and blood pressure (BP) control had association with DTPs occurrence whereas physical activity, salt restriction and duration of treatment had significant association with adherence. Occupation, alcohol use and BP control were statistically significant to ASCVD risk of 20% or higher.
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Keywords
Hypertension, Drug therapy problems, Cardiovascular disease risk, Ethiopia