Drug‐related problems in prescribing for coronary artery diseases in Vietnam: cross‐sectional study

Abstract

Objectives To determine the prevalence, patterns and determinants of drug‐related problems (DRPs) in prescribing for coronary artery diseases (CADs) in Vietnam. Methods Retrospective cross‐sectional study on outpatients with CADs at a general hospital in Can Tho, Vietnam. DRPs were classified according to Pharmaceutical Care Network Europe definitions. We determined the prevalence and patterns of DRPs. Logistic regression was used to identify the determinants of DRPs. Results Among 683 patients (mean age 63.4; 64.3% female), the prevalence of DRPs was 61.1%. DRPs comprised inappropriate indication (3.5%), inappropriate dosage (22.2%), wrong frequency of use (24.2%), wrong time of taking medications (4.1%), taking medications at the wrong time around meals (19.2%) and drug interactions (19.3%). Patients who took ≥ 5 drugs were more likely to have DRPs (adjusted odds ratio = 1.96; 95% confidence interval = 1.31–2.93). Patients without health insurance were more likely to have inappropriate indication (ORa = 2.93; 95%CI = 1.28–6.70). Taking medications at inappropriate times around meals was common among men (ORa = 1.82; 95%CI = 1.23–2.69) and among those with health insurance (ORa = 1.66; 95%CI = 1.05–2.63). Patients < 65 years old were more likely to be prescribed inappropriate doses (ORa = 1.67; 95%CI = 1.15–2.45). Prescriptions with ≥ 5 drugs were more likely to be taken at inappropriate frequency (ORa = 1.87; 95%CI = 1.09–3.21) and to cause drug interactions (ORa = 6.48; 95%CI = 2.59–16.24). Conclusions DRPs are common among patients with CADs in Vietnam. The number of DRPs increases with the number of drugs in prescriptions. Further studies should identify other potential determinants of DRPs and effective interventions to improve prescribing practice in Vietnam.

Pharmacist-led interventions to reduce drug-related problems in prescribing for Vietnamese outpatients

“…When prescribing, doctors often overlooked these (this was recorded when we reminded/intervened directly with each doctor). The proportion is higher than in Vietnamese patients with coronary artery diseases (23.3%) 19 .…”

Prevalence of Drug–Drug Interactions in Older Community-Dwelling Individuals: A Systematic Review and Meta-analysis

“…Table 1 presents the main characteristics of the 33 studies included in this systematic review. The majority of studies were conducted in Europe ( n = 13) [ 20 , 46 , 49 , 53 , 54 , 56 , 61 , 64 , 69 , 70 , 74 – 76 ], ten were conducted in North America [ 47 , 48 , 51 , 52 , 57 , 58 , 60 , 65 , 67 , 72 ], four in South America [ 59 , 62 , 63 , 68 ], three in Asia [ 50 , 66 , 71 ], two in Australia [ 22 , 55 ] and one in Africa [ 73 ]. Most studies ( n = 23) used a cross-sectional design.…”

“…The method used by individual studies to identify DDIs varied. Five studies [48,63,68,69,74] used the Micromedex ® drug interaction database; three studies [47,60,73] used the 2015 AGS Beers criteria ® ; three studies [46,54,67] used the Lexi-Interact ® drug interaction database; two studies [71,72] 1).…”

“…Most studies (n = 23) used a cross-sectional design. Studies ranged in [20,22,46,[48][49][50][51][52][53][54][55][56][57][58][59][60][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76] reported DDI prevalence estimates using study participants as the unit of analysis, one study [75] also reported DDI prevalence using the total number of prescriptions as the unit of analysis, and one study [64] also reported DDI prevalence using the total number of drugs as the unit of analysis. One study [61] only reported the total number of drug combinations potentially leading to serious DDIs, and one study [47] only reported the proportion of PIMs that were due to DDIs.…”

Evaluation of Drug Related Problems in Patients with Type 2 Diabetes

“…Patients with cardiovascular events add an additional burden to patient's conditions and complicate the drug regimens, which increase the risks of patients for iatrogenic ADEs [34]. Patients with cardiovascular events that have complex drug treatment and receives more than 5 drugs are at a high risk of developing DRPs [35]. In addition to the lack of physicians follow up and medical treatment reassessment [18].Therefore, attention must be paid to treatment instructions in order to limit the use of unnecessary drugs.…”