Drug related problems in type 2 diabetic patients with tuberculosis: A prospective study

Abstract

Background and aim: Tuberculosis (TB) and diabetes mellitus (DM) are leading causes of morbidity and mortality in Nigeria. Patients with both diseases are often required to take multiple medications which increases the risks of  developing drug-related problems (DRPs). This study aimed to identify and resolve  DRPs encountered by TB and DM patients under a collaborative care model.
Methods: A prospective, observational study involving 52 TB and DM patients in two secondary care chest  clinics in  Lagos State, South-west Nigeria was carried out. Identification and classification of DRPs were  based on the  Pharmaceutical Care Network Europe classification version 7-0, and data statistically  analysed. Number of DRPs were  presented as frequencies and percentages. A bivariate logistic regression  analysis identified determinants of DRPs at a statistical significance of P ⩽ 0.05.
Results: A total of 86 DRPs were reported in the study, averaging 1.5 DRP per patient. Adverse drug events  (73.1%),  untreated indications (46.2%) and suboptimal treatment (44.2%) were most commonly identified.  Main causes were  insufficient awareness of disease state (55.7%), new indications (46.2%), and wrong  administration of medications  (44.2%). Interventions carried out were accepted at patient (100%),  prescriber (76.9%) and drug levels (46.2%). Sixty- three and half percent (63.5%) were accepted and fully  implemented. DRPs were totally solved in 63.5% of instances.  There were no significant association  between patients’ sociodemographic data and occurrence of DRPs (P>0.05).  Conclusion: The presence of DRPs in TB-DM patients is substantial. Early detection, patient education and prompt  resolution will promote safe, effective and optimal treatment outcomes in TB-DM patients.