EVALUATION OF DRUG THERAPY PROBLEMS AND THEIR PREDICTORS AMONG TYPE 2 DIABETIC OUTPATIENTS AT A TERTIARY HEALTH CARE FACILITY IN A NIGERIAN CITY

Abstract

Evaluation of drug therapy problems (DTPs) and factors associated with them in chronic disease states like diabetes
will contribute to an improvement of patients’ treatment outcomes. The objective of this study was to evaluate DTPs
and their predictors among type 2 diabetes mellitus (T2DM) outpatients in Specialist Hospital, Sokoto. A
prospective cross-sectional study design and systematic random sampling technique were used for data collection
between the months of September and November, 2015 using a validated DTP instrument by Pharmaceutical Care
Network Europe V 5.01. The data were analysed using descriptive statistics, chi-square, correlation and logistic
regression analyses at p<0.05. The 210 patients evaluated were predominantly male – 127 (60.50%) with a mean age
of 54.29±12.66 years. A total of 235 DTPs, averaging 1.12±1.04 per patient were observed. The most common
DTPs were: drug not administered – 65 (27.70 %), insufficient awareness of health and disease – 33 (14.00 %),
potential interaction – 32 (13.60 %) and side effects – 31 (13.20 %). The major causes of the DTPs were
inappropriate drug selection – 39 (22.30 %), drug underused – 26 (14.90 %) and inappropriate dosage selection – 22
(12.60 %). Chi-square analysis indicated that gender, level of education, employment, monthly income, smoking
and patients’ exercise status were significantly associated with DTPs. Old age (r=0.65, p=0.000) and the number of
comorbidities (r=0.63, p=0.000) were strongly correlated with DTPs. The number of current medications (OR=1.87,
95% CI=1.39-2.51, p=0.000) and duration of T2DM (OR=1.57, 95% CI=1.21-2.04, p=0.001) were identified as
independent predictors of DTPs. In conclusion, each patient in the facility was affected by at least one DTP. Among
factors associated with DTPs in the facility, number of current medications and duration of T2DM were the only
predictors. Those factors should be considered in patients care in order to improve their outcomes.