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Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Drug-related problems in type 2 diabetes mellitus patients with dyslipidemia

Authors: Hasniza Zaman Huri, Lee Chai Ling

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

Drug-Related Problems (DRPs) commonly occur among type 2 diabetes mellitus (T2DM) patients. However, few studies have been performed on T2DM patients with dyslipidemia. This purpose of this study was to assess drug-related problems (DRPs) and factors associated with its occurrence.

Methods

The retrospective study involved 208 T2DM in-patients and out-patients with dyslipidemia, and was conducted at a tertiary hospital in Malaysia from January 2009 to December 2011. The identification and assessment of DRPs were based on the Pharmaceutical Care Network Europe (PCNE) tool version 5.01. The potentially inappropriate medication use in older adults was assessed based on the American Geriatrics Society updated Beers Criteria.

Results

A total of 406 DRPs were identified. Among these patients, 91.8% had at least one DRP, averaging 1.94 ± 1.10 problems per patient. The majority of T2DM patients with dyslipidemia (91.8%) had at least one DRP. The most frequent types of DRP were potential drug-drug interaction (18.0%), drug not taken or administered (14.3%) and insufficient awareness of health and diseases (11.8%). Anti-hypertensive, lipid-modifying and anti-diabetic agents were the drug classes that were most likely to be associated with DRPs. Male gender, renal impairment, polypharmacy and poor lipid control were factors that were significantly associated with DRP in diabetic dyslipidemia patients.

Conclusion

Early identification of DRPs and factors associated with them are essential to prevent and resolve DRPs in T2DM patients with dyslipidemia.
Appendix
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Literature
1.
go back to reference American Diabetes Association: Standard of medical care in diabetes. Diabetes Care. 2012, 35 (1): S11-S63. American Diabetes Association: Standard of medical care in diabetes. Diabetes Care. 2012, 35 (1): S11-S63.
2.
go back to reference Fagot CA, Rolka DB, Beckles GL, Gregg EW, Narayan KM: Prevalence of lipid abnormalities, awareness, and treatment in U.S. adults with diabetes. Abstract 318. Diabetes. 2000, 49 (Supplement 1): A78-A79. Fagot CA, Rolka DB, Beckles GL, Gregg EW, Narayan KM: Prevalence of lipid abnormalities, awareness, and treatment in U.S. adults with diabetes. Abstract 318. Diabetes. 2000, 49 (Supplement 1): A78-A79.
3.
go back to reference Mooradian SD: Dyslipidemia in type 2 diabetes mellitus. Nature Clin Pract: Endocrinol Metab. 2009, 5 (3): 150-159. 10.1038/ncpendmet1066. Mooradian SD: Dyslipidemia in type 2 diabetes mellitus. Nature Clin Pract: Endocrinol Metab. 2009, 5 (3): 150-159. 10.1038/ncpendmet1066.
4.
go back to reference Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR: Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS 23). BMJ. 1998, 316: 823-828. 10.1136/bmj.316.7134.823.CrossRefPubMedPubMedCentral Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR: Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS 23). BMJ. 1998, 316: 823-828. 10.1136/bmj.316.7134.823.CrossRefPubMedPubMedCentral
6.
go back to reference Haugbolle LS, Sorensen EW: Drug-related problems in patients with angina pectoris, type 2 diabetes and asthma: Interviewing patients at home. Pharm World Sci. 2006, 28: 239-247. 10.1007/s11096-006-9023-9.CrossRefPubMed Haugbolle LS, Sorensen EW: Drug-related problems in patients with angina pectoris, type 2 diabetes and asthma: Interviewing patients at home. Pharm World Sci. 2006, 28: 239-247. 10.1007/s11096-006-9023-9.CrossRefPubMed
7.
go back to reference Bob W, Ines K: Development of an evidence-based checklist for the detection of drug-related problems in type 2 diabetes mellitus. Pharm World Sci. 2009, 31: 580-595. 10.1007/s11096-009-9312-1.CrossRef Bob W, Ines K: Development of an evidence-based checklist for the detection of drug-related problems in type 2 diabetes mellitus. Pharm World Sci. 2009, 31: 580-595. 10.1007/s11096-009-9312-1.CrossRef
8.
go back to reference Keith GT, Anthony D, Vivian F, Tan MH: Spectrum of liver disease in type 2 diabetes and the management of patients with diabetes and liver disease. Diabetes Care. 2007, 30 (3): 734-743. 10.2337/dc06-1539.CrossRef Keith GT, Anthony D, Vivian F, Tan MH: Spectrum of liver disease in type 2 diabetes and the management of patients with diabetes and liver disease. Diabetes Care. 2007, 30 (3): 734-743. 10.2337/dc06-1539.CrossRef
9.
go back to reference Gunar S, Rosa LG: Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: A systematic literature review. BioMed Central Nephrol. 2011, 12 (35): 1-12. Gunar S, Rosa LG: Clinical pharmacy activities in chronic kidney disease and end-stage renal disease patients: A systematic literature review. BioMed Central Nephrol. 2011, 12 (35): 1-12.
10.
go back to reference Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, Wu SC: Drug-related problems (DRP) identified from geriatric medication safety review clinics. Arch Gerontol Geriatrics. 2011, 54 (1): 168-174.CrossRef Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, Wu SC: Drug-related problems (DRP) identified from geriatric medication safety review clinics. Arch Gerontol Geriatrics. 2011, 54 (1): 168-174.CrossRef
11.
go back to reference Somers A, Robays H, Vander SR, Van MG, Bogaert M, Petrovic M: Contribution of drug-related problems to hospital admission in the elderly. J Nutr Health Aging. 2010, 14 (6): 477-482. 10.1007/s12603-009-0237-0.CrossRefPubMed Somers A, Robays H, Vander SR, Van MG, Bogaert M, Petrovic M: Contribution of drug-related problems to hospital admission in the elderly. J Nutr Health Aging. 2010, 14 (6): 477-482. 10.1007/s12603-009-0237-0.CrossRefPubMed
12.
go back to reference American Geriatrics Society: American geriatrics society updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012, 1-16. doi: 10.1111/j.1532-5415.2012.03923.x American Geriatrics Society: American geriatrics society updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012, 1-16. doi: 10.1111/j.1532-5415.2012.03923.x
13.
go back to reference Mafauzy M, Hussein Z, Chan SP: The status of diabetes control in Malaysia: Results of DiabCare 2008. Medical J Malay. 2011, 66 (3): 175-181. Mafauzy M, Hussein Z, Chan SP: The status of diabetes control in Malaysia: Results of DiabCare 2008. Medical J Malay. 2011, 66 (3): 175-181.
14.
go back to reference National Cholesterol Education Program: Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001, 285 (19): 2486-2497. 10.1001/jama.285.19.2486.CrossRef National Cholesterol Education Program: Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001, 285 (19): 2486-2497. 10.1001/jama.285.19.2486.CrossRef
15.
go back to reference Jacobs MJ, Kleisli T, Pio JR, Malik S, L’Italien GJ, Chen RS, Wong ND: Prevalence and control of dyslipidemia among persons with diabetes in the United States. Diabetes Res Clin Pract. 2005, 70: 263-269. 10.1016/j.diabres.2005.03.032.CrossRefPubMed Jacobs MJ, Kleisli T, Pio JR, Malik S, L’Italien GJ, Chen RS, Wong ND: Prevalence and control of dyslipidemia among persons with diabetes in the United States. Diabetes Res Clin Pract. 2005, 70: 263-269. 10.1016/j.diabres.2005.03.032.CrossRefPubMed
17.
go back to reference Reamer LB, Emily BM, Temple WS, Jane CA, Kit N: Pharmacy: Misleading, but manageable. Clin Interv Aging. 2008, 3 (2): 383-389. Reamer LB, Emily BM, Temple WS, Jane CA, Kit N: Pharmacy: Misleading, but manageable. Clin Interv Aging. 2008, 3 (2): 383-389.
21.
go back to reference Lacy CF, Armstrong LL, Goldman MP, Lance LL: Drug Information Handbook. 2011, Ohio: Lexi-Comp Inc Lacy CF, Armstrong LL, Goldman MP, Lance LL: Drug Information Handbook. 2011, Ohio: Lexi-Comp Inc
22.
go back to reference British Medical Association & Royal Pharmaceutical Society: British National Formulary Edition 60. 2010, London: BMJ Group and Pharmaceutical Press British Medical Association & Royal Pharmaceutical Society: British National Formulary Edition 60. 2010, London: BMJ Group and Pharmaceutical Press
23.
go back to reference Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD: Drug-related problems: Their structure and function. Ann Pharmacother. 1990, 24: 1093-1097. Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD: Drug-related problems: Their structure and function. Ann Pharmacother. 1990, 24: 1093-1097.
24.
go back to reference Foppe VM: Drug-related problem: A cornerstone for pharmaceutical care. J Malta College of Pharmacy Practice. 2005, 10: 5-8. Foppe VM: Drug-related problem: A cornerstone for pharmaceutical care. J Malta College of Pharmacy Practice. 2005, 10: 5-8.
25.
go back to reference Eichenberger PM, Lampert ML, Kahmann IV, van Mil JWF, Hersberger KE: Classification of drug-related problems with new prescriptions using a modified PCNE classification system. Pharmaceut Weekblad Sci Ed. 2010, 32 (3): 362-372. Eichenberger PM, Lampert ML, Kahmann IV, van Mil JWF, Hersberger KE: Classification of drug-related problems with new prescriptions using a modified PCNE classification system. Pharmaceut Weekblad Sci Ed. 2010, 32 (3): 362-372.
26.
go back to reference Eichenberger PM, Haschke M, Lampert ML, Hersberger KE: Drug-related problems in diabetes and transplant patients: an observational study with home visits. Int J Clin Pharm. 2011, 33 (5): 815-823. 10.1007/s11096-011-9542-x.CrossRefPubMed Eichenberger PM, Haschke M, Lampert ML, Hersberger KE: Drug-related problems in diabetes and transplant patients: an observational study with home visits. Int J Clin Pharm. 2011, 33 (5): 815-823. 10.1007/s11096-011-9542-x.CrossRefPubMed
27.
go back to reference Granas AG, Berg C, Hjellvik V, Haukereid C, Kronstad A, Blix HS, Kilhovd B, Viktil KK, Horn AM: Evaluating categorization and clinical relevance of drug-related problems in medication reviews. Pharm World Sci. 2010, 32: 394-403. 10.1007/s11096-010-9385-x.CrossRefPubMed Granas AG, Berg C, Hjellvik V, Haukereid C, Kronstad A, Blix HS, Kilhovd B, Viktil KK, Horn AM: Evaluating categorization and clinical relevance of drug-related problems in medication reviews. Pharm World Sci. 2010, 32: 394-403. 10.1007/s11096-010-9385-x.CrossRefPubMed
28.
go back to reference Nishio S, Watanabe H, Kosuge K, Uchida S, Hayashi H, Ohashi K: Interaction between amlodipine and simvastatin in patients with hypercholesterolemia and hypertension. Hypertens Res. 2005, 28 (3): 223-227. 10.1291/hypres.28.223.CrossRefPubMed Nishio S, Watanabe H, Kosuge K, Uchida S, Hayashi H, Ohashi K: Interaction between amlodipine and simvastatin in patients with hypercholesterolemia and hypertension. Hypertens Res. 2005, 28 (3): 223-227. 10.1291/hypres.28.223.CrossRefPubMed
29.
go back to reference Park CG, Lee H, Choi JW, Lee SJ, Kim SH, Lim HE: Non-concurrent dosing attenuates the pharmacokinetic interaction between amlodipine and simvastatin. Intl J Clin Pharmacol Therapeut. 2010, 48 (8): 497-503. 10.5414/CPP48497.CrossRef Park CG, Lee H, Choi JW, Lee SJ, Kim SH, Lim HE: Non-concurrent dosing attenuates the pharmacokinetic interaction between amlodipine and simvastatin. Intl J Clin Pharmacol Therapeut. 2010, 48 (8): 497-503. 10.5414/CPP48497.CrossRef
31.
go back to reference Lorenzo AV, Ana MVC, Carlos O, Paloma E, Maria EF, Marcela Q: Pharmaceutical care program for dyslipidemic patients at three primary health care centers: Impacts and outcomes. Latin Am J Pharm. 2009, 28 (3): 415-420. Lorenzo AV, Ana MVC, Carlos O, Paloma E, Maria EF, Marcela Q: Pharmaceutical care program for dyslipidemic patients at three primary health care centers: Impacts and outcomes. Latin Am J Pharm. 2009, 28 (3): 415-420.
32.
go back to reference Koh Y, Kutty FB, Li SC: Drug-related problems in hospitalized patients on polypharmacy: The influence of age and gender. J Therapeut Clin Risk Manag. 2005, 1: 39-48. 10.2147/tcrm.1.1.39.53597.CrossRef Koh Y, Kutty FB, Li SC: Drug-related problems in hospitalized patients on polypharmacy: The influence of age and gender. J Therapeut Clin Risk Manag. 2005, 1: 39-48. 10.2147/tcrm.1.1.39.53597.CrossRef
33.
go back to reference Babwah F, Baksh S, Blake L, Cupid-Thuesday J, Hosein I, Sookhai A, Poon-King C, Hutchinson : The role of gender in compliance and attendance at an outpatient clinic for type 2 diabetes mellitus in Trinidad. Revista Panam Salud Publica. 2006, 19 (2): 79-84. Babwah F, Baksh S, Blake L, Cupid-Thuesday J, Hosein I, Sookhai A, Poon-King C, Hutchinson : The role of gender in compliance and attendance at an outpatient clinic for type 2 diabetes mellitus in Trinidad. Revista Panam Salud Publica. 2006, 19 (2): 79-84.
34.
go back to reference Carol V: Gender differences in determinants and consequences of health and illness. J Health Pop Nutrit. 2007, 25 (1): 47-61. Carol V: Gender differences in determinants and consequences of health and illness. J Health Pop Nutrit. 2007, 25 (1): 47-61.
35.
go back to reference Thomas MC, Macisaac RJ, Jerums G, Weekes A, Moran J, Shaw JE, Atkins RC: Non-albuminuric renal impairment in type 2 diabetic patients and in the general population (National evaluation of the frequency of renal impairment coexisting with NIDDM (Nefron) 11). Diabetes Care. 2009, 32 (8): 1497-1502. 10.2337/dc08-2186.CrossRefPubMedPubMedCentral Thomas MC, Macisaac RJ, Jerums G, Weekes A, Moran J, Shaw JE, Atkins RC: Non-albuminuric renal impairment in type 2 diabetic patients and in the general population (National evaluation of the frequency of renal impairment coexisting with NIDDM (Nefron) 11). Diabetes Care. 2009, 32 (8): 1497-1502. 10.2337/dc08-2186.CrossRefPubMedPubMedCentral
36.
go back to reference Hege SB, Kirsten KV, Tron AM, Aasmund R: Use of renal risk drugs in hospitalized patients with impaired renal function—an underestimated problem?. Nephrol Dialysis Transplant. 2006, 21: 3164-3171. 10.1093/ndt/gfl399.CrossRef Hege SB, Kirsten KV, Tron AM, Aasmund R: Use of renal risk drugs in hospitalized patients with impaired renal function—an underestimated problem?. Nephrol Dialysis Transplant. 2006, 21: 3164-3171. 10.1093/ndt/gfl399.CrossRef
37.
go back to reference Chan CM: Hyperlipidaemia in chronic kidney disease. Ann Acad Med Singapore. 2005, 35: 31-35. Chan CM: Hyperlipidaemia in chronic kidney disease. Ann Acad Med Singapore. 2005, 35: 31-35.
38.
go back to reference Roger PA: Polypharmacy as a risk factor in the treatment of type 2 diabetes. Diabetes Spectrum. 2006, 19 (1): 13-16. 10.2337/diaspect.19.1.13.CrossRef Roger PA: Polypharmacy as a risk factor in the treatment of type 2 diabetes. Diabetes Spectrum. 2006, 19 (1): 13-16. 10.2337/diaspect.19.1.13.CrossRef
39.
go back to reference Kirsten KV, Hege SB, Tron AM, Aasmund R: Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems. Brit J Clin Pharmacol. 2006, 63: 2187-2195. Kirsten KV, Hege SB, Tron AM, Aasmund R: Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems. Brit J Clin Pharmacol. 2006, 63: 2187-2195.
40.
go back to reference John CR, Kit FN, Hnin HA, Dennis WW: Role of triglyceride-rich lipoproteins in diabetic nephropathy. Nat Rev Nephrol. 2010, 6: 361-370. 10.1038/nrneph.2010.59. John CR, Kit FN, Hnin HA, Dennis WW: Role of triglyceride-rich lipoproteins in diabetic nephropathy. Nat Rev Nephrol. 2010, 6: 361-370. 10.1038/nrneph.2010.59.
Metadata
Title
Drug-related problems in type 2 diabetes mellitus patients with dyslipidemia
Authors
Hasniza Zaman Huri
Lee Chai Ling
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-1192

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