أسباب المشكلات المتعلقة بأدوية مرضى الكلى المزمن المصاحب لداء السكري مع أو بدون ارتفاع ضغط الدم في مستشفى خاص في اليمن
DOI:
https://doi.org/10.65693/irss.2022.v3i1.328الكلمات المفتاحية:
أمراض الكلى المزمنة - داء السكري من النوع الثاني - ارتفاع ضغط الدم - المشكلات المتعلقة بالدواءالملخص
الخلفية العلمية: يشهد العالم ارتفاعاً مقلقاً في معدلات انتشار مرض الكلى المزمن، والذي يرتبط بمعدلات مرضية ووفيات مرتفعة، مما يتطلب إيلاءه اهتماماً خاصاً كأحد أبرز المشكلات المتنامية في مجال الصحة العامة. وتُعد المشكلات المتعلقة بالدواء (DRPs) شائعة لدى المرضى المنومين في المستشفيات، بمن فيهم مصابو مرض الكلى المزمن، وتكمن خطورتها في أنها قد تؤدي إلى تمديد فترة الإقامة بالمستشفى، وزيادة تكاليف الرعاية الصحية، فضلاً عن تفاقم مخاطر المراضة والوفاة.الهدف: تحديد وتقييم المشكلات المتعلقة بالدواء (DRPs) وعوامل الخطر المقترنة بها لدى المرضى الخاضعين للعلاج من مرض الكلى المزمن (CKD) المصاحب لداء السكري و/أو ارتفاع ضغط الدم.
المنهجية: أُجريت دراسة استرجاعية رصدية على المرضى المشخَّصين بمرض الكلى المزمن مع داء السكري و/أو ارتفاع ضغط الدم، والذين أُدخلوا إلى أحد مستشفيات مدينة صنعاء (مستشفى جامعة العلوم والتكنولوجيا). استمرت الدراسة لمدة ثلاثة أشهر في الفترة من [1 ديسمبر 2021 إلى 10 فبراير 2022]. جُمعت البيانات المتعلقة بخصائص المرضى، والأدوية، والتشخيص، والنتائج المخبرية من خلال مراجعة السجلات الطبية للمرضى، وتُمّ تحليل البيانات باستخدام الحزمة الإحصائية للعلوم الاجتماعية (SPSS) الإصدار 21.0.
النتائج: من بين 106 مرضى مصابين بمرض الكلى المزمن مع داء السكري و/أو ارتفاع ضغط الدم، تبين أن 86 مريضاً (81.1%) عانوا من مشكلات متعلقة بالدواء، بمعدل لا يقل عن مشكلتين لكل مريض في المتوسط. وسُجّل إجمالي 233 مشكلة متعلقة بالدواء مع تحديد الأسباب المؤدية لكل منها. وكانت أكثر المشكلات الدوائية شيوعاً بين المرضى هي: اختيار الدواء (العدد = 140، بنسبة 40%)، واختيار الجرعة (العدد = 80، بنسبة 34.4%)، ومدة العلاج (العدد = 13، بنسبة 5.6%). وكان السبب الأكثر شيوعاً في فئة اختيار الدواء هو الاختيار غير المناسب للدواء (48.6%)، بينما كان السبب الأكثر شيوعاً في فئة اختيار الجرعة هو إعطاء جرعة منخفضة للغاية (52.5%).
المراجع
Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. The Lancet 2017; 389(10075): 1238-52.
Bikbov B, Purcell CA, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet 2020; 395(10225): 709-33.
Xie Y, Bowe B, Mokdad AH, et al. Analysis of the Global Burden of Disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney International 2018; 94(3): 567-81.
Bharath Raj KC et al. Drug-related problems among chronic kidney disease patients: a clinical pharmacist led study. International Journal of Pharmaceutical Research | Oct - Dec 2020 | Vol 12 | Issue.
[Guideline] Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013; 3:1-150.
Dipiro, J. T., Talbert, G. C., Yee, G. R., Matzke, B. G., & Wells, L. M. P. (2021). Pharmacotherapy: A Pathophysiology Approach, 10th Edition. McGraw-Hill Medical, 6007-6048.
Yohanes Ayele, Kibkab M, Mesay D, Mohammed BA, and Boressa AH. Assessment of drug related problems among type 2 diabetes mellitus patients with hypertension in Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. BMC Res Notes (2018) 11:728.
Tadesse Sheleme, Tamiru S, and Desalegn F. Identification and resolution of drug-related problems among diabetic patients attending a referral hospital: a prospective observational Study. Pharm Policy and Pract (2021) 14:50.
Belayneh Kefale, Gobezie TT, Yitayih K, Mulugeta M, Amien E, and Amsalu D. Magnitude and determinants of drug therapy problems among type 2 diabetes mellitus patients with hypertension in Ethiopia. Volume 8: 1-8 (2020).
Joseph Nzayisenga, Nicholas Njau Ngomi, John Nyiligira. Drug related problems among type II diabetes mellitus patients with hypertension: a cross-sectional study. DOI: 10.12032/life2020-0125-101.
Ejaz Cheema et al. Exploring Drug-Related Problems in Diabetic Patients during Ramadan Fasting in Saudi Arabia: A Mixed-Methods Study. Int. J. Environ. Res. Public Health 2019, 16, 499.
Silvy Hartuti, Azizah N, Santi S. The Effect of Drug-Related Problems on Blood Glucose Level in the Treatment of Patients with Type 2 Diabetes Mellitus. Open Access Macedonian Journal of Medical Sciences. 2019 Jun 15; 7(11):1798-1801.
Fildza Huwaina Fathnin et al. The Relation of Drug Amount, Comorbidity, Blood Pressure, and Residential Area to Drug-Related-Problems of Hypertension Patients. Public Health Perspectives Journal 5 (3) 2020 178-186.
Tientcheu D, Ayers C, Das SR, McGuire DK, De Lemos JA, Khera A, Vongpatanasin W. (2015). Target organ complications and cardiovascular events associated with masked hypertension and white-coat hypertension: Analysis from the Dallas Heart Study. Journal of the American College of Cardiology, 66(20), 2159-2169.
Hesty U Ramadaniati, Yusi Anggriani, Vonny M Wowor, Alvina Rianti. Drug-related problems in chronic kidneys disease patients in an Indonesian hospital: do the problems really matter? Int J Pharm Pharm Sci 2016;8(12):298-302.
Kirsten K. Viktil and Hege Salvesen Blix. The Impact of Clinical Pharmacists on Drug-Related Problems and Clinical Outcomes. Basic & Clinical Pharmacology & Toxicology 102, 275-280 (2008).
Parthasarthi G, Nyfort - Hansen K, Nahata MC. (2012). A textbook of Clinical Pharmacy Practice. 2nd ed. Hyderabad: Universities Press; Chapter 13, Medication Review, p.194.
Ayele M Argaw, Tsegaye T Hiwet, and Bodena B Derse. Drug Therapy Problems and Determinants among Ambulatory Type2 Diabetes Mellitus Patients: Pharmacists' Intervention in South-East Ethiopia. Endocrinol Metab Syndr, Vol. 8 Iss. 4 No: 303.
Aster Wakjira Garedow, Eshetu MB, Amare DW, Fantu KD, Fanta GF, Birtukan IL, et al. Drug-Related Problems and Associated Factors among Patients Admitted with Chronic Kidney Disease at Jimma University Medical Center, Jimma Zone, Jimma, Southwest Ethiopia: A Hospital-Based Prospective Observational Study. International Journal of Nephrology. Volume 2019, Article ID 1504371, 9 pages.
Norkasihan Ibrahim, Ian CK Wong, Susan Patey, Stephen Tomlin, Manish D Sinha, Yogini Jani. Drug-related problem in children with chronic kidney disease In London. Pediatr Nephrol (2013) 28:25-31.
Viswam K. Subeesh, Rishma A, Minnikanti VSS, Kranthi SK. Evaluation of prescribing practices and drug-related problems in chronic kidney disease patients: A cross-sectional study In India. Perspectives in Clinical Research | Volume 11 | Issue 2 | April-June 2020.
Hasniza Zaman Huri, and Hoo Fun Wee. Drug related problems in type 2 diabetes patients with hypertension: a cross-sectional retrospective study in Malaysia. BMC Endocrine Disorders 2013, 13:2.
Yaschilal Muche Belayneh, Teshome M, Solomon A, Zemene DK. A retrospective study of drug related problems and contributing factors among type 2 diabetes mellitus patients on follow up at public health institutions of kemisse town, north east Ethiopia. Metabolism Open 11 (2021) 100098.
Mechessa and Kebede. Drug-Related Problems and Their Predictors Among Patients with Diabetes Attending the Ambulatory Clinic of Gebre Tsadik Shawo General Hospital, Southwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2020:13.
Van Roozendaal BW, Krass I. Development of an evidence-based checklist for the detection of drug related problems in type 2 diabetes. Pharm World Sci 2009, 31(5):580-595.
Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, et al. Drug-related problems (DRPs) identified from geriatric medication safety review clinics. Arch Gerontol Geriatr 2011, 54:168-174.
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. Pharm World Sci 2010, 32(3):362-372.
Belayneh YM, Amberbir G, Agalu A. A prospective observational study of drug related problems in medical ward of a referral hospital in northeast Ethiopia. BMC Health Serv Res 2018 Dec;18(1):808.
Cipolle RJ, Strand LM, Morley PC. Pharmaceutical Care practice: A Clinician's Guide. Second ed. New York: McGraw-Hill; 2004. p. 178-9.
Yimama et al. Determinants of drug-related problems among ambulatory type 2 diabetes patients with hypertension comorbidity in Southwest Ethiopia: a prospective cross sectional study. BMC Res Notes (2018) 11:679.
Haymen Abdulmalik, Yohannes T, and Nanati L. Assessment of drug-related problems among type 2 diabetic patients on follow up at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. BMC Res Notes (2019) 12:771.
Ramadaniati HU, Anggriani YU, Wowor VM, et al. Drug-related problems in chronic kidneys disease patients in an Indonesian hospital: Do the problems really matter. Int J Pharm Phar Sci. 2016;8(12):298-302.
Stevens LA, Viswanathan G, Weiner DE. (2010). Chronic kidney disease and end-stage renal disease in the elderly population: current prevalence, future projections, and clinical significance. Advances in Chronic Kidney Disease, 17(4), 293-301.
Adibe MO, Igboeli NU, Ukwe CV. Evaluation of drug therapy problems among renal patients receiving care in some tertiary hospitals in Nigeria. Tropical Journal of Pharmaceutical Research. 2017;16(3):697-704.
Garedow AW, Mulisa Bobasa E, Desalegn Wolide A, et al. Drug-related Problems and Associated Factors Among Patients Admitted with Chronic Kidney Disease at Jimma University Medical Center, Jimma Zone, Jimma, Southwest Ethiopia: A Hospital-based Prospective Observational Study. International Journal of Nephrology. 2019;2019.
Subeesh VK, Abraham R, Sai MV, et al. Evaluation of prescribing practices and drug-related problems in chronic kidney disease patients: A cross-sectional study. Perspectives in Clinical Research. 2020 Apr;11(2):70.
Belaiche S, Romanet T, Allenet B, et al. Identification of drug-related problems in ambulatory chronic kidney disease patients: a 6-month prospective study. J Nephrol. 2012;25(5):782-8.
Matzke GR, Aronoff GR, Atkinson Jr AJ, et al. Drug dosing consideration in patients with acute and chronic kidney disease- a clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney International. 2011; 80(11):1122-37.
Saleem A, Masood I. Pattern and predictors of medication dosing errors in chronic kidney disease patients in Pakistan: a single center retrospective analysis. PloS ONE. 2016;11(7).
Dika P. Destiani, Athirah Ghazali. Drug Related Problems of Diabetic Nephropathy Patients in a Tertiary Hospital in Malaysia. Pharmacology and Clinical Pharmacy Research Vol.1 NO.2 August 2016.
Rana ABU FARHA, Akram SALEH, Salah ABURUZ. The impact of drug related problems on health-related quality of life among hypertensive patient. Pharmacy Practice 2017 Jul-Sep;15(3):995.
Rani NV, Rini Thoma RE, Soundararajan P. A study on drug related problems in chronic kidney disease patients of a tertiary care teaching hospital in south India. World Journal of Pharmaceutical Research. 2014;3(4).
Njeri, Lisper W. Assessment of medication related problems among patients with chronic kidney disease in Kenyatta National Hospital. Diss. University of Nairobi, 2016.
Kusumawardani LA, Andrajati R, Nusaibah A. Drug-related problems in hypertensive patients: A cross-sectional study from Indonesia. J Res Pharm Pract 2020;9:140-5.
Zazuli Z, Rohaya A, Adnyana IK. Drug-Related Problems in Type 2 Diabetic Patients with Hypertension: A Prospective Study. J Basic Clin Pharma 2017;8:251-254.
van Mil JW, Westerlund LO, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother. 2004;38(5):859-67.
1. Al-wesabi, Muneer. (2012). The Role of Quality Systems in Improving the Performance of Healthcare Facilities in Yemen: A Case Study of the 48 Model Hospital. https://doi.org/10.13140/RG.2.2.12720.32009
2. Al-wesabi, Muneer. (2017). The Effect of Health Human Resources Development on the Efficacy of Applying Accreditation Standards in Yemeni Hospitals: A Field Study. https://doi.org/10.13140/RG.2.2.28658.67527
3. Al-Wesabi, M., & Shamlan, M. (2022). The Effect of Applying Infection Prevention and Control Standards in Sana’a Governorate Hospitals at the Level of Reducing the Spread of Diseases and Epidemics. Journal of 21 September University for Medical and Applied Sciences, 1(1). https://doi.org/10.65693/masj.2022.v1i1.17
4. Alyahawi, A., Al-Wesabi, M., & ALKaf, A. (2022). Antimicrobial susceptibility of Acinetobacter clinical isolates among ICU Patients in Sana’a City, Yemen. Journal of 21 September University for Medical and Applied Sciences, 1(1). https://doi.org/10.65693/masj.2022.v1i1.14
5. Al-Wesabi, M. (2020). The reality of the Yemeni health sector and the role of September 21 University for Medical and Applied Sciences in reforming it and building the modern Yemeni state (M. Dael, Trans.). Institutional Repository for Scientific Scholarship at 21 September University for Medical and Applied Sciences, 1(1), 106-133. https://doi.org/10.65693/irss.2020.v1i1.47
الوصابي م. (2020). واقع القطاع الصحي اليمني ودور جامعة 21 سبتمبر للعلوم الطبية والتطبيقية في تطويره وبناء الدولة اليمنية الحديثة (دايل م.). المستودع الرقمي للانتاج العلمي بجامعة 21 سبتمبر للعلوم الطبية والتطبيقية, 1(1), 106-133. https://doi.org/10.65693/irss.2020.v1i1.47
التنزيلات
منشور
إصدار
القسم
الفئات
الرخصة
الحقوق الفكرية (c) 2026 عدي البريهي، ثريا شحيط، ثريا البدوي، ايناس راجح، فاطمة عبد اللطيف، فاطمة الغرسي، مرام شمسان، ابراهيم جواح، كمال مسعود، محمد السباعي، عمر المحبشي، الهام الظليمي، مروان سدهان، بسام العامري، انور حجر، أميمة الصباري، معاذ الادريسي، شاكر عثمان، فؤاد الخولاني، حميد القامص، بلال شمس الدين، احمد الشميري، حكيم السعيدي، عبد الحافظ البصلاني، عبدالله المحبشي، عبد الملك سيف، اقبال عبد الرحمن (المؤلف)
هذا العمل مرخص بموجب Creative Commons Attribution 4.0 International License.
