Drug-related problems in hypertension and gestational diabetes mellitus: A hospital cohort

Abstract

Objective To characterize the drug-related problems (DRPs) in high-risk pregnant women with hypertension and gestational diabetes mellitus according to frequency, type, cause, and factors associated with their occurrence in the hospital setting. Methodology This is an observational, longitudinal, prospective study that included 571 hospitalized pregnant women with hypertension and gestational diabetes mellitus using at least one medication. DRPs were classified according to the Classification for Drug-Related Problems (PCNE V9.00). In addition to descriptive statistics, a univariate and multivariate logistic regression model was employed to determine the factors associated with the DRPs. Results A total of 873 DRPs were identified. The most frequent DRPs were related to therapeutic ineffectiveness (72.2%) and occurrence of adverse events (27.0%) and the main drugs involved were insulins and methyldopa. These were followed in the first five days of treatment by: the ineffectiveness of insulin (24.6%), associated with underdosage (12.9%) or insufficient frequency of administration (9.5%) and methyldopa associated with the occurrence of adverse reactions (40.2%) in the first 48h. Lower maternal age (OR 0.966, 95% CI 0.938–0.995, p = 0.022), lower gestational age (OR 0.966, 95% CI 0.938–0.996, p = 0.026), report of drug hypersensitivity (OR 2.295, 95% CI 1.220–4.317, p = 0.010), longer treatment time (OR 1.237, 95% CI: 1.147–1.333, p = 0.001) and number of prescribed medications (OR 1.211, 95% CI: 0.240–5.476, p = 0.001) were risk factors for occurrence of DRPs. Conclusion DRPs are frequent in pregnant women with hypertension and gestational diabetes mellitus, and they are mainly related to therapeutic ineffectiveness and the occurrence of adverse events.