Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana

Gala, Pooja; Moshokgo, Veronica; Seth, Bhavna; Ramasuana, Kegomoditswe; Kazadi, Emmanuel; M'buse, Rudy; Pharithi, Solomon; Gobotsamang, Kabelo; Szymanowski, Paige; Kerobale, Ruth Olyn; Balekile, Kelennetse; Tshimbalanga, Jacques; Tieng'O, Jane Gillead; Tapela, Neo; Barak, Tomer

doi:10.1161/jaha.119.013766

Cited by 20 publications

(24 citation statements)

References 30 publications

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“…This is far less than the country’s target of controlling BP in 60% of those with hypertension, as per Botswana non-communicable diseases (NCDs) strategy of 2017–22 (NCD Strategy 17–22). An association between poor BP control and antihypertensive medication errors has been reported in Botswana 9 and is a likely contributor to increasing complications such stroke and heart diseases. May Measurement Month campaigns provide important national estimates of hypertension disease burden and can guide programme planning, policy or strategy reviews, amidst the epidemic of poorly controlled and undiagnosed hypertension in low- and middle-income countries.…”

Section: Discussionmentioning

confidence: 97%

May Measurement Month 2019: an analysis of blood pressure screening results from Botswana

Tlhakanelo

Makwati

Beaney

et al. 2021

European Heart Journal Supplements

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The May Measurement Month (MMM) 2019 campaign aimed to raise awareness of the health issues surrounding raised blood pressure (BP) among the general public. It also sought to identify and facilitate reduction of BPs of participants who require intervention to lower their BP according to current country treatment guidelines. Participants aged ≥18 years were recruited on site through interactions with the study team, educational fliers, and as voluntary walk-ins in response to the media engagement prior to the campaign. Blood pressures were measured using validated upper-arm cuff electronic devices provided by Omron Healthcare in partnership with International Society of Hypertension. With the participant seated, their back supported and legs resting uncrossed on the ground, three BP and heart rate readings were taken and recorded, 1 min apart. Participants’ basic demographic data were also collected. Hypertension was defined as being on treatment for hypertension, or a systolic BP ≥140 mmHg and/or a diastolic BP ≥90 mmHg (based on the mean of the last two of three readings). Of the 5459 screened participants, 1750 (32.1%) had hypertension, of whom 784 (44.8%) were aware they were hypertensive and 726 (41.5%) were on antihypertensive medication. Among those on antihypertensive treatment, 47.0% had their BP controlled (<140/90 mmHg). Only 19.5% of all those with hypertension had their BP controlled. A total of 1024 (21.6%) of the 4733 participants not on antihypertensive treatment were hypertensive. Intensified preventive and treatment measures to control BP at the health system, individual and population levels remain a critical requirement for Botswana.

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Section: Discussionmentioning

confidence: 97%

May Measurement Month 2019: an analysis of blood pressure screening results from Botswana

Tlhakanelo

Makwati

Beaney

et al. 2021

European Heart Journal Supplements

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“…Hypertensive patients are a group of patients who are susceptible to recurrent medication changes and poly-drug regimens, therefore, they are particularly vulnerable to medication errors, including discrepancies in their medications [ 12 ]. Thus, this study aimed to identify and quantify the different types of unintentional discrepancies among hospitalized hypertensive patients; it also explored the predictors of unintentional discrepancies among this cohort of patients.…”

Section: Introductionmentioning

confidence: 99%

Medication discrepancies among hospitalized patients with hypertension: assessment of prevalence and risk factors

Farha

Yousef

Gharaibeh

et al. 2021

BMC Health Serv Res

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Background Medication errors remained among the top 10 leading causes of death worldwide. Furthermore, a high percentage of medication errors are classified as medication discrepancies. This study aimed to identify and quantify the different types of unintentional medication discrepancies among hospitalized hypertensive patients; it also explored the predictors of unintentional medication discrepancies among this cohort of patients. Methods This was a prospective observational study undertaken in a large teaching hospital. A convenience sample of adult patients, taking ≥4 regular medications, with a prior history of treated hypertension admitted to a medical or surgical ward were recruited. The best possible medication histories were obtained by hospital pharmacists using at least two information sources. These histories were compared to the admission medication orders to identify any possible unintentional discrepancies. These discrepancies were classified based on their severity. Finally, the different predictors affecting unintentional discrepancies occurrence were recognized. Results A high rate of unintentional medication discrepancies has been found, with approximately 46.7% of the patients had at least one unintentional discrepancy. Regression analysis showed that for every one year of increased age, the number of unintentional discrepancies per patient increased by 0.172 (P = 0.007), and for every additional medication taken prior to hospital admission, the number of discrepancies increased by 0.258 (P= 0.003). While for every additional medication at hospital admission, the number of discrepancies decreased by 0.288 (P < 0.001). Cardiovascular medications, such as diuretics and beta-blockers, were associated with the highest rates of unintentional discrepancies in our study. Medication omission was the most common type of the identified discrepancies, with approximately 46.1% of the identified discrepancies were related to omission. Regarding the clinical significance of the identified discrepancies, around two-third of them were of moderate to high significance (n= 124, 64.2%), which had the potential to cause moderate or severe worsening of the patient´s medical condition. Conclusions Unintentional medication discrepancies are highly prevalent among hypertensive patients. Medication omission was the most commonly encountered discrepancy type. Health institutions should implement appropriate and effective tools and strategies to reduce these medication discrepancies and enhance patient safety at different care transitions. Further studies are needed to assess whether such discrepancies might affect blood pressure control in hypertensive patients.

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“…In Jordan, according to the latest statistics by the Jordanian pharmacists Association (JPA), there are 25,700 pharmacists registered in JPA [14,15]. The responsibilities of most of the pharmacists remain focused on dispensing medications, inventory control, and executing physician orders [16]. Besides their responsibilities, pharmacists are still the most competent and qualified healthcare professionals in providing medication-related information [17].…”

Section: Introductionmentioning

confidence: 99%

Pharmacists’ perceptions of the use of internet-based medication information by patients: A cross-sectional survey

2021

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Purpose The credibility and the reliability of Internet webpages to seek medication-related information is questionable. The main objective of the current study was to evaluate perception and experience of pharmacists with the use of Internet-based medication information by their patients. Methods This is a cross-sectional descriptive study that was conducted to evaluate perception and experience of pharmacists with the use of Internet-based medication information by their patients. During the study period, 200 pharmacists were approached to participate in the study using a paper-based survey to assess their perceptions and current experience with the use of Internet-based medication information by their patients. Data were analyzed using descriptive statistics (mean/standard deviation for continuous variables, and frequency/percentages for qualitative variables). Also, simple linear regression was utilized to screen factors affecting pharmacists’ perception scores of the use of Internet-based medication information. Results Among 161 recruited pharmacists, the majority (n = 129, 80.1%) reported receiving inquiries from patients about Internet-based medication information within the last year. Among them, only 22.6% (n = 29) of pharmacists believed that Internet-based medication information is somewhat or very accurate. Unfortunately, only 24.2% (n = 31) of them stated that they always had enough time for their patient to discuss their Internet-based medication information. Regarding pharmacists’ perception of the use of Internet-based medication information by their patients, more than half of the pharmacists (>50%) believe that Internet-based medication information could increase the patient’s role in taking responsibility. On the other hand, 54.7% (n = 88) of the pharmacists believed that Internet-based medication information would contribute to rising the healthcare cost by obtaining unnecessary medications by patients. Finally, pharmacists’ educational level was found to significantly affect their perception scores toward patient use of Internet-based medication information where those with higher educational level showed lower perception score (r = -0.200, P-value = 0.011). Conclusion Although pharmacists felt that usage of Internet-based data by patients is beneficial, they also have believed that it has a negative impact in terms of rising the healthcare cost, and it promotes unnecessary fear or concern about medications. We suggest that pharmacists be trained on principles of critical appraisal to become professional in retrieval information on the Internet that might improve their delivery of healthcare information and their recommendations to patients.

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Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana

Cited by 20 publications

References 30 publications

May Measurement Month 2019: an analysis of blood pressure screening results from Botswana

May Measurement Month 2019: an analysis of blood pressure screening results from Botswana

Medication discrepancies among hospitalized patients with hypertension: assessment of prevalence and risk factors

Pharmacists’ perceptions of the use of internet-based medication information by patients: A cross-sectional survey

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