Drug Therapy Problems among Patients with both Cardiovascular Diseases and Diabetes Mellitus in a Sub-Saharan African Referral Hospital

Background: Patients with both type 2 diabetes mellitus and cardiovascular disease receive multiple medications but there are limited studies on drug therapy problems among them in Sub-Saharan Africa. Objective: To determine the predictors of drug therapy problems among adult patients with both type 2 diabetes and cardiovascular diseases. Setting: Kenyatta National Hospital. Method: A cross-sectional study involving 180 adult patients with both comorbidities was conducted. Data collected included sociodemographic and clinical characteristics, medications prescribed and drug therapy problems. Data was analyzed using STATA v.13 at p<0.05. Main outcome measures: Drug therapy problems and their predictors. Results: Majority (91.1%) of the patients had at least one drug therapy problems; most common being untreated indication, 87 (48.3%) which was significantly associated with furosemide use (p=0.003) and >72 months living with diabetes (p=0.007). Non-adherence was associated with the perception of disease control or cure (p<0.001). Under dosing of medications was significant in poor glycemic control (=<0.001) and poor blood pressure control (p=0.012). Conclusion: Clinicians should be aware that patients with both comorbidities are more likely to be under dosed, non-adhere to treatment or have other untreated conditions. Recommendation for Practice • Health care practitioners need to continuously monitor the drug therapy problems among patients with comorbidities • Prescribers should holistically manage patients specifically by identification of untreated conditions • Diabetic hypertensive patients who are not responding to treatment should always be assessed for under dosing and non- adherence • Kenyatta National Hospital should be encouraged to have counseling programs, especially to patients with long standing comorbidities, to improve adherence