Drug-related problems in hypertension and gestational diabetes mellitus: a hospital cohort
Drug-Related Problems, High-Risk Pregnancy, Gestational Diabetes Mellitus, Gestational Hypertension, Clinical Pharmacy.
Pregnant women are particularly vulnerable to drug-related problems (DRPs), especially those at high risk. Despite its relevance, there are few data on frequency, type, cause, and associated factors in this population. In Brazil, as far as we know, there are no studies with this theme. The aim of this study was to characterize 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 environment. Observational, longitudinal and prospective study that included 297 pregnant women hosendal with hypertension and gestational diabetes mellitus using at least one drug. The DRPs were classified according to Classification for Drug-Related Problems (PCNE V9.00). In addition to descriptive statistics, multivariate logistic regression model was used to determine the factors associated with DRPs. Preliminary results indicate a total of 572 DRPs identified. The frequent DRPs were related to therapeutic ineffectiveness (57.5%) and occurrence of adverse events (41.1%) and the main pharmacological classes involved were insulins and methyldopa. Therefore, the first five days of treatment highlight the ineffectiveness of insulin (26.4%), associated with underdosis (14.5%) or insufficient frequency of administration (8.6%) and methyldopa associated with the occurrence of adverse reactions (43.3%) in the first 48h. Longer treatment time (OR 1.573, 95% CI: 1,309 - 1,889, p = 0.001) and number of drugs prescribed (OR 1.233, 95% CI: 1.080 – 1.408, p = 0.002) were risk factors for the occurrence of PRMs. In short, the DRPs are frequent in pregnant women with hypertension and gestational diabetes mellitus, especially related to therapeutic ineffectiveness and the occurrence of adverse events.