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

Priscilla Karilline Vale Bezerra; Jéssica Escorel Chaves Cavalcanti; Solimar Ribeiro Carlete Filho; Sarah Dantas Viana Medeiros; Antonio Gouveia Oliveira; Rand Randall Martins

doi:10.1371/journal.pone.0284053

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

PLoS One. 2023 Apr 7;18(4):e0284053. doi: 10.1371/journal.pone.0284053. eCollection 2023.

Authors

Priscilla Karilline Vale Bezerra¹, Jéssica Escorel Chaves Cavalcanti², Solimar Ribeiro Carlete Filho³, Sarah Dantas Viana Medeiros⁴, Antonio Gouveia Oliveira^{1

3}, Rand Randall Martins^{1

2

3}

Affiliations

¹ Graduate Program of Pharmaceutical Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
² Graduate Program in Sciences Applied to Women's Health, Maternidade Escola Januário Cicco, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
³ Pharmacy Department, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
⁴ School Maternity Januário Cicco, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

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.

Copyright: © 2023 Vale Bezerra et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Diabetes, Gestational* / drug therapy
Diabetes, Gestational* / epidemiology
Drug-Related Side Effects and Adverse Reactions*
Female
Hospitals
Humans
Hypertension* / drug therapy
Hypertension* / epidemiology
Insulin
Methyldopa
Pregnancy
Prospective Studies

Substances

Methyldopa
Insulin

Grants and funding

This study was funded by the National Counsel of Technological and Scientific Development (CNPq, Finance Code 001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.