Antihypertensive drug-related problems in Vietnamese ambulatory care
Abstract Evidence of antihypertensive drug-related problems (aDRP) is limited in Asian ambulatory care. To better detect aDRP without causing alert fatigue, we investigated whether adding more antihypertensive agents was associated with increasing aDRP risk and factors associated with physician acce...
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2025-01-01
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| author | Hoang Hai Nguyen Le Anh Thu Vu Minh-Hoang Tran Hong Tham Pham |
| author_facet | Hoang Hai Nguyen Le Anh Thu Vu Minh-Hoang Tran Hong Tham Pham |
| author_sort | Hoang Hai Nguyen |
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| description | Abstract Evidence of antihypertensive drug-related problems (aDRP) is limited in Asian ambulatory care. To better detect aDRP without causing alert fatigue, we investigated whether adding more antihypertensive agents was associated with increasing aDRP risk and factors associated with physician acceptance of aDRP correction. We conducted a cross-sectional study targeting ambulatory prescriptions of Vietnamese patients with hypertension who either received standard therapy (using two or fewer medications, SdT) or standard plus add-on therapy (using more than two medications, SdT + add-on). Primary and secondary outcomes were number of aDRP and correction ratio of aDRP. We used multivariable Poisson regression to estimate the incidence rate ratio (IRR) and 95% confidence interval (95%CI). We analyzed 221 cases (patient age of 64.1 ± 9.0 years, 51.1% being female). On average, patients with SdT and SdT + add-on had 1.6 ± 1.3 and 1.6 ± 1.5 aDRP, respectively. Compared to the SdT group, SdT + add-on group did not have a higher number of aDRP (IRR = 1.11, 95%CI 0.87–1.43, p = 0.393) or likelihood of aDRP correction (IRR = 0.97, 95%CI 0.86–1.09, p = 0.578). We found the following factors to be associated with aDRP correction: unnecessary indication (IRR = 1.98, 95%CI 1.39–2.81, p < 0.001), missing indication (IRR = 1.93, 95%CI 1.68–2.21, p < 0.001), major-to-contraindicated drug interaction (IRR = 1.74, 95%CI 1.39–2.18, p < 0.001), adverse effects (IRR = 1.71, 95%CI 1.26–2.31, p < 0.001), nonconformity indication (IRR = 1.66, 95%CI 1.44–1.92, p < 0.001), and administration (IRR = 1.45, 95%CI 1.26–1.67, p < 0.001). In conclusion, adding antihypertensive agents was not associated with a higher number of aDRP or likelihood of aDRP corrections. Physician acceptance of aDRP corrections could be strongly related to unnecessary/missing indication, major-to-contraindicated drug interaction, and adverse effects. These findings could improve DRP alerts and maximize treatment outcomes in Asian patients with hypertension. |
| format | Article |
| id | doaj-art-8b9aad9c21664008959546c459072d07 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-8b9aad9c21664008959546c459072d072025-02-02T12:21:54ZengNature PortfolioScientific Reports2045-23222025-01-011511710.1038/s41598-025-88041-0Antihypertensive drug-related problems in Vietnamese ambulatory careHoang Hai Nguyen0Le Anh Thu Vu1Minh-Hoang Tran2Hong Tham Pham3Department of Cardiology, Nhan Dan Gia Dinh HospitalFaculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Pharmacy, Nhan Dan Gia Dinh HospitalDepartment of Pharmacy, Nhan Dan Gia Dinh HospitalAbstract Evidence of antihypertensive drug-related problems (aDRP) is limited in Asian ambulatory care. To better detect aDRP without causing alert fatigue, we investigated whether adding more antihypertensive agents was associated with increasing aDRP risk and factors associated with physician acceptance of aDRP correction. We conducted a cross-sectional study targeting ambulatory prescriptions of Vietnamese patients with hypertension who either received standard therapy (using two or fewer medications, SdT) or standard plus add-on therapy (using more than two medications, SdT + add-on). Primary and secondary outcomes were number of aDRP and correction ratio of aDRP. We used multivariable Poisson regression to estimate the incidence rate ratio (IRR) and 95% confidence interval (95%CI). We analyzed 221 cases (patient age of 64.1 ± 9.0 years, 51.1% being female). On average, patients with SdT and SdT + add-on had 1.6 ± 1.3 and 1.6 ± 1.5 aDRP, respectively. Compared to the SdT group, SdT + add-on group did not have a higher number of aDRP (IRR = 1.11, 95%CI 0.87–1.43, p = 0.393) or likelihood of aDRP correction (IRR = 0.97, 95%CI 0.86–1.09, p = 0.578). We found the following factors to be associated with aDRP correction: unnecessary indication (IRR = 1.98, 95%CI 1.39–2.81, p < 0.001), missing indication (IRR = 1.93, 95%CI 1.68–2.21, p < 0.001), major-to-contraindicated drug interaction (IRR = 1.74, 95%CI 1.39–2.18, p < 0.001), adverse effects (IRR = 1.71, 95%CI 1.26–2.31, p < 0.001), nonconformity indication (IRR = 1.66, 95%CI 1.44–1.92, p < 0.001), and administration (IRR = 1.45, 95%CI 1.26–1.67, p < 0.001). In conclusion, adding antihypertensive agents was not associated with a higher number of aDRP or likelihood of aDRP corrections. Physician acceptance of aDRP corrections could be strongly related to unnecessary/missing indication, major-to-contraindicated drug interaction, and adverse effects. These findings could improve DRP alerts and maximize treatment outcomes in Asian patients with hypertension.https://doi.org/10.1038/s41598-025-88041-0HypertensionDrug-related problemAmbulatory careVietnam |
| spellingShingle | Hoang Hai Nguyen Le Anh Thu Vu Minh-Hoang Tran Hong Tham Pham Antihypertensive drug-related problems in Vietnamese ambulatory care Scientific Reports Hypertension Drug-related problem Ambulatory care Vietnam |
| title | Antihypertensive drug-related problems in Vietnamese ambulatory care |
| title_full | Antihypertensive drug-related problems in Vietnamese ambulatory care |
| title_fullStr | Antihypertensive drug-related problems in Vietnamese ambulatory care |
| title_full_unstemmed | Antihypertensive drug-related problems in Vietnamese ambulatory care |
| title_short | Antihypertensive drug-related problems in Vietnamese ambulatory care |
| title_sort | antihypertensive drug related problems in vietnamese ambulatory care |
| topic | Hypertension Drug-related problem Ambulatory care Vietnam |
| url | https://doi.org/10.1038/s41598-025-88041-0 |
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