Study on risk factors and associated drug related problems in patients with stroke.

Abstract

Background: The second most common cause of death and disability worldwide is stroke. Drug-related problems (DRPs) can arise during any step of the medication process, whether it involves prescribing, transcribing, dispensing, or administering drugs. The purpose of this study was to assess risk factors and associated DRPs in patients with stroke.

Methods: A cross-sectional study was conducted involving patients who had been diagnosed with stroke for 3 months using a purposive sampling technique at Annapurna Hospital. Data on demographics, comorbidities, and medications were collected through patient medical records, medicine Cardex, and nursing notes. DRPs were identified and classified using the Hepler-Strand classification system. Medscape software was used to assess potential drug-drug interactions (pDDIs). Descriptive statistics, chi-square tests, and binary logistic regression were performed.

Results: Among the 111 patients, the mean age was 58.72 ± 15.68 years. The majority of strokes were ischemic (68.5%), with the middle cerebral artery being the most commonly affected (24.3%). Males were more commonly affected (76.6%) than females (23.4%). Hypertension was the most prevalent comorbidity (61.3%), followed by diabetes mellitus (27.0%) and hyperlipidemia (21.6%). Hyperlipidemia was significantly associated with risk factors for ischemic stroke. The study found that 91.9% of stroke patients experienced DRPs, with pDDIs being the most common type (91.09%). The severity of pDDIs was predominantly categorized as "monitor closely" (73.2%). The use of more than 10 medications was a significant predictor for high-severity pDDIs.

Conclusion: The study concludes that polypharmacy is a significant predictor for high-severity pDDIs, highlighting the need for careful consideration when adding new medications to a patient's therapy. The high rate of pDDIs (91%) emphasizes the critical role of clinical pharmacists in identifying and mitigating these interactions to prevent further drug-related complications in stroke patients. Further research is needed to explore interventions to reduce DRPs.

Clinical trial number: Not applicable.