Factors Associated With Drug Therapy Problems in Patients on Anticoagulants at Kenyatta National Hospital

Abstract

Background: Anticoagulants are used to manage thrombosis. Achievement of the goals of therapy may be complicated by drug therapy problems. Disruption of anticoagulation can be detrimental to patients and can have severe effects. Objectives: This study sought to identify the drug therapy problems encountered frequently by patients using anticoagulants, to ascertain the frequency of the problem and investigate the factors associated with drug therapy problems. Methodology: This was a cross-sectional study. A questionnaire and data collection tool was used to get data by interviewing consenting patients and abstracting data from their medical records. The study was confined to adult patients in the medical wards of Kenyatta National Hospital. Convenience sampling was used to recruit study participants. The data was analysed to give the prevalence of the drug therapy problems in the study population, the associated factors and the anticoagulant drugs in which drug therapy problems are common. Chi-square, Fisher’s exact and logistic regression analysis were used to identify associated factors. Results: There were 125 participants recruited into the study, 52.8% female and 47.2% males. Drug therapy problems occurred in 37.6%. The main drug therapy problem encountered was drug-drug interactions in 18.4% and treatment safety problems in 16%. Most patients were on enoxaparin (81%) but drug therapy problems were more common in warfarin. There were no significant associated factors identified in the study. Conclusion and Recommendations: Drug therapy problems are common in patients using anticoagulants. Drug-drug interactions in anticoagulants thought to be safe should not be overlooked. All members of the healthcare team should be alert to identify and intervene in case these problems arise. The healthcare team should be aware of the common drug therapy problems in patients on anticoagulant therapy and be prepared to intervene. A follow up prospective study with a larger study population should be done to reveal associations that were not captured by this study