• AZIZAH NASUTION Faculty of Pharmacy, University of Sumatera Utara


Objective: This study aimed to evaluate the antihypertensive utilization and drug therapy problems (DTPs) in the treatment of patients with
Methods: This prospective analytical study used a self-determined questionnaire to collect 2-month period data of hypertensive patients (n=107)
admitted to four primary health centers in Medan (Medan Deli, Helvetia, Glugur Darat, and Teladan). Inclusion criteria were patients diagnosed
with hypertension, age ≥18 years, and under treatment of antihypertensive drugs. Data collected include gender, age, education, the administered
antihypertensive drugs, and DTPs. Characteristics of the patients were descriptively analyzed. DTPs were identified based on strand classification
system and trustable literature. All analyzes were performed using Statistical Package for the Social Sciences (SPSS, version 19, Chicago, IL, USA)
(p<0.05 was considered significant).
Results: Characteristics of the patients: Male, 25.2%; female, 74.8%; mean age, 61.6±10.3 (years). Education: Primary school, 25.2%; junior high
school, 17.8%; senior high school, 43.9%; university, 13.1%. The most frequently provided antihypertensive drugs were amlodipine (47.7%) and
captopril (22.4%). Overall, there were 66 DTPs experienced by 45.8% of the patients. Patients experienced: 1 DTP, 75.5%; 2 DTPs, 18.3%; 3 DTPs,
2.1%; 4 DTPs, 4.1%. There was no significant association between the patients' education and DTPs, p=0.88. The most frequently occurred DTP (47%)
was indication without drug therapy in which patients with hypertension Stage 2 only received single antihypertensive drugs mostly was captopril.
Conclusion: The most frequently provided antihypertensive drug was captopril. DTPs in the management of hypertensive patients are still high in
primary health centers in Medan and need to be resolved.
Keywords: Hypertension, Drug therapy problems, Strand classification.

Author Biography

AZIZAH NASUTION, Faculty of Pharmacy, University of Sumatera Utara

Department of Pharmaceutical Pharmacology


1. Cooney MT, Vartiainen E, Laatikainen T, Juolevi A, Dudina A,
Graham IM. Elevated resting heart rate is an independent risk factor
for cardiovascular disease in healthy men and women. Am Heart J
2. Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions
used to improve control of blood pressure in patients with hypertension.
Cochrane Database Syst Rev 2010;(3):CD005182.
3. Krishnan A, Garg R, Kahandaliyanage A. Hypertension in the
South-East Asia Region: An overview. Regional Health Forum
4. Europe PCN. PCNE Classification for Drug Related Problems V6. 2.
Tilgjengelig fra: http://www pcne org/sig/drp/documents/drp/PCNE%
20classification. 2010; 20.
5. Mutmainah N, Ernawati S, Sutrisna EM. Identification of drug related
problems (DRPs) in management of hypertensive patents with diabetes
mellitus in inpatient installation of Jepara Hospital X, 2007. Pharmacon
6. Manley HJ, Cannella CA, Bailie GR, St Peter WL. Medication-related
problems in ambulatory hemodialysis patients: A pooled analysis. Am J
Kidney Dis 2005;46(4):669-80.
7. Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: Updating
the cost-of-illness model. J Am Pharm Assoc (Wash) 2001;41(2):192-9.
8. Stemer G, Lemmens-Gruber R. Clinical pharmacy activities in chronic
kidney disease and end-stage renal disease patients: A systematic
literature review. BMC Nephrol 2011;12:35.
9. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J,
et al. Definition and classification of chronic kidney disease: A
position statement from Kidney Disease: Improving Global Outcomes
(KDIGO). Kidney Int 2005;67(6):2089-100.
Asian J Pharm Clin Res, Vol 9, Issue 1, 2016, 87-90
Nasution et al.
10. Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD.
Drug-related problems: Their structure and function. DICP
11. Stockley IH. Drug Interaction: A Source Book of Adverse Interactions,
Their Mechanisms, Clinical Importance and Management. 5
London: Pharmaceutical Press; 2001.
12. Medscape Reference. Assessed online June 1
to June 16
. Available
from: http://www.emedicine.medscape.com/article/241381medication.
13. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA,
Izzo JL Jr, et al. Seventh report of the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood
Pressure. Hypertension 2003;42(6):1206-52.
14. Ramli A, Ahmad NS, Paraidathathu T. Medication adherence among
hypertensive patients of primary health clinics in Malaysia. Patient
Prefer Adherence 2012;6:613-22.
15. Rose AJ, Glickman ME, D’Amore MM, Orner MB, Berlowitz D,
Kressin NR. Effects of daily adherence to antihypertensive medication
on blood pressure control. J Clin Hypertens 2011;13(6):416-21.
16. Marfo AF, Owusu-Daaku F, Addo MO, Saana II. Ghanaian hypertensive
patients understanding of their medicines and life style modification for
managing hypertension. Int J Pharm Pharm Sci 2014;6(4):165-70.
17. Zaman Huri H, Fun Wee H. Drug related problems in type 2 diabetes
patients with hypertension: A cross-sectional retrospective study. BMC
Endocr Disord 2013;13:2.
18. Govindan K, Ranganayakulu D. Benefits of clinical pharmacists
pharmaceutical care intervention to quality of patient’s life and control
hypertension. Asian J Pharm Clin Res 2014;7(4):223-6.
19. Jainaf Nachiya RA. Identification and categorization of drug related
problems in hypertensive subjects associated with CHD at tertiary
care teaching hospital: An observational prospective study. Indo Am J
Pharm Res 2014;4(4):2196-204.
20. Brater DC, Johnson AR. Goth’s Medical Pharmacology. St. Louis, MO:
Mosby-Year Book; 1988. p. 177-80.
21. Pratiwi D. Impact of counseling on medication adherence of
hypertensive patients admitted to polyclinic of Dr. M Djamil, Hospital
Padang, Indonesia. Available from: http://www.pasca.unand.ac.id/id/
wp.../2011/09/ARTIKEL4.pdf. [Last accessed on 2014 Dec 03].
22. Taitel M, Jiang J, Rudkin K, Ewing S, Duncan I. The impact of
pharmacist face-to-face counseling to improve medication adherence
among patients initiating statin therapy. Patient Prefer Adherence
23. Nasution A, Khairunnisa, Tanjung HR. Impacts of counseling on
adherence to prescribed medications and blood pressure of hypertensive
patients in four Indonesian primary health centers. Int J Pharm Pharm
Sci 2015;7(3):114-7.
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How to Cite
NASUTION, A., KHAIRUNNISA, and H. R. TANJUNG. “DRUG THERAPY PROBLEMS IN MANAGEMENT OF HYPERTENSIVE OUTPATIENTS ADMITTED TO FOUR INDONESIAN PRIMARY HEALTH CENTERS”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 9, no. 1, Jan. 2016, pp. 87-90, https://innovareacademics.in/journals/index.php/ajpcr/article/view/9551.
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