Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana
Background The prevalence of hypertension in low‐ and middle‐income countries is rapidly increasing, with most cases undiagnosed and many poorly controlled among those diagnosed. Medication reconciliation studies from high‐income countries have demonstrated a high occurrence of antihypertensive medi...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.119.013766 |
| _version_ | 1811274958876180480 |
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| author | Pooja Gala Veronica Moshokgo Bhavna Seth Kegomoditswe Ramasuana Emmanuel Kazadi Rudy M'buse Solomon Pharithi Kabelo Gobotsamang Paige Szymanowski Ruth Olyn Kerobale Kelennetse Balekile Jacques Tshimbalanga Jane Tieng'o Neo Tapela Tomer Barak |
| author_facet | Pooja Gala Veronica Moshokgo Bhavna Seth Kegomoditswe Ramasuana Emmanuel Kazadi Rudy M'buse Solomon Pharithi Kabelo Gobotsamang Paige Szymanowski Ruth Olyn Kerobale Kelennetse Balekile Jacques Tshimbalanga Jane Tieng'o Neo Tapela Tomer Barak |
| author_sort | Pooja Gala |
| collection | DOAJ |
| description | Background The prevalence of hypertension in low‐ and middle‐income countries is rapidly increasing, with most cases undiagnosed and many poorly controlled among those diagnosed. Medication reconciliation studies from high‐income countries have demonstrated a high occurrence of antihypertensive medication errors and a strong association between medication errors and inadequate blood pressure control, but data from low‐ and middle‐income countries are lacking. Methods and Results We conducted a cross‐sectional study from April to October 2018 of adult patients on pharmacologic management for known hypertension at 7 public health facilities in Kweneng East District, Botswana. Our aims included to evaluate the frequency of uncontrolled hypertension, the frequency and type of medication errors causing discrepancies between patient‐reported and prescribed antihypertensive medications, and the association between medication errors and uncontrolled hypertension. Descriptive analyses and multivariable logistic regression were used. The prevalence of uncontrolled hypertension was 55% among 280 enrolled adult patients, and 95 (34%) had ≥1 medication error. The most common errors included patients taking medications incorrectly (11.1%; 31/280), patients omitting medications (7.9%; 22/280), and unfilled prescriptions caused by pharmacy stock outs (7.5%%; 21/280). Uncontrolled hypertension was significantly associated with having ≥1 medication error compared with no errors (adjusted odds ratio, 3.26; 95% CI, 1.75–6.06; P<0.001). Conclusions Medication errors are strongly associated with poor blood pressure control in this setting. Further research is warranted to assess whether medication reconciliation and other low‐cost interventions addressing root causes of medication errors can improve the control of hypertension and other chronic conditions in low‐ and middle‐income countries. |
| first_indexed | 2024-04-12T23:29:42Z |
| format | Article |
| id | doaj.art-90b332323cde405e97fc7f575bf46df9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T23:29:42Z |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-90b332323cde405e97fc7f575bf46df92022-12-22T03:12:19ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-01-019210.1161/JAHA.119.013766Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in BotswanaPooja Gala0Veronica Moshokgo1Bhavna Seth2Kegomoditswe Ramasuana3Emmanuel Kazadi4Rudy M'buse5Solomon Pharithi6Kabelo Gobotsamang7Paige Szymanowski8Ruth Olyn Kerobale9Kelennetse Balekile10Jacques Tshimbalanga11Jane Tieng'o12Neo Tapela13Tomer Barak14Section of Hospital Medicine Department of General Medicine University of Chicago ILDepartment of Public Health Imperial College London United KingdomDepartment of Medicine Beth Israel Deaconess Hospital Boston MADepartment of Medicine Scottish Livingstone Hospital Molepolole BotswanaDepartment of Medicine Scottish Livingstone Hospital Molepolole BotswanaDepartment of Medicine Scottish Livingstone Hospital Molepolole BotswanaDepartment of Medicine Kweneng East District Management Team Molepolole BotswanaDepartment of Medicine Thamaga Hospital Thamaga BotswanaDepartment of Medicine Beth Israel Deaconess Hospital Boston MADepartment of Medicine Kweneng East District Management Team Molepolole BotswanaDepartment of Medicine Scottish Livingstone Hospital Molepolole BotswanaDepartment of Medicine Kweneng East District Management Team Molepolole BotswanaDepartment of Medicine Scottish Livingstone Hospital Molepolole BotswanaBotswana Harvard AIDS Institute Partnership Gaborone BotswanaDepartment of Medicine Beth Israel Deaconess Hospital Boston MABackground The prevalence of hypertension in low‐ and middle‐income countries is rapidly increasing, with most cases undiagnosed and many poorly controlled among those diagnosed. Medication reconciliation studies from high‐income countries have demonstrated a high occurrence of antihypertensive medication errors and a strong association between medication errors and inadequate blood pressure control, but data from low‐ and middle‐income countries are lacking. Methods and Results We conducted a cross‐sectional study from April to October 2018 of adult patients on pharmacologic management for known hypertension at 7 public health facilities in Kweneng East District, Botswana. Our aims included to evaluate the frequency of uncontrolled hypertension, the frequency and type of medication errors causing discrepancies between patient‐reported and prescribed antihypertensive medications, and the association between medication errors and uncontrolled hypertension. Descriptive analyses and multivariable logistic regression were used. The prevalence of uncontrolled hypertension was 55% among 280 enrolled adult patients, and 95 (34%) had ≥1 medication error. The most common errors included patients taking medications incorrectly (11.1%; 31/280), patients omitting medications (7.9%; 22/280), and unfilled prescriptions caused by pharmacy stock outs (7.5%%; 21/280). Uncontrolled hypertension was significantly associated with having ≥1 medication error compared with no errors (adjusted odds ratio, 3.26; 95% CI, 1.75–6.06; P<0.001). Conclusions Medication errors are strongly associated with poor blood pressure control in this setting. Further research is warranted to assess whether medication reconciliation and other low‐cost interventions addressing root causes of medication errors can improve the control of hypertension and other chronic conditions in low‐ and middle‐income countries.https://www.ahajournals.org/doi/10.1161/JAHA.119.013766hypertensionlow‐ and middle‐income countriesmedication errorsmedication reconciliation |
| spellingShingle | Pooja Gala Veronica Moshokgo Bhavna Seth Kegomoditswe Ramasuana Emmanuel Kazadi Rudy M'buse Solomon Pharithi Kabelo Gobotsamang Paige Szymanowski Ruth Olyn Kerobale Kelennetse Balekile Jacques Tshimbalanga Jane Tieng'o Neo Tapela Tomer Barak Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease hypertension low‐ and middle‐income countries medication errors medication reconciliation |
| title | Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana |
| title_full | Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana |
| title_fullStr | Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana |
| title_full_unstemmed | Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana |
| title_short | Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana |
| title_sort | medication errors and blood pressure control among patients managed for hypertension in public ambulatory care clinics in botswana |
| topic | hypertension low‐ and middle‐income countries medication errors medication reconciliation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.119.013766 |
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