Identification of Drug-Related Problems in Hypertension Comorbid Type 2 Diabetes Mellitus Patients at Primary Health Care Center Batununggal District Bandung

Many factors can increase the risk of hypertension, one of which is diabetes mellitus. The study aims to provide an overview of DrugRelated Problems (DRPs) in patients with hypertension comorbid type 2 diabetes mellitus at Primary Health Care Center Batununggal District Bandung. This research was an observational study with retrospective data collection and descriptive analysis. Data were taken from patient prescriptions January-December 2019 period. The sample inclusion criteria are patients aged 30-75 years, patients diagnosed with hypertension comorbid type 2 diabetes mellitus, and patients treated in January-December 2019. The number of samples that met the inclusion criteria was 268 patients, of which 69 patients (25.75%) are male, and 199 patients (74.25%) are female. 164 patients (61.2%) are aged 60-75 years old. It is found that 1 case (0.37%) has the drugrelated problem of drug overdose and as many as 34 cases (12.69%) have potential drug interactions.


INTRODUCTION
Our previous research has found that T2DM is a common comorbid disease in hypertension patients 8 .
However, there is no research on drug-related problems in hypertension with comorbid T2DM patients at Primary Health Care Center at Batununggal District, Bandung. Therefore, researchers are interested in researching drug-related problems in hypertension with comorbid T2DM patients, which has never been done before. This research aimed to find whether there are drug-related problems in hypertension with comorbid T2DM patients, providing information for other health professionals to improve patients' service and achieve treatment targets.

Materials
The tool for data collection was a laptop, and the materials used were a prescription sheet of hypertension with comorbid T2DM patients, references, i.e., research journals, and textbook (Pharmacotherapy: A Pathophysiology Approach) 9 . The data for the study was taken from a prescription sheet. Data collected included patient name (initials), gender, age, diagnosis, drugs data (name, dosage strength, dosage form, quantity, and frequency of use). A prescription sheet of hypertension comorbid T2DM patients between January and December 2019 was obtained with a total of 303 samples.

Methods
The research conducted was an observational study with retrospective data collection and descriptive analysis. The   prevalence in female patients was higher than in male patients. The incidence of hypertension is higher in women because in the menopause phase, there is a hormonal imbalance, which is a decrease in the ratio of estrogen and androgen, which causes an increase in the release of renin, which will lead to an increase in blood pressure 11 . Apart from gender, age also affects the incidence of hypertension, the age range 55-90 years has a four times higher risk than those aged 18-54 years 12 .
The patients taken were at least 30 years old because, from previous research 8 , patients admitted to Primary Health Care Center at Batununggal District Bandung were at least 30 years old. In this study, patients aged 60-75 years (61.20%) had the most hypertension due to increasing age, structural and functional changes that caused the arteries to lose their flexibility. When the flexibility decreases, the blood vessels become stiff; therefore, the blood with each heartbeat is forced through the narrow blood vessels, increasing blood pressure 13 .
Factors like gender, smoking, alcohol consumption, overweight, and obesity also were associated with hypertension, diabetes, and dyslipidemia 14 .
The majority of hypertension with comorbid T2DM patients suffer from other comorbidities. Due to this multi-diagnosis condition, the patient takes a wide range of drugs and increases the risk of drug-related problems 15 . Another comorbidity with the highest percentage in hypertension with comorbid T2DM patients was hyperlipidemia (31.34%).

CONCLUSION
In the January-December 2019 period at Primary Health Care Center Batununggal District Bandung, drug-related problems on hypertension with comorbid T2DM patients were overdose and potential drug interactions.
The pharmacist's role is needed in identifying drugrelated problems and being able to communicate these problems with other health professionals. It is recommended to carry out further research at the same health center or other health centers in order to obtain a more comprehensive conclusion.

ACKNOWLEDGMENT
We are grateful to the Institute for Research and Community Service (LPPM) of Universitas Jenderal Achmad Yani (UNJANI); therefore, this research can be carried out well.

DATA AVAILABILITY
None.