Assessment of drug-related problems and associated factors among patients with chronic obstructive pulmonary disease in Dailekh, Nepal: a cross-sectional study

Chronic Obstructive Pulmonary Disease (COPD) is a major health concern in low and middle-income countries. Drug-related problems (DRPs), defined as issues in drug therapy that interfere with desired outcomes, add further challenges. Evidence on the prevalence and costs burden of DRPs in COPD patients is limited. This study assessed the prevalence of DRPs, identified associated factors, and compared prescription costs between patients with and without DRPs. A cross-sectional study was conducted among 156 COPD patients attending a first referral hospital in Dailekh, Nepal, from May to September 2024. Data were collected through in-person interviews using a structured questionnaire and medical record review. DRPs were classified using the Pharmaceutical Care Network 9.1 system. Prevalence and medications costs were reported. Factors associated with DRPs were analyzed using bivariate tests and multivariate logistic regression. Medication costs were calculated using hospital pharmacy prices and mean costs with 95% confidence interval were compared across groups. The prevalence of DRPs was 71.8%, with patients experiencing an average of 1.45 DRPs. Male patients (AOR 3.0; 95% CI 1.2-7.4), those from disadvantaged ethnic group (AOR 3.3; 95% CI 1.1-9.8), and patients with comorbidity (AOR 2.7; 95% CI 1.2-5.9) were more likely to have DRPs. The mean cost per patient was NRs. 6543 ± 1423.4). DRPs are highly prevalent among COPD patients and contribute to significant financial burden. Strengthening the role of pharmacists and other health professionals in identifying and preventing DRPs is essential. Targeted interventions for high-risk groups can help reduce DRPs, improve treatment outcomes, and lessen the economic impact on patients.