Identification of Drug-Related Problems Using PCNE Classification in Type 2 Diabetes Mellitus Outpatients at Labuang Baji Hospital

Sri Maharani; Nurhikma Awaluddin; Andi Meinar Dwi Rantisari Thayeb; Ghina Ramadhani

doi:10.33759/jrki.v8i3.1027

Authors

Sri Maharani Program Studi S1 Farmasi, Fakultas Farmasi, Universitas Megarezky
Nurhikma Awaluddin Program Studi S1 Farmasi, Fakultas Farmasi, Universitas Megarezky
Andi Meinar Dwi Rantisari Thayeb Faculty of Pharmacy, Universitas Megarezky, Makassar, Indonesia
Ghina Ramadhani Faculty of Pharmacy, Universitas Megarezky, Makassar, Indonesia

DOI:

https://doi.org/10.33759/jrki.v8i3.1027

Keywords:

type 2 diabetes mellitus; drug-related problems; medication safety; pharmaceutical care; outpatient care

Abstract

Type 2 diabetes mellitus requires prolonged and often complex pharmacotherapy, which increases the likelihood of drug-related problems and may compromise treatment safety. This study identified drug-related problems among outpatients with type 2 diabetes mellitus at Labuang Baji Regional General Hospital, Makassar, using the Pharmaceutical Care Network Europe classification version 9.1. A descriptive observational study with a retrospective design was conducted using outpatient medical records from August 2025 to February 2026. Total sampling yielded 35 patients who met the eligibility criteria, and medication regimens were evaluated for problems and causes within the classification framework. Most patients were 51–60 years old (63%), 51% were women, and hypertension was the leading comorbidity (42%). The review identified 43 problem events and 49 documented causes. A possibly occurring adverse drug event was the most frequent problem category (25 cases; 58%), followed by unnecessary treatment (13 cases; 30%). Inappropriate drug combinations were the leading cause (20 cases; 41%), followed by medicines without a documented indication (13 cases; 27%) and medicines that did not conform to guidelines or the formulary (11 cases; 22%). Drug-related problems remain common in this outpatient population and are driven mainly by medication selection and combination issues, supporting routine medication review and closer pharmacist involvement in long-term diabetes care.

Downloads

Download data is not yet available.

References

1. International Diabetes Federation. IDF Diabetes Atlas. 11th ed. International Diabetes Federation; 2025.

2. American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(suppl 1):S20-S42. doi:10.2337/dc24-S002

3. Harreiter J, Roden M. Diabetes mellitus: definition, classification, diagnosis, screening and prevention (update 2023). Wien Klin Wochenschr. 2023;135(suppl 1):7-17. doi:10.1007/s00508-022-02122-y

4. Riviani R, Mutiara E, Santosa H, Masyitah A. Analisis spasial kasus diabetes melitus dan faktor risiko di Provinsi Sumatera Utara tahun 2023. J Pengabdi Masy dan Ris Pendidik. 2025;4(1):972-979. doi:10.31004/jerkin.v4i1.1683

5. Akbar A, Jafar N. The description of health literacy, knowledge, and skills of elderly people with diabetes mellitus using insulin injections at public health centers in Makassar City. Indones Contemp Nurs J. 2025;9(2):109-123. doi:10.20956/icon.v9i2.42025

6. Latief MS. Drug related problems penggunaan obat antidiabetik pada pasien rawat inap diabetes mellitus tipe 2. Indones J Health Sci. 2024;4(5):572-579. doi:10.54957/ijhs.v4i5.1089

7. Sasmitha D, Fortuna TA. Evaluasi drug related problems pada pasien diabetes melitus tipe 2 di RS “X” Surakarta. Usadha J Pharm. 2025;3(4):357-369. doi:10.23917/ujp.v3i4.431

8. Indrawan SA, Yulianti T. Identifikasi drug related problems pada pasien diabetes mellitus di instalasi rawat jalan. J Farm Klin Indones. 2024;3(1):29-42.

9. Cahyanti AP, Yulianti T. Identifikasi drug related problems pada pasien diabetes mellitus tipe 2 di instalasi rawat jalan RSUD Ir. Soekarno Sukoharjo tahun 2022. J Kesehat Tambusai. 2024;5(3):5857-5866.

10. Kurniawan A, Fatkhiya MF, Oktaviani N, Haq MFI, Zahra AM. Analisis permasalahan penggunaan obat pada pasien diabetes melitus menggunakan metode Pharmaceutical Care Network Europe. Babul Ilmi J Ilm Multi Sci Kesehat. 2025;17(2).

11. Ahmed KO, Muddather HF, Yousef BA. Pharmaceutical Care Network Europe drug-related problems classification version 9.1: first implementation in Sudan. J Pharm Res Int. 2021;33:699-706. doi:10.9734/jpri/2021/v33i59a34321

12. Pharmaceutical Care Network Europe Association. Classification for Drug-Related Problems V9.1. PCNE Association; 2020.

13. Perkumpulan Endokrinologi Indonesia. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. PB PERKENI; 2021.

14. Anwar KP, Sutrisna E. Identifikasi drug related problems pasien diabetes mellitus tipe 2 yang terkonfirmasi COVID-19. Sasambo J Pharm. 2023;4(1):19-23. doi:10.29303/sjp.v4i1.218

15. Al-Azayzih A, Kanaan RJ, Altawalbeh SM. Assessment of drug-related problems and health-related quality of life domains in elderly patients with type 2 diabetes mellitus. Ther Clin Risk Manag. 2023;19:913-928. doi:10.2147/TCRM.S434235

16. Chapagain S, Pathak N, Subedi K, et al. Drug-related problems among type 2 diabetic patients in Sunwal Municipality of Western Nepal. PLoS One. 2024;19(11):e0309781. doi:10.1371/journal.pone.0309781

17. Ambrož M, Geelink M, Smits KPJ, de Vries ST, Denig P. Sex disparities in medication prescribing amongst patients with type 2 diabetes mellitus managed in primary care. Diabet Med. 2023;40(1):e14987. doi:10.1111/dme.14987

18. Larasati N, Satibi, Kristina SA, Lazuardi L. The association between drug-related problems and length of stay of type 2 diabetes mellitus patients. Malays J Med Sci. 2024;31(4):162-173. doi:10.21315/mjms2024.31.4.13

19. Samanta S, Bhat WH, George J, Ramaiah B. Drug-related problems among type 2 diabetes mellitus patients with hypertension: a prospective observational study. Int J Basic Clin Pharmacol. 2025;14(2):213-218. doi:10.18203/2319-2003.ijbcp20250480

20. Annisa BS, Puspitasari CE, Aini SR. Profil penggunaan obat antidiabetes pada pasien diabetes mellitus tipe 2 di instalasi rawat jalan RSUD Provinsi NTB tahun 2018. Sasambo J Pharm. 2021;2(1):37-41.

21. Kurniawati T, et al. Evaluasi profil penggunaan obat antidiabetes pada pasien diabetes melitus tipe 2 rawat jalan di salah satu rumah sakit Kabupaten Bogor. J Sci Technol Entrep. 2021;3(1):24-34.

22. Bulan MI, Annisaa E, Dini IRE. Cost effectiveness analysis of captopril and amlodipine in hypertensive patients with diabetes mellitus at Magelang Regency Health Center. J Kedokt Diponegoro. 2022;11(5):237-241.

23. Rafi’i M, Budianti Y, Fadillah A. Profil penggunaan obat pada pasien hipertensi dengan diabetes melitus tipe 2 di Puskesmas Banjarbaru Selatan tahun 2023. J Sains Farm Kesehat. 2025;2(3):180-193.

24. Wang SJ. Type 2 diabetes mellitus management guideline. 6th ed. McGill J Med. 2020;97:1-8.

25. Zeni IF, Farnandi R, Rosi DH, Deswati D. Profil penggunaan statin terhadap risiko atherosclerotic cardiovascular disease pada pasien rawat jalan dengan diabetes melitus di RSUD Dr. Adnaan WD Payakumbuh. J Sci Clin Pharm Res. 2025;1(2):92-109.