Peer Review History

Original SubmissionOctober 24, 2022
Decision Letter - Nnabuike Chibuoke Ngene, Editor

PONE-D-22-28909Drug-related problems in hypertension and gestational diabetes mellitus: a hospital cohortPLOS ONE

Dear Dr. Martins,

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We look forward to receiving your revised manuscript.

Kind regards,

Nnabuike Chibuoke Ngene, Dip HIV Med; MMed(FamMed); FCOG; MMed(O&G); Ph.D

Academic Editor

PLOS ONE

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“This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) - Finance Code 001”

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Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows:

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Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

Statistical analysis, sentence: “The sample size was set at 600 individuals, which ensures a maximum error of the estimates of ± 4 percentage points with 95% confidence.” Was the sample size determined a priori or post hoc? Provide details about how 4% was calculated (including the software/formula used).

In statistical analysis, the authors mentioned absolute and relative frequency. Provide additional explanation. Did the authors report relative frequency in the manuscript?

In statistical analysis, state the method used for selecting the variables that were included in the multivariable regression analysis.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for asking me to review this article. The article is not only interesting but quite informative as it appears to bring to our consciousness some of the obscure factors affecting drug effectiveness in high risk pregnancy. The methodology is appropriate for the research objectives. The use of a single institution for data collection seems to be a major concern, but this can be addressed with a multi centre study in future. I would recommend this article for publication

Reviewer #2: In the abstract, the following, the univariate analysis is not mentioned. Also Insulin and methyldopa are not pharmacological classes. Please check and correct

52 addition to descriptive statistics, a multivariate logistic regression model was employed to

53 determine the factors associated with the DRPs. Results: A total of 873 DRPs were identified.

54 The most frequent DRPs were related to therapeutic ineffectiveness (72.2%) and occurrence of

55 adverse events (27.0%) and the main pharmacological classes involved were insulins and

56 methyldopa.

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Reviewer #1: Yes: Ekwuazi Kingsley Emeka

Reviewer #2: Yes: Modupe Olufunmilayo Ogunrombi

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Revision 1

23th February 2023

Dear Dra Irles,

In this letter, we detail the changes introduced in the manuscript “Drug-related problems in hypertension and gestational diabetes mellitus: a hospital cohort” in response to the reviewers’ comments. All reviewers’ comments were accepted and we appreciate the important collaborations.

Yours sincerely,

Rand Randall Martins, PharmD. PhD.

Corresponding Author

Journal Requirements

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

Response: The style template was readequate as suggested.

2. Thank you for stating the following financial disclosure: “This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) - Finance Code 001”. Please state what role the funders took in the study. If the funders had no role, please state: ""The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.""

If this statement is not correct you must amend it as needed.

Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf.

Response: The cover letter was readjusted as suggested.

3. Thank you for stating the following in the Acknowledgments/ Funding Section of your manuscript: “This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível 25 Superior – Brasil (CAPES) - Finance Code 001.”

We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form.

Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows:

“This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) - Finance Code 001”

Please include your amended statements within your cover letter; we will change the online submission form on your behalf.

Response: The manuscript has been corrected as per the suggestions.

4. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Response: The references were thoroughly reviewed and corrected to align with the formatting guidelines of the journal. In order to meet the publication criteria, minor changes were made to the formatting, including replacing one reference with a more current and relevant source. (page 25, line 478-486).

Deleted reference:

Ghosh KR, Akhter S, Das AK, Naher N, Paul SR, Islam B. Outcome of Labetalol and Methyldopa as Oral Antihypertensive Agent in the Treatment of Pregnancy Induced Hypertension. Mediscope. 2021;8(1):19-26. doi: https://doi.org/10.339/mediscope.v8i1.52200

Added reference:

Van de Vusse D, Mian P, Schoenmakers S, Flint RB, Visser W, Allegaert K, et al. Pharmacokinetics of the most commonly used antihypertensive drugs throughout pregnancy methyldopa, labetalol, and nifedipine: a systematic review. Eur J Clin Pharmacol. 2022;78(11):1763-1776. doi: 10.1007/s00228-022-03382-3

5. Statistical analysis, sentence: “The sample size was set at 600 individuals, which ensures a maximum error of the estimates of ± 4 percentage points with 95% confidence.” Was the sample size determined a priori or post hoc? Provide details about how 4% was calculated (including the software/formula used).

Response: The text was changed to (page 8, line 163-169):

“The sample size was set at 600 individuals, which ensures a maximum error of the estimates of ± 4 percentage points with 95% confidence. We employed the following formula to calculate the sample size:

Sample size=(〖Z_(1-∝/2)〗^2 p(1-p))/d^2

Here:

Z 1- α/2 = 1.96 (standard normal variable considering a type 1 error of 5% and p <0.05).

p = Expected proportion of DRP in the population. As there are no similar studies available, we opted for a proportion that enables the largest sample size (50%).

d = Absolute error (4%).”

6. In statistical analysis, the authors mentioned absolute and relative frequency. Provide additional explanation. Did the authors report relative frequency in the manuscript?

Response: Thanks for the observation, the term used was imprecise. The text was changed to (page 8, line 173):

“The descriptive statistics included the median and 25th and 75th percentiles (p25-75%); relative and absolute frequency and percent proportion; and mean and standard deviation according to the type of variable under analysis.”

7. In statistical analysis, state the method used for selecting the variables that were included in the multivariable regression analysis.

Response: The text was changed to (page 9, line 182-188):

“All variables with an association test with p-value <0.10 were included in a multivariate logistic regression model, and a significance level of p<0.05 was then adopted to identify the factors independently associated with the occurrence of DRPs in pregnant women. Variables that exhibited a significant association with a p-value < 0.10 were included in a multivariate logistic regression model. The stepwise backward variable selection method, with a significance level of p < 0.05, was used to identify independent factors associated with the occurrence of DRPs in pregnant women.”

Reviewer #1

8. Thank you for asking me to review this article. The article is not only interesting but quite informative as it appears to bring to our consciousness some of the obscure factors affecting drug effectiveness in high risk pregnancy. The methodology is appropriate for the research objectives. The use of a single institution for data collection seems to be a major concern, but this can be addressed with a multi centre study in future. I would recommend this article for publication.

Reviewer #2

9. In the abstract, the following, the univariate analysis is not mentioned. Also Insulin and methyldopa are not pharmacological classes. Please check and correct.

Response: Following the reviewer's suggestion, the text was changed to (page 3, line 51-56):

“In addition to descriptive statistics, a univariate and multivariate logistic regression model was employed to determine the factors associated with the DRPs. Results: A total of 873 DRPs were identified. The most frequent DRPs were related to therapeutic ineffectiveness (72.2%) and occurrence of adverse events (27.0%) and the main drugs and the main pharmacological classes involved were insulins and methyldopa.”

Attachments
Attachment
Submitted filename: Response to reviewers.docx
Decision Letter - Nnabuike Chibuoke Ngene, Editor

Drug-related problems in hypertension and gestational diabetes mellitus: a hospital cohort

PONE-D-22-28909R1

Dear Dr. Martins,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Nnabuike Chibuoke Ngene, Dip HIV Med; MMed(FamMed); FCOG; MMed(O&G); Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The comments made earlier in the review I submitted on the manuscript titled: "Drug-related problems in hypertension and gestational diabetes mellitus: a hospital cohort" have now been addressed by the authors in the resubmission and the manuscript can now be accepted for publication.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: Yes: Modupe Olufunmilayo Ogunrombi

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Formally Accepted
Acceptance Letter - Nnabuike Chibuoke Ngene, Editor

PONE-D-22-28909R1

Drug-related problems in hypertension and gestational diabetes mellitus: a hospital cohort.

Dear Dr. Martins:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

If we can help with anything else, please email us at plosone@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Nnabuike Chibuoke Ngene

Academic Editor

PLOS ONE

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