1
|
Dagnew EM, Ayalew MB, Alemnew Mekonnen G, Geremew AB, Abdela OA. Drug-related problems and associated factors among adult psychiatric inpatients in Northwest Ethiopia: Multicenter cross-sectional study. SAGE Open Med 2022; 10:20503121221112485. [PMID: 36032653 PMCID: PMC9403454 DOI: 10.1177/20503121221112485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: To determine the prevalence of drug-related problems and the factors
influencing them among adult psychiatric inpatients. Methods: A multi-centre cross-sectional observational study was conducted from April
to July 2021 at five randomly selected hospitals in Northwest Ethiopia. A
total of 325 consecutively sampled patients participated in the study.
Clinical pharmacists assessed the drug-related problems based on clinical
judgement supported by updated evidence-based disease guidelines. We used
the Medscape drug-interactions checker to check drug-to-drug interactions.
The results were summarised using descriptive statistics, including
frequency, mean, and standard deviation. For each variable, an odds ratio
with a 95% confidence interval was calculated, as well as the related
p-value. The value of p ⩽ 0.05 was
considered statistically significant. Results: From the total number of 325 study participants, more than half of them
(52.9%) were females, and the mean age ± (standard deviation) was
30.8 ± 11.3 years. At least one drug-related problem was recorded by 60.9%
to 95% confidence interval (55.7–65.8) of study participants, with a mean of
0.6 ± 0.49 per patient. Additional drug therapy was the most common
drug-related problem (22.8%) followed by non-adherence to medicine (20.6%)
and adverse drug reactions (11%), respectively. Factors independent
associated with drug-related problems were rural residence (adjusted odds
ratio = 1.96, 95% confidence interval: 1.01–2.84,
p-value = 0.046), self-employed (adjusted odds ratio = 6.0,
95% confidence interval: 1.0–36.9, p-value = 0.035) and
alcohol drinkers (adjusted odds ratio = 6.40, 95% confidence interval:
1.12–37.5, p-value = 0.034). Conclusion: The prevalence of drug-related problems among adult psychiatric patients
admitted to psychiatric wards was high. Healthcare providers give more
attention to tackling these problems. Being a rural resident, self-employed,
and alcohol drinkers were associated with drug-related problems.
Collapse
Affiliation(s)
- Ephrem Mebratu Dagnew
- Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Pharmacy, School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - Gizework Alemnew Mekonnen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alehegn Bishaw Geremew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ousman Abubeker Abdela
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
2
|
Ayalew MB, Spark MJ, Quirk F, Dieberg G. Potentially inappropriate prescribing for adults living with diabetes mellitus: a scoping review. Int J Clin Pharm 2022; 44:860-872. [PMID: 35776376 PMCID: PMC9393152 DOI: 10.1007/s11096-022-01414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND People living with diabetes often experience multiple morbidity and polypharmacy, increasing their risk of potentially inappropriate prescribing. Inappropriate prescribing is associated with poorer health outcomes. AIM The aim of this scoping review was to explore and map studies conducted on potentially inappropriate prescribing among adults living with diabetes and to identify gaps regarding identification and assessment of potentially inappropriate prescribing in this group. METHOD Studies that reported any type of potentially inappropriate prescribing were included. Studies conducted on people aged < 18 years or with a diagnosis of gestational diabetes or prediabetes were excluded. No restrictions to language, study design, publication status, geographic area, or clinical setting were applied in selecting the studies. Articles were systematically searched from 11 databases. RESULTS Of the 190 included studies, the majority (63.7%) were conducted in high-income countries. None of the studies used an explicit tool specifically designed to identify potentially inappropriate prescribing among people with diabetes. The most frequently studied potentially inappropriate prescribing in high-income countries was contraindication while in low- and middle-income countries prescribing omission was the most common. Software and websites were mostly used for identifying drug-drug interactions. The specific events and conditions that were considered as inappropriate were inconsistent across studies. CONCLUSION Contraindications, prescribing omissions and dosing problems were the most commonly studied types of potentially inappropriate prescribing. Prescribers should carefully consider the individual prescribing recommendations of medications. Future studies focusing on the development of explicit tools to identify potentially inappropriate prescribing for adults living with diabetes are needed.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Pharmacy, School of Rural Medicine, University of New England, Armidale, NSW 2351 Australia ,Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - M. Joy Spark
- Pharmacy, School of Rural Medicine, University of New England, Armidale, NSW 2351 Australia
| | - Frances Quirk
- School of Rural Medicine, University of New England, Armidale, NSW 2351 Australia
| | - Gudrun Dieberg
- Biomedical Science, School of Science and Technology, University of New England, Armidale, NSW 2351, Australia.
| |
Collapse
|
3
|
Tessema GA, Kinfu Y, Dachew BA, Tesema AG, Assefa Y, Alene KA, Aregay AF, Ayalew MB, Bezabhe WM, Bali AG, Dadi AF, Duko B, Erku D, Gebrekidan K, Gebremariam KT, Gebremichael LG, Gebreyohannes EA, Gelaw YA, Gesesew HA, Kibret GD, Leshargie CT, Meazew MW, Mekonnen A, Mirkuzie AH, Mohammed H, Tekle DY, Tesfay FH. The COVID-19 pandemic and healthcare systems in Africa: a scoping review of preparedness, impact and response. BMJ Glob Health 2021; 6:e007179. [PMID: 34853031 PMCID: PMC8637314 DOI: 10.1136/bmjgh-2021-007179] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has overwhelmed health systems in both developed and developing nations alike. Africa has one of the weakest health systems globally, but there is limited evidence on how the region is prepared for, impacted by and responded to the pandemic. METHODS We conducted a scoping review of PubMed, Scopus, CINAHL to search peer-reviewed articles and Google, Google Scholar and preprint sites for grey literature. The scoping review captured studies on either preparedness or impacts or responses associated with COVID-19 or covering one or more of the three topics and guided by Arksey and O'Malley's methodological framework. The extracted information was documented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension checklist for scoping reviews. Finally, the resulting data were thematically analysed. RESULTS Twenty-two eligible studies, of which 6 reported on health system preparedness, 19 described the impacts of COVID-19 on access to general and essential health services and 7 focused on responses taken by the healthcare systems were included. The main setbacks in health system preparation included lack of available health services needed for the pandemic, inadequate resources and equipment, and limited testing ability and surge capacity for COVID-19. Reduced flow of patients and missing scheduled appointments were among the most common impacts of the COVID-19 pandemic. Health system responses identified in this review included the availability of telephone consultations, re-purposing of available services and establishment of isolation centres, and provisions of COVID-19 guidelines in some settings. CONCLUSIONS The health systems in Africa were inadequately prepared for the pandemic, and its impact was substantial. Responses were slow and did not match the magnitude of the problem. Interventions that will improve and strengthen health system resilience and financing through local, national and global engagement should be prioritised.
Collapse
Affiliation(s)
- Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Yohannes Kinfu
- University of Canberra, Canberra, Australian Capital Territory, Australia
- College of Medicine, Qatar University, Doha, Qatar
| | - Berihun Assefa Dachew
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Azeb Gebresilassie Tesema
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Kefyalew Addis Alene
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Atsede Fantahun Aregay
- Monash University, Clayton, Victoria, Australia
- School of Nursing, Mekelle University, Mekelle, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Pharmacy, University of New England, Armidale, New South Wales, Australia
- Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia
| | | | - Ayele Geleto Bali
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Menzies Health Research Institute, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Bereket Duko
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Daniel Erku
- Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | | | - Kidane Tadesse Gebremariam
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Lifelong Health, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Lemlem Gebremedhin Gebremichael
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Department of Pharmacology, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Eyob Alemayehu Gebreyohannes
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Yalemzewod Assefa Gelaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Telethon Kids Institute, Perth, Western Australia, Australia
- Population Child Health Research Group, School of Women's and Child Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Hailay Abrha Gesesew
- Public Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Department of Epidemiology, School of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Getiye Dejenu Kibret
- Public Health, Debre Markos University, Debre Markos, Ethiopia
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Cheru Tesema Leshargie
- College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | - Alemayehu Mekonnen
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Alemnesh H Mirkuzie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Hassen Mohammed
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Dejen Yemane Tekle
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Fisaha Haile Tesfay
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Deakin University, Institute of Health Transformation, Melbourne, Victoria, Australia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
4
|
Ayalew MB, Dieberg G, Quirk F, Spark MJ. Development and validation of explicit criteria to identify potentially inappropriate prescribing for adults with type 2 diabetes mellitus. Res Social Adm Pharm 2021; 18:2989-2996. [PMID: 34330635 DOI: 10.1016/j.sapharm.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Early detection and timely resolution of potentially inappropriate prescribing (PIP) prevents adverse outcomes and improves patient care. An explicit tool specifically designed to detect PIP among people with Type 2 Diabetes Mellitus (T2DM) has not been published. OBJECTIVES This study aims to develop and validate the Inappropriate Medication Prescribing Assessment Criteria for Type 2 Diabetes Mellitus (IMPACT2DM); an explicit tool that can be used to identify PIP for adults with T2DM. METHODS Current national and international guidelines for the management of T2DM and drug information software programs were used to generate potential items. The content of the IMPACT2DM was validated by 2 consecutive rounds of Delphi method. Physicians and clinical pharmacists experienced in providing care for people with diabetes and authors of selected diabetes guidelines were invited to participate in the Delphi panel. Consensus was assumed if 90% (first round) and 85% (second round) of expert panelists showed agreement to include or exclude an item. RESULTS A total of 95 potential items were generated from selected diabetes guidelines and drug information software programs. After the first Delphi round 27 items had ≥90% agreement and were included in the tool; 19 items were considered not PIP and were excluded from the tool. The second round contained 49 items; of these 43 were included and 6 were excluded from the tool. The final IMPACT2DM contains 70 items categorized by type of PIP and arranged in terms of medical conditions and medication classes. IMPACT2DM can be applied using information on medical charts and requires minimal or no clinical knowledge to assess quality of diabetes care and improve medication selection. CONCLUSIONS IMPACT2DM has been developed from current quality evidence and undergone content validation. It is the first explicit tool specifically designed to identify PIP for adults with T2DM.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Pharmacy, School of Rural Medicine, University of New England, Armidale, 2351, Australia; Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Gudrun Dieberg
- Biomedical Science, School of Science and Technology, University of New England, Armidale, 2351, Australia
| | - Frances Quirk
- Faculty of Medicine and Health, University of New England, Armidale, 2351, Australia
| | - M Joy Spark
- Pharmacy, School of Rural Medicine, University of New England, Armidale, 2351, Australia.
| |
Collapse
|
5
|
Gesesew HA, Koye DN, Fetene DM, Woldegiorgis M, Kinfu Y, Geleto AB, Melaku YA, Mohammed H, Alene KA, Awoke MA, Birhanu MM, Gebremedhin AT, Gelaw YA, Shifti DM, Muluneh MD, Tegegne TK, Abrha S, Aregay AF, Ayalew MB, Gebre AK, Gebremariam KT, Gebremedhin T, Gebremichael L, Leshargie CT, Kibret GD, Meazaw MW, Mekonnen AB, Tekle DY, Tesema AG, Tesfay FH, Tesfaye W, Wubishet BL, Dachew BA, Adane AA. Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review. BMJ Open 2021; 11:e044618. [PMID: 33602714 PMCID: PMC7896374 DOI: 10.1136/bmjopen-2020-044618] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. DESIGN A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. DATA SOURCES Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. ELIGIBILITY CRITERIA Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. DATA EXTRACTION AND SYNTHESIS We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. RESULTS Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. CONCLUSIONS Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.
Collapse
Affiliation(s)
- Hailay Abrha Gesesew
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Digsu Negese Koye
- Department of Medicine at Royal Melbourne Hospital and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Yohannes Kinfu
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- College of Medicine, Doha, Qatar
| | - Ayele Bali Geleto
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
- School of Public Health, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Yohannes Adama Melaku
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Hassen Mohammed
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, Adelaide, South Australia, Australia
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Kefyalew Addis Alene
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mamaru Ayenew Awoke
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Mulugeta Molla Birhanu
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
- Saint Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia
| | - Amanuel Tesfay Gebremedhin
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Yalemzewod Assefa Gelaw
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Population Child Health Research Group, School of Women's & Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Desalegn Markos Shifti
- Saint Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Muluken Dessalegn Muluneh
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
- Amref Health Africa in Ethiopia, Addis Ababa, Ethiopia
| | - Teketo Kassaw Tegegne
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Solomon Abrha
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Pharmacology, Mekelle University, Mekelle, Ethiopia
| | - Atsede Fantahun Aregay
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- School of Nursing, Mekelle University, Mekelle, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Pharmacy, University of New England, Armidale, New South Wales, Australia
- Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Abadi Kahsu Gebre
- School of Pharmacy, Mekelle University, Mekelle, Ethiopia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Kidane Tadesse Gebremariam
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Lifelong Health, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Tesfaye Gebremedhin
- Canberra School of Politics, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Lemlem Gebremichael
- Department of Pharmacology, Mekelle University, Mekelle, Ethiopia
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Cheru Tesema Leshargie
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Getiye Dejenu Kibret
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Maereg Wagnew Meazaw
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Alemayehu Berhane Mekonnen
- Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Dejen Yemane Tekle
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Azeb Gebresilassie Tesema
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Fisaha Haile Tesfay
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- School of Health and Social development, Deakin University, Melbourne, Victoria, Australia
| | - Wubshet Tesfaye
- Health research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Befikadu Legesse Wubishet
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Berihun Assefa Dachew
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Akilew Awoke Adane
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| |
Collapse
|
6
|
Abdela OA, Abay E, Beka S, Mengistie B, Ayalew MB. Medication-Related Needs and Humanistic Impact of Patient-Centered Pharmaceutical Care at University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia. Integr Pharm Res Pract 2020; 9:229-242. [PMID: 33194566 PMCID: PMC7655507 DOI: 10.2147/iprp.s268248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/24/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess patients’ medication-related needs and the humanistic impact of patient-centered pharmaceutical care. Patients and Methods A hospital-based cross-sectional study was conducted using self-administered structured questionnaires from February 4 to 28, 2019, on patients attending ambulatory care for chronic non-communicable diseases at the University of Gondar specialized teaching hospital, North-west Ethiopia. Data were entered to SPSS version 22 for analysis. Descriptive statistics was used to describe the socio-demographic characteristics and medication-related needs of study participants. Independent sample t-test and one-way ANOVA analysis were performed to check for possible associations between dependent and independent variables. Results Information about what to do if patients missed doses and the potential side-effects or abnormal conditions caused by the prescribed medicines were not explained for most of the 425 patients studied. The majority of the study participants reported that they felt worried about adverse medicine effects, drug interactions, and long-term medicine use. Patients who were older than 50 or those receiving two or more medications were less satisfied with the effect of their medicine as compared to younger ones and those on monotherapy, respectively. People who were illiterate or had attended only primary schools thought that they received less disease and medicine information from health professionals than people who attended tertiary education. Conclusion and Recommendation Most of the participants were particularly unhappy with the amount of information received about side-effects and what to do if doses were missed. Special emphasis should be given to patients with a low level of education as they were not satisfied with medicine and disease information obtained from health professionals, experienced more psychological impacts of medicine use, and had poor overall quality-of-life.
Collapse
Affiliation(s)
- Ousman Abubeker Abdela
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science College, University of Gondar, Gondar, Ethiopia
| | - Enathun Abay
- School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | | | - Biset Mengistie
- School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science College, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
7
|
Muche EA, Kiflu M, Ayalew MB. Patient Reported Central Nervous System Adverse Events of Efavirenz-Based Antiretroviral Therapy in People Living with HIV in Northwest Ethiopia. HIV AIDS (Auckl) 2020; 12:601-609. [PMID: 33116922 PMCID: PMC7585818 DOI: 10.2147/hiv.s276111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background Central nervous system (CNS) toxicities from regimens containing efavirenz are the main reasons for non-adherence, switch and discontinuation of antiretroviral therapy (ART). We aimed to assess prevalence of CNS adverse events and associated factors among HIV patients taking efavirenz-based regimens at the University of Gondar Comprehensive and Specialized Hospital (UoGCSH), Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted from March 15 to May 15, 2018 on 345 patients living with HIV who were taking efavirenz-based regimens. Information on sociodemographic and clinical characteristics was taken from medical records and patient interview. Binary logistic regression analysis was done to determine association. Statistical significance was declared at P value of ≤ 0.05. Results About 52.8% of participants experienced CNS adverse events. Vivid dreams, confusion, insomnia and somnolence were the most frequently reported adverse events. Most of the CNS adverse events occurred in the first year of treatment initiation and resolved within 1–4 weeks. Age, economic status, CD4 count, disease stage, presence of comorbidities and concurrent use of other medication had a significant association with the occurrence of CNS adverse events. Conclusion More than half of HIV patients taking efavirenz-based regimens at UoGCSH experienced CNS adverse events. Health-care providers should give attention to patients on efavirenz therapy to monitor for CNS adverse events, especially for patients who have low CD4 count, advanced disease, comorbidities, low income and are older in age.
Collapse
Affiliation(s)
- Esileman Abdela Muche
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekdes Kiflu
- Department of Pharmacy, College of Medicine and Health Sciences, Debremarkose University, Debremarkos, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
8
|
Abstract
Objective: To derive findings from different studies done on drug related hospital admissions and comprehensively express the incidence and preventability of drug related hospital admissions; identify the common types of drug related problems that caused hospital admission, and identify factors associated with drug related hospital admission. Methods: Literatures that assessed hospitalization due to drug related problems were searched online using Pub Med and Google Scholar databases. The relevant reference lists of retrieved articles were also searched manually on Google. Prospective and retrospective studies conducted anywhere in the world on drug related hospitalization, published from January 2012 to January 2017 as an original article and written in English language were included. Result: The prevalence of drug related hospital admission varies from 1.3% to 41.3% with the average rate of 15.4%. Among hospitalized patients 2.7% were died due to drug-related problems (DRPs). Drugs that were frequently reported as causing drug related admission were antithrombotic drugs, antihypertensive drugs, analgesics, anti-diabetics, antipsychotics, and anti-neoplastic drugs. Poly pharmacy, old age and female sex were mentioned as determinants for drug related hospitalization by a number of studies. About one third of drug related hospital admissions were definitely preventable and more than 40% were also potentially preventable. Conclusion: Drug related problems contribute for more than 15% of hospital admissions. Higher risk of admission due to DRPs was observed in patients who were on poly pharmacy and those who were old. As most of drug related hospital admissions were preventable an emphasis should be given for preventive strategies to avoid complications and costs associated with admission.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Henok Getachew Tegegn
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Ousman Abubeker Abdela
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| |
Collapse
|
9
|
Horsa BA, Ayele Y, Ayalew MB. Assessment of pharmacologic prophylaxis use against stress ulcer in the medical wards of University of Gondar Hospital. SAGE Open Med 2019; 7:2050312119827409. [PMID: 30746144 PMCID: PMC6360640 DOI: 10.1177/2050312119827409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/07/2019] [Indexed: 12/13/2022] Open
Abstract
Background Critically ill patients with moderate-to-severe physiologically stressful event are at high risk of developing stress ulcers. The use of pharmacological prophylaxis significantly reduces the incidence of stress ulcer in high-risk patients. Objective The aim of this study was to assess the use of pharmacological prophylaxis for stress ulcer in the medical wards of University of Gondar Hospital. Methods A cross-sectional study design was used. In total, 234 patients were selected through simple random sampling technique. The risk of stress ulcer development was assessed using Evidence-Based Medicine Guideline for stress ulcer prepared by Orlando Regional Medical Center. SPSS version 21 was used for data analysis. Result The most common acute risk factor to stress ulcer was coagulopathy (18.4%), followed by hypoperfusion (9.8%). The concomitant non-steroidal anti-inflammatory drug use (16.7%), mild-to-moderate brain or spinal cord injury (11.1%), and concomitant or recent corticosteroid use (9.4%) were frequently seen risk factors that necessitate administration of a prophylaxis. In total, 82 (35%) study participants were given stress ulcer prophylaxis, among which 52 (63.4%) were given without indication. The most commonly used drug class in the prevention of stress ulcer was proton pump inhibitors (76/82, 92.7%). In total, 43 (18.4%) study subjects were not given stress ulcer prophylaxis while there was clear indication. Patients with a long hospital stay and a diagnosis of central nervous system disorders had significant risk for inappropriate stress ulcer prophylaxis use. Conclusion In this study, inappropriate use of prophylaxis for stress ulcer was common. The higher proportion of inappropriateness was due to the use of stress ulcer prophylaxis while there was no enough indication. We recommend future researchers to assess the cost and impact of inappropriate stress ulcer prophylaxis use, and the physicians should be adherent to the standard guidelines.
Collapse
Affiliation(s)
- Boressa Adugna Horsa
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohanes Ayele
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
10
|
Ayele AA, Tegegn HG, Ayele TA, Ayalew MB. Medication regimen complexity and its impact on medication adherence and glycemic control among patients with type 2 diabetes mellitus in an Ethiopian general hospital. BMJ Open Diabetes Res Care 2019; 7:e000685. [PMID: 31321061 PMCID: PMC6606061 DOI: 10.1136/bmjdrc-2019-000685] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/20/2019] [Accepted: 05/30/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Different studies reported that higher diabetes-specific Medication Regimen Complexity Index (MRCI) has a negative impact on glycemic control potentially by decreasing medication adherence. However, information about regimen complexity and its association with adherence and glycemic control in Ethiopian patients with diabetes is unknown. AIM To evaluate medication regimen complexity and to assess its impact on medication adherence and glycemic control among patients with type 2 diabetes Mellitus (T2DM). METHODS A hospital-based cross-sectional design was conducted at Debre Tabor General Hospital from 1 May 2018 to 30 June 2018. Medication regimen complexity was evaluated using the 65-item validated tool called Medication Complexity Index (MRCI). Adherence was measured using Morisky Medication Adherence Scale while patients were classified as having poor or good glycemic control based on the recent record of their fasting blood glucose. Multivariable logistic regression analysis was applied to determine the association between predictive variables and outcome variables. RESULTS A total of 275 patients with T2DM who meet the inclusion criteria were included in the final analysis. About 22.2% of the participants were classified as having high diabetes-specific MRCI, whereas 35.6% of the participants were classified as having high patient-level MRCI. The majority (70.5%) of the respondents were adherent to their medications, and 42.9% of the total population were categorized as having good glycemic control. According to the result of the multivariate analysis, patients with low-level and moderate-level MRCI of both diabetes-specific and patient-level MRCI were more adherent to their medication compared with patients with high MRCI. High diabetes medication regimen complexity was associated with poor glycemic control in the adjusted analyses (adjusted OR = 0.276; 95% CI = 0.100 o 0.759). CONCLUSION The prevalence of high MRCImedication regimen complexity index is high among patients with T2DM. Patients with low and moderate regimen complexity had improved adherence. High diabetes-specific medication regimen complexity was associated with poor glycemic control. Simplification of a complex medication regimen for patients with diabetes should be sought by physicians and pharmacists to improve medication adherence and subsequent improvement in glycemic control.
Collapse
Affiliation(s)
- Asnakew Achaw Ayele
- Department of clinical pharmacy, School of Pharmacy, College of Medicineand Health Science, University of Gondar, Gondar, Ethiopia
| | - Henok Getachew Tegegn
- Department of clinical pharmacy, School of Pharmacy, College of Medicineand Health Science, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public health, College of Medicineand Health Science, University of Gondar, Gondar, Ethiopia
| | - Mohammed Biset Ayalew
- Department of clinical pharmacy, School of Pharmacy, College of Medicineand Health Science, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
11
|
Ayele Y, Melaku K, Dechasa M, Ayalew MB, Horsa BA. Assessment of drug related problems among type 2 diabetes mellitus patients with hypertension in Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. BMC Res Notes 2018; 11:728. [PMID: 30314443 PMCID: PMC6186051 DOI: 10.1186/s13104-018-3838-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 10/09/2018] [Indexed: 11/24/2022] Open
Abstract
Objective This study was conducted to assess magnitude and pattern of drug related problems among patients with type 2 diabetes mellitus (T2DM) and hypertension. Results This study identified 364 drug related problems (DRPs) across the three categories of drug related problems, giving an average of 1.8 DRPs per patient. The effect of drug treatment being not optimal 179 (49.2%), untreated indication and symptoms 77 (21.1%), unnecessary drug-treatment 39 (10.7%) and adverse drug reactions 69 (19%) were the most frequent categories of DRPs identified. In general, high prevalence of drug-related problems was identified among patients with T2DM hypertension. The effect of drug treatment being not optimal, untreated indication and symptoms, unnecessary drug-treatment and adverse drug reactions were the most frequent categories of drug related problems identified. Therefore, the clinicians should work to improve patient care through prevention and resolving drug related problems since it can affect the quality of the care significantly.
Collapse
Affiliation(s)
- Yohanes Ayele
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O.Box 235, Harar, Ethiopia.
| | - Kibkab Melaku
- Hiwot Fana Specialized University Hospital, Harar, Ethiopia
| | - Mesay Dechasa
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O.Box 235, Harar, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Boressa Adugna Horsa
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
12
|
Seid MA, Ayalew MB, Muche EA, Gebreyohannes EA, Abegaz TM. Drug-susceptible tuberculosis treatment success and associated factors in Ethiopia from 2005 to 2017: a systematic review and meta-analysis. BMJ Open 2018; 8:e022111. [PMID: 30257846 PMCID: PMC6169771 DOI: 10.1136/bmjopen-2018-022111] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES The main aim of this study was to assess the overall tuberculosis (TB) treatment success in Ethiopia and to identify potential factors for poor TB treatment outcome. DESIGN A systematic review and meta-analysis of published literature was conducted. Original studies were identified through a computerised systematic search using PubMed, Google Scholar and Science Direct databases. Heterogeneity across studies was assessed using Cochran's Q test and I2 statistic. Pooled estimates of treatment success were computed using the random-effects model with 95% CI using Stata V.14 software. RESULTS A total of 230 articles were identified in the systematic search. Of these 34 observational studies were eligible for systematic review and meta-analysis. It was found that 117 750 patients reported treatment outcomes. Treatment outcomes were assessed by World Health Organization (WHO) standard definitions of TB treatment outcome. The overall pooled TB treatment success rate in Ethiopia was 86% (with 95% CI 83%_88%). TB treatment success rate for each region showed that, Addis Ababa (93%), Oromia (84%), Amhara (86%), Southern Nations (83%), Tigray (85%) and Afar (86%). Mainly old age, HIV co-infection, retreatment cases and rural residence were the most frequently identified factors associated with poor TB treatment outcome. CONCLUSION The result of this study revealed that the overall TB treatment success rate in Ethiopia was below the threshold suggested by WHO (90%). There was also a discrepancy in TB treatment success rate among different regions of Ethiopia. In addition to these, HIV co-infection, older age, retreatment cases and rural residence were associated with poor treatment outcome. In order to further improve the treatment success rate, it is strategic to give special consideration for regions which had low TB treatment success and patients with TB with HIV co-infection, older age, rural residence and retreatment cases.
Collapse
|
13
|
Ayalew MB, Horsa BA, Zeleke MT. Appropriateness of Pharmacologic Prophylaxis against Deep Vein Thrombosis in Medical Wards of an Ethiopian Referral Hospital. Int J Vasc Med 2018; 2018:8176898. [PMID: 30105097 PMCID: PMC6076918 DOI: 10.1155/2018/8176898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/27/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Most of hospitalized patents are at risk of developing deep vein thrombosis (DVT). The use of pharmacological prophylaxis significantly reduces the incidence of thromboembolic events in high risk patients. The aim of this study was to assess appropriateness of DVT prophylaxis in hospitalized medical patients in an Ethiopian referral hospital. METHODS Cross-sectional study design was employed. Patients with a diagnosis of DVT, taking anticoagulant therapy, and those who refused to participate were excluded from the study. Two hundred and six patients were included in the study using simple random sampling method. Modified Padua Risk Assessment Model was used to determine the risk of thromboembolism. SPSS (version 21) was used for analysis. RESULT The total risk score for the study subjects ranged from 0 to 11 with a mean score of 3.41 ± 2.55. Nearly half (47.6%) of study participants had high risk to develop thromboembolism. Thrombocytopenia (platelets < 50 billion/L) or coagulopathy, active hemorrhage, and end stage liver disease (INR > 1.5) were the frequently observed absolute contraindications that potentially prevent patients from receiving thromboprophylaxis. Thromboprophylaxis use in nearly one-third (31.6%) of patients admitted in the medical ward of UoGRH was irrational. Patients who had high risk for thromboembolism are more likely to be inappropriately managed for their risk of thromboembolism and patients with thrombocytopenia or coagulopathy were more likely to be managed appropriately. CONCLUSION There is underutilization of pharmacologic thromboprophylaxis in medical ward patients. Physicians working there should be aware of risk factors for DVT and indications for pharmacologic thromboprophylaxis and should adhere to guideline recommendations.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Boressa Adugna Horsa
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Meseret Tilahun Zeleke
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| |
Collapse
|
14
|
Ayalew MB, Muche EA. Patient reported adverse events among epileptic patients taking antiepileptic drugs. SAGE Open Med 2018; 6:2050312118772471. [PMID: 29760918 PMCID: PMC5946606 DOI: 10.1177/2050312118772471] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/28/2018] [Indexed: 11/23/2022] Open
Abstract
Objective: The aim of this study was to assess patient reported adverse events and associated factors among epileptic patients taking antiepileptic drugs on follow-up at University of Gondar Referral Hospital. Methods: Cross-sectional study was done on 354 adult epileptic patients. Patients who were on antiepileptic drugs for epilepsy treatment for less than a year, those who were below 18 years old, patients with incomplete information on the chart and those who were involuntary or uncooperative were excluded from the study. Data were entered in to SPSS version 20.0 for analysis. Bivariate and multivariate binary logistic regression analysis was done to see factors associated with antiepileptic drugs adverse effect. Level of statistical significance was declared at p ≤ 0.05. Result: Generalized tonic clonic seizure was the most common (86.2%) type of epilepsy. A total of 79 adverse events were reported. The most frequently encountered adverse events were fatigue (5.08%), gastrointestinal disturbance (4.24%) and sedation/depression (4.24%). Adverse drug effect of antiepileptic drugs was significantly associated with illiterate educational status, increased number of antiepileptic drugs, no seizure during last follow-up and last year, and 1–5 seizures for the last year. Conclusion: About one-sixth of epileptic patients reported adverse drug effects. Adverse drug effects were more commonly seen in patients with low educational status, increased number of antiepileptic drugs, absence of seizure during last follow-up and last year, and 1–5 seizures for the last year. So clinicians should give emphasis for patients with these characteristics to counsel on how to minimize or prevent adverse drug events from antiepileptic drugs or giving reassurance about it if it is minor.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Esileman Abdela Muche
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
15
|
Ayalew MB. Therapeutic efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia: a systematic review and meta-analysis. Infect Dis Poverty 2017; 6:157. [PMID: 29137664 PMCID: PMC5686809 DOI: 10.1186/s40249-017-0372-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 10/26/2017] [Indexed: 12/11/2022] Open
Abstract
Background As Ethiopia is one of the sub-Saharan countries with a great burden of malaria the effectiveness of first line anti-malarial drugs is the major concern. The aim of this study was to synthesize the available evidence on the efficacy of artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia. This was done by performing a meta-analysis of recent studies conducted in the country on this topic. Methods Studies published between January 2010 and January 2017 that reported on the efficacy of artemether-lumefantrine in the treatment of P. falciparum malaria in Ethiopian patients were searched for using the PubMed and Google Scholar databases. Ten prospective single-arm cohort studies that followed patients for 28–42 days were included in this analysis. All of the included studies were deemed to be of high quality. Results Ten studies involving 1179 patients that were eligible for meta-analysis were identified. At recruitment, the average parasite count per patient was 1 2981/μl of blood. On the third day of treatment, 96.7% and 98.5% of the study subjects become fever-free and parasite-free, respectively. Based on the per protocol analysis, the cure rate after use of artemether-lumefantrine was 98.2% (polymerase chain reaction corrected) and 97.01% (polymerase chain reaction uncorrected) after 28 days of follow-up. The reinfection rate within 28 days was 1.1% and the recrudescence rate was 1.9%. Conclusions This review found that the cure rate for uncomplicated P. falciparum malaria using artemether-lumefantrine in Ethiopia is still high enough to recommend the drug as a first-line agent. There should be careful periodic monitoring of the efficacy of this drug, as treatment failure may occur due to resistance, sub-therapeutic levels that may occur due to non-adherence, or inadequate absorption. Electronic supplementary material The online version of this article (10.1186/s40249-017-0372-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia.
| |
Collapse
|
16
|
Tegegn HG, Abebe TB, Ayalew MB, Bhagavathula AS. Patient safety attitudes of pharmacy students in an Ethiopian university: a cross-sectional study. Drug Healthc Patient Saf 2017; 9:19-24. [PMID: 28507450 PMCID: PMC5428765 DOI: 10.2147/dhps.s128137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Patient safety is a major health care concern and is being included in an undergraduate curriculum as it plays a major role in lessening harm. Therefore, we aim to assess the attitude of pharmacy students toward patient safety. METHODS A cross-sectional study using a self-administered questionnaire containing 21 items was conducted at the University of Gondar among fourth and fifth year students. Data analysis was performed to calculate mean, standard deviation, percentages, and logistic regressions using SPSS software version 22 (IBM Corporation, Armonk, NY, USA). Statistical significance was set at P<0.05. RESULTS A total of 83 pharmacy students (fourth year groups=50, fifth year groups=33) participated in the study with response rate of 92%. Majority of the students 70/83 (84.33%) had the overall positive attitude of patient safety. Most of the respondents (80.7%) agree or strongly agree that after an error occurs, an effective strategy is to work hard to be more careful. Most of them (79.6%) believe that pharmacists should routinely spend part of their professional time working to improve patient care. About half (48.2%) of pharmacy students disagree or strongly disagree that pharmacists should discuss and report errors to an affected patient and their family even if the patient is not harmed. No significant association between the attitude of pharmacy students toward patient safety and their age, sex and year of study was found. CONCLUSION Pharmacy students have the overall good attitude to patient safety. However, they claimed the culture and attitude within the pharmacy workplace lacked for patient safety. Moreover, standardized patient safety course should be considered in the curriculum for junior pharmacy students to improve their attitude toward patient safety.
Collapse
Affiliation(s)
- Henok Getachew Tegegn
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tamrat Befekadu Abebe
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Akshaya Srikanth Bhagavathula
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
17
|
Abstract
BACKGROUND Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia. MATERIALS AND METHODS Databases (PubMed, Google Scholar, ResearchGate, and Hinari) were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were "self medication", "Ethiopia", "self care", "non-prescription", "OTC drug use", "drug utilization", and "drug hoarding". Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded. RESULTS The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends/relatives. CONCLUSION Self-medication practice is prevalent in Ethiopia and varies in different populations and regions of the country. Some of the self-medication practices are harmful and need prompt action. Special attention should be given to educating the public and health care providers on the types of illnesses that can be self-diagnosed and self-treated and the types of drugs to be used for self-medication.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Mohammed Biset Ayalew, College of Medicine and Health Sciences, University of Gondar, PO Box 196, Gondar, Ethiopia, Tel +251 93 949 6171, Email
| |
Collapse
|
18
|
Ayalew MB, Taye K, Asfaw D, Lemma B, Dadi F, Solomon H, Tazeze H, Tsega B. Patients'/Clients' Expectation Toward and Satisfaction from Pharmacy Services. J Res Pharm Pract 2017; 6:21-26. [PMID: 28331862 PMCID: PMC5348852 DOI: 10.4103/2279-042x.200995] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Satisfaction is becoming a popular health-care quality indicator as it reflects the reality of service or care provided. The aim of this study was to assess the level of patients' expectation toward and satisfaction from pharmacy service provided and to identify associated factor that might affect their expectation and satisfaction. METHODS A cross-sectional study was conducted on 287 patients, who were served in five pharmacies of Gondar University Hospital in May 2015. Data regarding socio-demographic characteristics and parameters that measure patients' expectation and satisfaction were collected through interview using the Amharic version of the questionnaire. Data were entered into SPSS version 21, and descriptive statistics, cross-tabs, and binary logistic regressions were utilized. P < 0.05 was used to declare association. FINDINGS Among 287 respondents involved in the study, 149 (51.9%) claimed to be satisfied with the pharmacy service and setting. Two hundred and twenty-nine (79.4%) respondents have high expectation toward gaining good services. Even though significant association was observed between the pharmacy type and patients level of satisfaction, sociodemographic characteristics of a patient were not found to predict the level of satisfaction. There is a higher level of expectation among study participants who earn higher income per month (>(2000 Ethiopian birr [ETB]) than those who get less income (<1000 ETB). CONCLUSION Although patients have a higher level of expectation toward pharmacy services, their satisfaction from the service was found to be low.
Collapse
Affiliation(s)
| | - Kaleab Taye
- Department of Pharmaceutics, Gondar University, Gondar, Ethiopia
| | - Daniel Asfaw
- Department of Pharmaceutical Chemistry, Gondar University, Gondar, Ethiopia
| | - Bethlehem Lemma
- School of pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Filagot Dadi
- School of pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Habtamu Solomon
- School of pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Haile Tazeze
- School of pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Bayew Tsega
- Department of Clinical Pharmacy, Gondar University, Gondar, Ethiopia
| |
Collapse
|
19
|
Ayalew MB, Horssa BA, Getachew N, Amare S, Getnet A. Knowledge and attitude of health care professionals regarding hepatitis B virus infection and its vaccination, University of Gondar Hospital, Ethiopia. Hepat Med 2016; 8:135-142. [PMID: 28008291 PMCID: PMC5167489 DOI: 10.2147/hmer.s120477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Hepatitis B is a global public health problem affecting approximately 10% of the world population. Health care professionals (HCPs) are at an increased risk of acquiring hepatitis B infection due to occupational exposure. Having enough knowledge and proper attitudes toward the infection and its vaccination is crucial in preventing the infection. This study aimed to assess knowledge of and attitudes toward hepatitis B virus (HBV) infection as well as its vaccination among HCPs working in University of Gondar Hospital. Methods An institution-based cross-sectional study design was employed from April 1 to May 1, 2016 on 297 HCPs working at University of Gondar Hospital. A self-administered questionnaire prepared in the English language was used to collect the data. The questionnaire contained sociodemographic characteristics, knowledge, and attitude-related questions. Data were entered and analyzed using SPSS software version 20.1. Descriptive statistics, cross-tabs, and binary logistic regression were utilized. P<0.05 was used to declare association. Results From a total of 297 HCPs participated in the study 73.1% have good knowledge of HBV transmission, progress, and its vaccination. The majority (91.3%) of the respondents believe that their job puts them at risk of HBV infection. The majority of study participants (94%) believe vaccination is necessary. Medical doctors have 8.4 times better knowledge of HBV and its vaccination than other professionals (adjusted odds ratio =8.399, CI =1.536–45.936). Conclusion The majority of HCPs working in University of Gondar Hospital have good knowledge of HBV transmission, progress, and its vaccination. The majority of HCPs believe that their job puts them at greater risk for HBV and vaccination is necessary. Knowledge of the HCPs significantly varies across professions.
Collapse
Affiliation(s)
| | | | - Nardose Getachew
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sitotaw Amare
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Getnet
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
20
|
Ayalew MB, Kumilachew D, Belay A, Getu S, Teju D, Endale D, Tsegaye Y, Wale Z. First-line antiretroviral treatment failure and associated factors in HIV patients at the University of Gondar Teaching Hospital, Gondar, Northwest Ethiopia. HIV AIDS (Auckl) 2016; 8:141-6. [PMID: 27621669 PMCID: PMC5015875 DOI: 10.2147/hiv.s112048] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Antiretroviral therapy (ART) restores immune function and reduces HIV-related adverse outcomes. But treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. The aim of this study was to determine the prevalence and factors associated with first-line ART failure in HIV patients at the University of Gondar Teaching Hospital. PATIENTS AND METHODS A retrospective study was conducted on 340 adults who had started ART during the period of September 2011 to May 2015. Data regarding patients' sociodemographics, baseline characteristics, and treatment-related information were collected through review of their medical charts. Data were analyzed using SPSS version 21. Descriptive statistics, cross-tabs, and binary and multiple logistic regressions were utilized. P<0.05 was used to declare association. RESULTS Among the 340 patients enrolled, 205 were females (60.3%). The mean age at ART initiation was 34.4 years. A total of 14 (4.1%) patients were found to have treatment failure. The median duration of treatment failure from initiation of treatment was 17.5 months (8-36 months). Poor adherence to treatment and low baseline CD4 cell count were found to be significant predictors of treatment failure. CONCLUSION The prevalence of first-line ART failure was 4.1%. Treatment failure was most likely to occur for the patients who had poor drug adherence and those who were delayed to start ART till their CD4 cell count became very low (<100 cells/mm(3)).
Collapse
Affiliation(s)
| | | | | | - Samson Getu
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Derso Teju
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Endale
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yemisirach Tsegaye
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zebiba Wale
- School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
21
|
Abstract
Objective: This study was aimed to determine the prevalence of drug-related problems (DRPs), identify the most common drugs, and drug classes involved in DRPs as well as associated factors with the occurrence of DRPs. Methods: A prospective cross-sectional study was conducted on 225 patients admitted to medical wards of Tikur Anbessa Specialized Hospital, Addis Ababa from March to June 2014. Data regarding patient characteristics, medications, diagnosis, length of hospitalization, investigation, and laboratory results were collected using data abstraction forms through review of patients’ medical card and medication charts. Identified DRPs were recorded and classified using DRP registration forms. The possible intervention measures for the identified DRPs were proposed and communicated to either the physician or the patient. Data were entered into Epi Info 7 and analyzed using SPSS version 21 (IBM Corp. Released 2012, Armonk, NY: IBM Corp). Findings: DRPs were found in 52% of study subjects. A drug-drug interaction (48% of all DRPs) was the most common DRP followed by adverse drug reaction (23%). Anti-infectives and gastrointestinal medicines were commonly involved in DRPs. Drugs with the highest drug risk ratio were gentamycin, warfarin, nifedipine, and cimetidine. The number of drugs taken by the patient per day is an important risk factor for DRPs. Conclusion: DRPs are common among medical ward patients. Polypharmacy has a significant association with the occurrence of DRP. Drugs such as gentamycin, warfarin, nifedipine, and cimetidine have the highest probability of causing DRP. So, patients who are taking either of these drugs or polypharmacy should be closely assessed for identification and timely correction of DRPs.
Collapse
Affiliation(s)
- Mohammed Biset Ayalew
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia
| | - Teshome Nedi Megersa
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | |
Collapse
|