Pharmacy

DRUG RELATED PROBLEMS AND IT’S DETERMINANTS AMONG GERIATRICS PATIENTS ADMITTED AT MEDICAL WARDS OF SELECTED HOSPITALS OF SOUTH-WEST ETHIOPIA.

2025-01-02T13:59:17Z

DRUG RELATED PROBLEMS AND IT’S DETERMINANTS AMONG GERIATRICS PATIENTS ADMITTED AT MEDICAL WARDS OF SELECTED HOSPITALS OF SOUTH-WEST ETHIOPIA. Zewudie, Ameha; Mamo, Yitagesu; Abebe, Lemi Geriatric patients are vulnerable to drug related problems because of poly-morbidity associated poly-pharmacy, age related physiological alterations, pharmacodynamics and pharmacokinetics changes. Since these groups of patients often excluded from premarketing clinical trial, the approved doses might be resulted in adverse drug events that further increases drug related problems. This increased Drug related problems can be associated with increased healthcare costs, increased hospital admissions, prolonged hospital stays, reduced quality of life, and increased morbidity and/or mortality. Objectives: To identify drug related problems and its determinants among geriatric patients admitted in medical wards of Mizan-Tepi University Teaching Hospital, Tepi General Hospital and G/Tsadik Shawo Hospital, South-west Ethiopia. Methods: A prospective observational study was conducted among geriatric patients admitted to medical wards of Mizan-Tepi University Teaching Hospital, Tepi General Hospital and G/Tsadik Shawo Hospital, from January to December 2019. Clinical pharmacists reviewed drug therapy of patients and identified drug related problems. Descriptive statics was used to summarize categorical variables of drug related variables. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with backward stepwise approach was done to identify determinants of drug related problems. Results: A total of 384 geriatric patients were included in the study. The average age of the subjects was 67.88 (SD 6.1) years. A total of 609 drug related problem were identified from 86.2% of geriatric patients with an average of 1.58 ±1.02 drug related problems per patient. Having no formal education (AOR=1.93, 95%CI=1.08-3.43, P=0.026), more than two weeks of hospitalization (AOR=3.43, 95%CI=1.86-6.32, P<0.001) and poly-pharmacy (AOR=9.88, 95%CI=4.07-23.97, P <0.001) were determinants of drug related problems. Conclusion: Significant number of geriatric patients experienced one or more drug related problems. Patients who have no formal education, with poly-pharmacy and those who had longer hospital stay were more likely to have drug related problems. Hence, special attention should be given to reduce the occurrence of drug related problems in these patients.

Depression and Its Associated Factors among Diabetes Mellitus Patients Attending Selected Hospitals in Southwest Ethiopia: A Cross-Sectional Study

2025-01-02T13:40:30Z

Depression and Its Associated Factors among Diabetes Mellitus Patients Attending Selected Hospitals in Southwest Ethiopia: A Cross-Sectional Study Aseffa, Adane; Zewudie, Ameha; Henok, Andualem; Mamo, Yitagesu; Nigussie, Tadesse Background. Diabetes mellitus and depression are very common diseases worldwide, and the prevalence rates of both conditions are increasing rapidly. Depression among patients with diabetes mellitus results in poor glycemic control through different mechanisms. Besides, the coexistence of a chronic medical illness with depression reduces the probability of recognizing and treating depression. The study is aimed at assessing the prevalence and factors associated with depression among adults with diabetes mellitus. Methods. A hospital-based cross-sectional study was conducted among adult diabetes mellitus patients on follow-up in Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to recruit the study participants, and data were collected through face-to-face interview and medical chart review. Depression was measured using Patient Health Questionnaire-nine (PHQ-9). Binary logistic regression analysis was done and a p value of less than 0.05 was used as a level of significance. Results. The prevalence of depression among study participants was 37.0% (95% CI 32.0%-42.0%). The majority (44.7%) of the patients had mild depression, while only 2% had severe depression. Being male (AOR = 1:92, 95% CI: 1.15-3.22), urban residence (AOR = 3:02, 95% CI: 1.57-5.78), single marital status (AOR = 7:72, 95% CI: 3.6-16.53), duration of diabetes mellitus 5 years and more (AOR = 2:00, 95% CI: 1.21-3.5), and having sexual dysfunction (AOR = 3:55, 95% CI: 2.13-5.91) were associated with increased odds of depression among diabetes mellitus patients. Conclusions. The prevalence of depression among diabetes mellitus was high. Therefore, the patients should be thoroughly screened for this comorbid condition, and the significant factors should be addressed during routine follow-up.

Antiretroviral treatment failure and associated factors among HIV patients on the first-line antiretroviral therapy at Mizan-Tepi University teaching hospital, Southwest Ethiopia

2025-01-02T13:29:17Z

Antiretroviral treatment failure and associated factors among HIV patients on the first-line antiretroviral therapy at Mizan-Tepi University teaching hospital, Southwest Ethiopia Siraj, Jafer The use of Antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. The therapy restores immune function and reduces HIV-related adverse outcomes. However, treatment failure erodes this advantage and leads to an increased morbidity and compromised quality of life in HIV patients. Thus,this study aimedto assess anti-retroviral treatment failure and associated factors among HIV patients on the first line ART at Mizan-Tepi University Teaching Hospital. A cross-sectional study was undertaken among adult patient who have been on ART and attending ART Clinic of Mizan-Tepi University Teaching Hospital from September 2014 to September 2018. Data were collected retrospectively by reviewing patients’ medical charts using a standard structured questionnaire. Data were entered into Epi data version 4.0.2 and then exported to SPSS version 21.0 for analysis. To identify the predictors of anti-retroviral treatment failure, multiple stepwise backward logistic regression analysis were done. P value<.05 was considered as statistically significant. Among 221 patients included in the study, 118 (53.39%) were females. The mean weight of study participants at ART initiation was 57.04 kg. Of the 221 patients on the first line ART, 10 (4.5%) experienced treatment failure. Of these patients, 5 (50%) and 3 (30%) experienced virological failure and clinical failure, respectively. Functional status (AOR: 3, CI: [1.13–6.5], P<.001) and low baseline CD4 cell count (AOR: 4.3, CI: [3.4–10.6],P<.0001) were found to be an independent predictors of treatment failure. The rate of first-line ART treatment failure in the study setting was substantial. Functional status and low baseline CD4 cell count were found to be an independent predictors of virological, clinical and immunological failure. Therefore, more attention should be given for the lifestyle of pateints’ on ART and maximize virological tests for monitoring treatment failures. Abbreviations: AIDS = Acquired Immune Deficiency Syndrome, ART = Anti Retroviral Therapy, cART = Combination AntiRetroviral Therapy, CD4 = Clusters of Differentiation, HAART = Highly Active Anti-retroviral Therapy, HIV = Human Immunodeficiency Virus, HIVDR = HIV Drug Resistance, MDR-TB = Multi-Drug Resistance Tuberculosis, MTUTH = Mizan Tepi University Teaching Hospital, NRTI = Nucleoside Reverse-Transcriptase Inhibitors, PCP = Pneumocystis Carnivi Pneumonia, PTB = Pulmonary Tuberculosis, PUD = Peptic Ulcer Disease, UTI = Urinary Tract Infection, WHO = World Health Organization.

Patterns and Determinants of Adverse Drug Reaction among Adult HIV/AIDS Patients on HAART at MTUTH, Tepi General Hospital and G/Tsadik Shawo General Hospital, Southwest Ethiopia

2024-10-22T07:23:52Z

Patterns and Determinants of Adverse Drug Reaction among Adult HIV/AIDS Patients on HAART at MTUTH, Tepi General Hospital and G/Tsadik Shawo General Hospital, Southwest Ethiopia Zewudie, Ameha; Mamo, Yitagesu; Aferu, Temesgen Human immunodeficiency virus (HIV) infection has continued to be a challenge to public health globally even though the overall growth of this epidemic has stabilized. Due to increase in people receiving antiretroviral therapy (ART) there is a significant reduction in AIDSrelated morbidity and mortality. People infected with HIV are now living longer, and healthier life. However significant number of patients discontinue their initial HAART regimen because of adverse drug reaction. Objective: To assess patterns and determinants of adverse drug reaction among adult patients on HAART at MTUTH, Tepi General Hospital and G/Tsadik Shawo general hospital, Southwest Ethiopia. Methods: Facility based retrospective cohort study was conducted among peoples living with HIV/AIDS receiving antiretroviral therapy. The data were entered into Epidata manager version 4.0.2 and analyzed using SPSS version 26. Both bivariate and multivariable Cox proportional hazard models were used to identify predictor variables. Variables with p-value 0.25 and less in the bivariate analysis were entered into the multivariable proportional hazard model. P-values less than 0.05 and the corresponding hazard ratio with its 95% confidence intervals (CI) in the multivariable Cox proportional hazards model were considered to be significantly associated with the timing of ADRs. Results: Of the total 1182 patients followed retrospectively for the last five years, 164(13.87%) had experienced ADRs. One hundred seventeen (71.43%) of the total ADRs occurred in the first year of ART initiation while 28(17.07%) occurred in the second year of ART initiation. Females were 2.31 times at risk of developing ADR compared to males. The odds of ADR development among patients who never attended formal education were 2.84 times higher than those who attended secondary school and above. Smokers were 3.47 times more likely to develop ADR compared to non-smokers. Patients with WHO clinical stage III and IV were 3.61 times at higher risk of getting ADR compared to those who were at stage I and II. Participants who did not receive cotrimoxazole prophylaxis were at 2.65 times odd of having ADR compared to those who received the prophylaxis. Patients who were non-adherent to HAART regimen were 2.13 times more likely to develop ADR compared to those who adhered to their medication while those who did not get isoniazid prophylaxis were at 1.72 times odd of developing ADR compared to those who received this prophylaxis. 4 | P a g e Conclusion: The risk of adverse drug reaction among the study participants was high in the early years of ART initiation and it decreased over the time of treatment. Patients’ sex, educational status, smoking status, WHO clinical stage, cotrimoxazole prophylaxis, adherence to HAART regimen and isoniazid prophylaxis were the independent predictors of ADR risk.