Assessment of Potentially Inappropriate Prescribing for People With Type 2 Diabetes Mellitus Using IMPACT2DM, a New Explicit Tool.

BACKGROUND: People with type 2 diabetes mellitus (T2DM) are at greater risk of potentially inappropriate prescribing (PIP) due to multiple comorbidities and polypharmacy. IMPACT2DM (Inappropriate Medication Prescribing Assessment Criteria for Type 2 Diabetes Mellitus) is a tool designed to identify PIP for adults with T2DM. OBJECTIVES: To assess PIP for adults with T2DM in Ethiopia using the IMPACT2DM and to test the face validity and clinical validity of the tool. METHODS: A cross-sectional study was undertaken using data extracted retrospectively from the medical records of adults being managed for T2DM at Debretabore Hospital. PIP was assessed using IMPACT2DM. Some items/item components of IMPACT2DM were modified to increase the tool's applicability for the outpatient setting, to clarify content or to use the terms most common in this particular setting. Multivariant logistic regression analyses were conducted to identify factors associated with PIP. RESULTS: More than 90% of medical records had at least 1 PIP. Prescribing omission (80.9%) was the most commonly identified type of PIP. Adults with prescribing omissions are more likely to be ≥40 years old or to be prescribed with <5 medications. Adults with dosing problems were more likely ≥50 years old, or have had a fasting blood sugar (FBS) level out of the target range (80-130 mg/dL). CONCLUSIONS: IMPACT2DM is a clinically valid PIP identification tool for application in an Ethiopian outpatient setting. Health professionals should be alert to check for potential prescribing omissions for adults ≥40 years old and dosing problems for adults with an FBS level out of the target range or >50 years.

Potentially inappropriate prescribing for adults with diabetes mellitus: a scoping review protocol.

OBJECTIVE: This scoping review aims to explore and map studies investigating potentially inappropriate prescribing (PIP) for adults with diabetes mellitus. INTRODUCTION: Inappropriate prescribing for people with diabetes mellitus has been reported by various authors focusing on different aspects of inappropriateness. A preliminary search revealed no published reviews on PIP for adults with diabetes mellitus. As a result, it is difficult to obtain a comprehensive map of PIP in this patient group. INCLUSION CRITERIA: This scoping review will consider all studies on PIP for adults with the diagnosis of type 1 or type 2 diabetes mellitus from any clinical setting. Studies conducted in pediatric populations or in adults with pre-diabetes or gestational diabetes will be excluded. METHODS: A three-step search strategy (i.e. an initial limited search in PubMed and ProQuest Central databases, a main search of eight databases and gray literature, and manual searches of reference lists of included articles) will be utilized. No language restrictions will be applied. All retrieved articles will be screened against the inclusion/exclusion criteria at title, abstract, and full-text stages. Data to be extracted from each study will include, but not be limited to, country, objective, study population, study methodology, type of PIP studied, examples of PIP events, medications involved, and criteria used for PIP identification. Data will be extracted by study team members using an online application for conducting systematic synthesis of evidence.

Pharmaceutical Care Practice in Community and Institutional Drug Retail Outlets of Gondar Town, North West Ethiopia.

BACKGROUND: Pharmaceutical care (PC) practice in Ethiopia is not well developed and is at its infant stage. As a result, very little is known about the level of involvement of pharmacy professionals in PC activities. OBJECTIVE: The aim of this study was to assess PC practice at drug retail outlets (DROs) of Gondar town and to identify factors associated with it. METHOD: A cross-sectional study was conducted on 150 pharmacy professionals working in 55 DROs located in Gondar town, Northwest Ethiopia. Data on sociodemographic characteristics of respondents, their involvement in PC activities, handling of drug-related problems (DRPs), and consultation with colleagues and other health-care providers were collected and analyzed using statistical package for social sciences (SPSS) version 21. RESULTS: Majority of study participants were degree holders in pharmacy (68.7%) and work in community DROs (78%). Over half of the respondents (56.5%) were found to practice good PC, asking at least 3 of their last 5 patients what the goal of their drug therapy was. Nearly a quarter (24%) of pharmacy professionals did not document the desired therapeutic objectives for all the 5 patients they served. Handling of DRPs is poor for majority (76%) of the pharmacy professionals. Respondents working in the community DROs and diploma holders are poorly involved in PC activities. Age < 30 years, male sex, and working in the community DROs are significantly associated with poorer relation with colleague and other health-care providers. CONCLUSIONS: Pharmacy professionals working in DROs of Gondar town have little involvement in the provision of PC. Especially, their handling of DRPs is very poor. The level of involvement of pharmacy professionals on some types of PC services was significantly associated with their sex, age, working site, and level of education.

Ethiopian university students' knowledge and perception towards cardiovascular disease risk factors: a cross sectional study.

Cardiovascular disease (CVD) is the commonest cause of morbidity and mortality with an estimation of 17.9 million deaths worldwide annually. Knowledge about the disease and risk factors changes individuals' health attitudes, behaviors and lifestyle practices. We assessed the knowledge and perception of University students towards CVD risk factors. A cross-sectional survey was done on undergraduate students at University of Gondar, Ethiopia. We stratified sampled students based on their colleges and then used convenience sampling technique to pick up study participants from each college. Data was analyzed using SPSS version 20.0. Descriptive statistics were used to describe frequencies, percentages, mean and standard deviations of variables. Presence of association between independent and dependent variables was examined using logistic regression analysis. A P-value of < 0.05 was considered to be statistically significant. Four hundred twenty-three students with a mean age of 22.07 ± 2.17 participated. Majority of them were male 279 (66.0%). Nearly one third (32.2%) of study subjects had good knowledge on CVD risk factors. More than 75% of study participants disagreed with ideas relating them to susceptibility towards CVD. Students from the college of medicine and health sciences were 2.6 times more knowledgeable about CVD risk factors than students from other colleges (P = 0.024). Similarly, students from college of medicine and health sciences perceived 2.3 times more positive towards severity of CVD than students from other colleges (P = 0.027). Students at University of Gondar were poorly knowledgeable about CVD risk factors and they perceive that they are not at risk of CVD. Educational intervention is needed to improve their knowledge.