Medication Errors Among Hospitalized Adults in Medical Wards of Nekemte Specialized Hospital, West Ethiopia: A Prospective Observational Study.

PURPOSE: A high prevalence of medication errors in older adults are due to a combination of different factors such as polypharmacy, polymorbidity, enrolment in several disease-management programs, and fragmentation of care that causes medication errors in all age groups. This study aims to assess the incidence and determinants of medication errors among hospitalized adults in medical wards of Nekemte Specialized Hospital (NSH), West Ethiopia. PATIENTS AND METHODS: A prospective observational study design was conducted at Nekemte Specialized Hospital among hospitalized adults from October 30, 2018 to January 30, 2019. Data were collected by using checklist-guided observation and review of medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, logistic regression analysis was used. Statistical significance was considered at a p-value <0.05. RESULTS: A total of 351 patients were included in the present study. The mean age of the patients was 40.67+15.78 years. A total of 813 medication errors were recorded. The most common stage for medication errors was physician ordering 263 (32.4%). In the multivariable analysis, age ≥65 years (AOR: 2.54, 95%CI: 1.12-5.75, p=0.025), hospital stay ≥7 days (AOR: 2.16, 95%CI: 1.17-3.98, p=0.014), number of medication taken (AOR: 1.75, 95%CI: 1.13-2.73, p=0.013) and presence of comorbidity (AOR: 1.57, 95%CI: 1.01-2.46, p=0.049) had shown statistical significance in predicting medication errors. CONCLUSION: Medication errors are common at Nekemte Specialized Hospital with an incidence of 48.3 per 100 orders, 231.6 per 100 admissions, and 433.4 per 1000 patient days. In particular, adults with older age, increased hospital stay, a greater number of medications, and presence of comorbidities were at greater risk for medication errors.

Challenges And Factors Associated With Poor Glycemic Control Among Type 2 Diabetes Mellitus Patients At Nekemte Referral Hospital, Western Ethiopia.

BACKGROUND: Diabetes is increasing at an alarming rate throughout the world, and ~80% of diabetics live in developing countries. Similar to the rest of sub-Saharan African countries, Ethiopia is experiencing a significant burden of diabetes, with increased prevalence, complications, and mortality, as well as life threatening disabilities. Reasons for poor glycemic control among type 2 diabetes patients are complex and multivariable. Hence, this study aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients. METHOD: A hospital-based cross-sectional study was conducted among type 2 diabetic patients attending the diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose levels of the last three clinic visits were obtained and the mean fasting blood glucose measurement was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable P<0.05 was considered statistically significant. RESULTS: Out of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of patients was 43±12.4 years and 154 (67.5%) were found to not be following their general dietary program correctly. Nearly one third, 73 (32%), of patients never attended diabetic education and 52 (22.8%) of the patients had greater than 10 years' duration on treatment. The majority, 148 (64.9%), of patients had poor blood glucose control. Age 40-60 years (AOR=2.01, 95% CI=0.04-0.06, P=0.044), being illiterate (AOR=3.12, 95% CI=1.52-8.50, P=0.001), having informal education only (AOR=2.28, 95% CI=2.14-32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR=3.94, 95% CI=1.51-27.83, P=0.012), inadequate physical exercise (AOR=3.19, 95% CI=1.05-19.84, P=0.019), and smoking (AOR=4.51, 95% CI=0.00-0.50, P=0.022) were independent predictors of poor glycemic control on multivariable logistic regression analysis. CONCLUSION: Nearly two-thirds of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment, and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education, and barriers of glycemic control should be explored with further research.

Determinants of anti-retroviral regimen changes among HIV/AIDS patients of east and west Wollega zone health institutions, Oromia region, west Ethiopia: a cross-sectional study.

BACKGROUND: Human Immunodeficiency Virus (HIV) is one of the main causes of morbidity and mortality; because of this it continues to be a major global public health concern. It has believed to kill more than 34 million lives so far. Sub Saharan Africa constitutes about 70% of people living with HIV among the 37 million on the globe. This region, accounted for more than two third of the global new HIV infections and about 15 million (40%) were receiving antiretroviral therapy (ART) at the end of 2014 throught the world. ART has fundamentally changed the treatment of HIV and transformed this infection from a disease of high mortality to chronic and medically managed disease. The issues of drug induced toxicities & complexity of current highly active antiretroviral therapy (HAART) regimens has remained of great concern. The aim of this study was to determine factors leading to antiretroviral regimen changes among HIV/AIDS Patients in the study area. METHODS: A facility based retrospective cross-sectional study was conducted from April 28, 2017 to May 30, 2017 in the ART clinics of east and west Wollega zone health institutions using a pre-tested data collecting form and chart review. The sample included the 243 patients whose medication had been switched. RESULTS: Majority 145 (59.67%) of the patients had been on ART for > 10 years duration. More than half 126(51.9%) of the patients had received tuberculosis (TB) treatment and almost three out of five patients (57.2%) had received isoniazid & cotrimoxazole prophylaxis. The most common reason for regimen change was peripheral neuropathy 146(60.1%) and the most common medication for this reason was stavudine, lamivudine and neverapine based 108(44.44%). CONCLUSIONS: The number of patients who changed ARV drug in our resource constrained setting present a challenge to the restricted treatment choices that we currently own. Less toxic and better-tolerated HIV treatment options should be available and used more frequently.

Epidemiology of self-medication with modern medicines among health care professionals in Nekemte town, western Ethiopia.

OBJECTIVE: Self-medication is defined as use of medicines to treat self-recognized illnesses. It is widely used in Ethiopia. However, its extent of use is unknown among health professionals. This study aimed to assess prevalence and reasons of self-medication with modern medicines among health professionals. A cross-sectional study was conducted on the health professionals, working in the public health facilities. Data were collected from March to May, 2016 using semi-structured questionnaire. Data were entered and analyzed using statistical package for the social sciences. A chi square test was used as test of significance at 95% of confidence interval. RESULTS: A total of 154 health professionals were enrolled, with 53% were being females. The finding revealed that prevalence of self-medication with modern medicines was 67.5%. Financial constraints (32.5%) and familiarity with medicines (24%) were the major reasons of self-medication. It also showed that self-medication with modern medicines was significantly associated with marital status (χ2 = 19.57, P = 0.00). Analgesics (53%) and antibiotics (36%) were the most commonly used categories of medicines. Self-medication with modern medicines was highly practiced among health professionals. Financial constraints and familiarity with medicines were the two major reasons of practicing.