Potentially Inappropriate Medications Use and Associated Factors Among Older Patients on Follow-Up at the Chronic Care Clinic of Hiwot Fana Comprehensive Specialized Hospital in Eastern Ethiopia.

Background: Potentially inappropriate medications (PIMs) use often cause to poor health outcomes in older patients. There is a dearth of information on PIMS use in this population of patients seeking treatment at Hiwot Fana Comprehensive Specialized Hospital. Objective: To assess PIMs use and associated factors among older patients receiving follow-up treatment at the chronic care clinic of Hiwot Fana Comprehensive Specialized Hospital in eastern Ethiopia. Methods: A retrospective cross-sectional study using medical records of 419 older patients was conducted. older patients, aged 65 years or older, treated in the ambulatory care clinic were included. Simple random sampling technique was used. PIMs use was identified by using the 2023 American Geriatrics Society Beers Criteria (AGS Beers Criteria) and Screening Tool of Older People's Potentially Inappropriate Prescriptions Criteria and Screening Tool to Alert Doctors to Right Treatment (STOPP/START) version 2 criteria. The multivariable logistic regression analysis was employed to identify factors associated with PIMs use. The strength of statistical association was measured by adjusted odds ratio (aOR) and 95% CI. P values < 0.05 were considered statistically significant. Results: A total of 419 patients' medical records were reviewed. Of these, 411 patients' medical records fulfilled the inclusion criteria and were considered for final analysis. About 56.9% (n= 234) of the study population was women. The prevalence of PIMs use was 28.5% and 18.5%, according to 2023 AGS Beers Criteria and STOPP/START version 2 criteria, respectively. In accordance with 2023 AGS Beers Criteria, male sex (aOR = 1.78; 95% CI, 1.10-2.87), diabetes mellitus (aOR = 0.35; 95% CI, 0.19-0.62), and chronic kidney disease (aOR = 6.68; 95% CI, 2.55-9.32) were found to be the determining factors for PIMs use. According to STOPP/START version 2 criteria, deep vein thrombosis, diabetes mellitus, hypertension, and advanced age were the primary factors influencing PIMs use. Conclusions: Compared with other study findings from across the world, the prevalence of PIMs use was low. Based on 2023 AGS Beers Criteria, male sex, diabetes mellitus, and chronic kidney disease were found to be the determinant factors for PIMs use. Deep vein thrombosis, diabetes mellitus, hypertension, and advanced age were significant factor of PIMs use according STOPP/START version 2 criteria.

Prescribing patterns of statins and associated factors among type 2 diabetes mellitus patients attended at Jugol General Hospital in eastern Ethiopia: A cross-sectional study.

Background: Most clinical practice guidelines support the use of statins in patients with type 2 diabetes mellitus to lower the risk of cardiovascular disease. However, nothing is known about the prescribing patterns of statins at Jugol General Hospital in eastern Ethiopia. Objective: This study aimed to assess the prescribing patterns of statins and associated factors among type 2 diabetes mellitus patients attended at Jugol General Hospital in eastern Ethiopia. Methods: A retrospective cross-sectional study was conducted among 423 patients with type 2 diabetes mellitus who received follow-up care from 1 June 2017 to 1 June 2022. The study participants were enrolled consecutively using a convenience sampling technique. The data were extracted from patients' medical records using a data abstraction checklist. The extracted data were entered into EpiData, version 3.1, and exported to Statistical Package for the Social Sciences (SPSS), version 22, for analysis. Associations were considered to be statistically significant at a p-value < 0.05 and presented as adjusted odds ratios and 95% confidence intervals. Result: The medical records of 423 patients were reviewed. The review revealed that medical records were complete for 410 of these patients, and these records were included in the analysis. The majority of the study participants were female (72.2%) and between the age of 40 and 65 years (61.2%). All of the study participants were eligible for statin prescription; however, statins were prescribed for only 257 (62.7%) study participants. Of the statins prescribed, moderate-dose-intensity statins were prescribed for 40 (15.6%) participants who were at high risk of cardiovascular disease. Atorvastatin was the most commonly (93.3%) prescribed statin. The presence of hypertension, coronary artery disease, and cerebrovascular events was significantly associated with statin prescribing. Conclusion: The magnitude of prescribing statins for patients with type 2 diabetes mellitus was low in comparison with the clinical practice guidelines recommendation. This finding is alarming and is a call for action to improve the execution of clinical practice guidelines for the benefit of this high-risk population.

Treatment Outcome and Associated Factors Among Patients Admitted with Hypertensive Crisis in Public Hospitals at Harar Town, Eastern Ethiopia: A Cross-Sectional Study.

Background: Hypertensive crisis is a significant global health issue that raises the costs to healthcare systems and requires specific attention to improve clinical outcome. There is scarce information on hypertensive crisis cases treatment outcome in the study setting. Objective: This study aimed to assess treatment outcome and associated factors among patients admitted with hypertensive crisis at Public Hospitals in Harar Town, Eastern Ethiopia. Methods: A cross-sectional study was conducted among 369 hypertensive crisis patients who had been admitted to the emergency department of Hiwot Fana Comprehensive Specialized Hospital and Jugol General Hospital from May 1, 2017, to May 1, 2022. All hypertensive crisis patients who fulfilled the inclusion criteria were included. The data were extracted from medical records using a data abstraction format. The collected data were analyzed using Statistical Package for Social Sciences version 22. Binary logistics regression model using bivariate and multivariable analysis with 95% confidence intervals and P-values were used to determine the association between variables. Results: The medical records of 369 patients in total were reviewed. Of these, the medical records of 363 patients contained all the necessary information and were used in the study. More than half of the patients (238; 65.6%) were males. Among 363 patients admitted with hypertensive crisis, 98 (27.0%, 95% Confidence Interval (CI):22.5%-31.9%) of them had poor treatment outcome of hypertensive crisis. Being female (Adjusted Odds Ratio (AOR)=3.4; 95% CI=1.7-7.9), residing in rural areas (AOR=2.4; 95% CI=2.7-5.1), taking captopril during admission (AOR=5.6; 95% CI=2.4-7.9), taking antihypertensive treatment before admission (AOR=0.5; 95% CI=0.2-0.9), and being non compliant to treatment (AOR=2.7; 95% CI=1.4-3.5) had statistically significant associations with poor treatment outcome of hypertensive crisis compared to their counterparts. Conclusion: The magnitude of poor treatment outcome of hypertensive crisis was high. Sex, residence, non-compliance, and type of emergency drug administered during admission were substantially related with poor treatment outcome of hypertensive crisis. Health professionals should put great emphasis on emergency drugs administered during admission to achieve the desired outcome.

Youth friendly services utilization and associated factors among school youths in North Shewa Zone, Amhara Region, Ethiopia: A mixed-method study.

Objective: To assess youth friendly services utilization and associated factors among school youths in North Shewa zone, Ethiopia, 2020. Methods: Institution-based cross-sectional study complemented with qualitative inquiry was conducted from 25 February to 20 March 2020. Multistage and purposive sampling technique was used. A total of 605 randomly selected students were recruited. Seven in-depth interviews and four focus group discussions were conducted for qualitative study. p-value < 0.05 and adjusted odds ratio with 95% confidence interval were computed to measure the strength of associations between variables. Qualitative data were transcribed verbatim, analyzed manually, and presented in narration. Result: One hundred ninety-five (32.7%, 95% confidence interval: 29.0%, 36.6%) respondents had used youth friendly services during the survey. Educational level of father (can read and write) (adjusted odds ratio = 3.12, 95% confidence interval: (1.47, 6.65)), being knowledgeable about reproductive health issues (adjusted odds ratio = 4.84, 95% confidence interval: (2.77, 8.47)), discussion on reproductive health issues (adjusted odds ratio = 2.50, 95% confidence interval: (1.49, 4.19)), having sexual exposure (adjusted odds ratio = 3.37, 95% confidence interval: (1.54, 7.39)), perceiving oneself as risky for acquiring HIV/AIDS (adjusted odds ratio = 4.49, 95% confidence interval: (2.63,7.65)), history of sexually transmitted infections (adjusted odds ratio = 4.40, 95% confidence interval: (1.61, 12.04)), favorable attitude toward service providers (adjusted odds ratio = 2.20, 95% confidence interval: (1.16, 4.17)), and ever supported to use the services (adjusted odds ratio = 4.18, 95% confidence interval: (2.51, 6.97)) were factors associated with youth friendly services utilization. Conclusion: Compared with previous findings, youth friendly services utilization in the study area was relatively low. Knowledge on reproductive health issues, sexual exposure, perceiving as risky of acquiring HIV, history of sexually transmitted infection, ever supported to use the services, and attitude of youth toward youth friendly service providers were among factors associated with youth friendly services utilization. Health facilities and schools should work coordinately to scale up youth friendly services utilization.

Practice of Traditional Medicine and Associated Factors Among Residents in Eastern Ethiopia: A Community-Based Cross-Sectional Study.

Introduction: Although the Practice of traditional medicine is accorded great importance worldwide, it seems to face a notable challenge. A notable challenge is the lack of a reference standard for determining the appropriate utilization of traditional medicine for patients. There is little evidence about the usual utilized traditional medicine in the study area. Therefore, this study aimed to assess practice of traditional medicine and associated factors among residents in Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted from January 20, 2022 to February 20, 2022. About 818 study participants were recruited using a systematic random sampling technique. Data were collected by face-to-face interviews. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) version 22 computer software. The association between an outcome variable and independent variables was assessed using binary logistic regression and the strength of association was presented using Adjusted Odd Ratio (AOR) with its 95% confidence intervals (CI). Result: A total of 803 participants were included in the final analysis with a 98.2 % response rate. From the total study participants, 563 (70.1%) [95%CI: 66.8-73.3] had used traditional medicine in the past 6 months. Factors such as being farmer [AOR = 1.06; 95%CI: (1.03-3.7)], having a diploma degree or higher [AOR = 3.2, 95% CI (1.4-7.3)] and having no history of chronic disease [AOR = 0.21; 95% CI: (0.1-0.5)] were significantly associated traditional medicine practice. Conclusion: The proportion of traditional medicine practice was high. The most commonly utilized traditional medicines were Damakase, Tenadam, Zingibil and Erate. A national health policy should give a great emphasize on rational utilization of traditional medicine.

Treatment outcome and associated factors among patients admitted with acute poisoning in a tertiary hospital in Eastern Ethiopia: A cross-sectional study.

INTRODUCTION: Acute poisoning causes morbidity and mortality worldwide. There is scarce of information on acute poisoning in the study area. OBJECTIVE: To assess treatment outcome and the associated factors among patients admitted with acute poisoning at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia. METHODS: A cross-sectional study was conducted. All acutely poisoned patients who had been admitted at the emergency department of Hiwot Fana Comprehensive Specialized Hospital from 1 January 2016 to 31 December 2020 who fulfilled the inclusion criteria of the study were included. Data were collected by review of medical records. Poor treatment outcome of acute poisoning was defined as the acutely poisoned patient was died, or survived with disability. Multivariate logistic regression analysis was used to determine factors associated with the outcome of acute poisoning. RESULT: A total of 175 patient's medical records were reviewed. Of these, 150 patient's medical records had complete information and were included in the final analysis. The majority of participants 89 (59.3%) were in the age group of 19-37 years. More than half of the participants 86 (57.3%) were females. Organophosphate was the most poisoning agent encountered in 62 cases. Acetaminophen was the predominant drug poisoning agent encountered in 10 participants. Among 30 patients managed with antidote, 18 patients were treated with atropine for organophosphate poisoning. Of all the poisoning cases admitted during the study period, 16.7% died. Participants who were poisoned by themselves were 2.4 times more likely to have poor treatment outcomes than those who were poisoned accidentally: 2.44 (95% confidence interval: 1.10-5.42). The odd of having poor treatment outcome in participants who were poisoned by drugs was 2.13 more likely: 2.13 (95% confidence interval: 1.21-3.32). CONCLUSION: Organophosphate was the predominant cause of acute poisoning encountered in 62 cases. The modes of poisoning and drug poisoning were significant risk factors associated with poor treatment outcomes of acute poisoning.