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1.
BMC Prim Care ; 25(1): 255, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39009959

RESUMO

BACKGROUND: Self-efficacy is the ability to execute, and it is a critical predictor of health-related outcomes among people living with human immunodeficiency virus (PLHIV). Self-efficacy directly determines treatment outcome. However, there is no evidence on the self-efficacy of PLHIV for self-management in Ethiopia. Currently, HIV is considered a manageable chronic disease. However, the burden remains high despite all the taken measures. OBJECTIVES: This study aimed to assess the self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital (UOGCSH), northwest Ethiopia, 2022. METHODS: A cross-sectional study was conducted on PLHIV selected by a systematic random sampling technique using an interviewer-administered questionnaire at the UOGCSH from August 10 to September 30, 2022. The data was entered and analyzed using the Statically Package for Social Science version 25.0. Categorical variables were summarized as frequency (percentage) of the total. Both descriptive and inferential statistics, such as the Kruskal-Wallis H test and Mann-Whitney U test were performed to detect difference. P-value < 0.05 was considered to indicate statistically significance. RESULTS: Overall, 405 PLHIV participated in the study, giving a 96% response rate. The overall median (Interquartile range) self-efficacy score of PLHIV for self-management was 22 (4) and 67.4% of the PLHIV self-efficacy score was above the median. A statistically significant difference was detected between the social support groups (χ2 (2) = 37.17, p < 0.0001), education background (U = 10,347, Z = 2.279, P = 0.023, r = 0.113), living conditions (U = 12,338, Z = 2.457, P = 0.014, r = 0.122) and medication adherence (U = 9516.5, Z = 3.699, P < 0.0001, r = 0.184). CONCLUSION: Most participants' self-efficacy score was above the median. Statistically significant differences in self-efficacy were observed based on individual, environmental, and clinical factors. We suggest training and workshops for healthcare workers and the hospital and adherence support groups should work to improve the self-efficacy of PLHIV.


Assuntos
Infecções por HIV , Autoeficácia , Autogestão , Humanos , Etiópia , Estudos Transversais , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecções por HIV/psicologia , Adulto Jovem , Inquéritos e Questionários , Adolescente , Hospitais Especializados , Hospitais Universitários
2.
Int J Clin Pharm ; 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-39007992

RESUMO

BACKGROUND: Anticholinergic medications are now widely acknowledged for their unfavorable risk-to-benefit profile owing to their adverse effects. Health-related quality of life (HRQoL) is commonly regarded as a crucial person-centered outcome. AIM: This study aimed to investigate the association between anticholinergic burden and HRQoL in hospitalized and ambulatory patients seen in Ethiopia. METHOD: This cross-sectional study utilized a questionnaire and medical records to collect data from a convenience sample of adult patients attending both inpatient wards and ambulatory clinic of University of Gondar Comprehensive Specialized Hospital between April and September 2022. Anticholinergic burden was measured by anticholinergic cognitive burdens scale (ACBS), while HRQoL was measured using EQ5D-index (Euroqol-5 dimensions-5-Levels index) and EQ5D-VAS (visual analogue scale). Linear regression was used to assess the influence of high anticholinergic burden (ACBS score ≥ 3) on EQ5D-index and EQ5D-VAS, with adjustments made for sociodemographic and clinical confounders. RESULTS: A total of 828 patients participated in this study (median (IQR) age was 45.0 (30, 60) and 55.9% were female). On multiple linear regression analysis, high anticholinergic burden was associated with a statistically significant decline in HRQoL, as evidenced by reductions in both EQ5D index (- 0.174 (- 0.250, - 0.098)) and EQ5D-VAS scores (- 9.4 (- 13.3, - 5.2)). CONCLUSION: A significant association between high anticholinergic burden and diminished HRQoL was found among a relatively younger cohort in a resource-limited setting, even after adjustment for important confounding variables. Clinicians should be cognizant of the cumulative impact of anticholinergic burden on HRQoL outcomes and strive to minimize anticholinergic burden.

3.
SAGE Open Med ; 12: 20503121241256569, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38826823

RESUMO

Background: Community pharmacy professionals play a vital role in health care, have a greater impact on public health programs, and play a critical role in patient counseling for both non-pharmacological and pharmacological management. This study aimed to evaluate the knowledge, attitude, and practice of community pharmacy professionals toward nutrition and lifestyle counseling in Gondar City, Ethiopia. Methods: A cross-sectional survey was undertaken in Northwestern Ethiopia from May to June 2021. Face-to-face structured interviews were performed to collect data using a specially created questionnaire. Descriptive, independent t-test, and one-way ANOVA analyses were used. A significant difference was defined as a p-value of less than 0.05. Results: This survey drew 100 community pharmacy professional from a pool of 105 participants, with a 95.2% response rate. More than a third of the participants (n = 43, 43%) defined medical nutrition therapy as the use of food to prevent disease, and almost half of the participants (n = 51, 51%) viewed therapeutic nutrition to be part of their job responsibilities. More than half (64%) believe that patients should be provided a combination of nutritional and pharmacological treatments in the majority of cases. The majority of participants (75%) gave patients counseling on drug-food interactions. Conclusion: The majority of community pharmacy professionals said they knew a lot about medical nutrition therapy and were enthusiastic about nutrition evaluation and medical nutrition therapy, they see these tasks as part of their job, and they practiced dietary counseling that was limited to pregnancy and chronic diseases.

4.
J Pharm Policy Pract ; 17(1): 2326381, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562557

RESUMO

Objectives: This study evaluated the level of community pharmacy professionals' (CPPs) actual practices and contrasted it with their self-reported perceived involvement in diabetes management. Methods: A self-reported cross-sectional and simulated patient (SP)-based study were employed at community drug retail outlets (CDROs) in Northwest Ethiopia. SP-case scenarios were used to examine the actual practices of CPPs in diabetes management and were compared with self-reported perceived involvement. The data were managed and analysed using SPSS version 26. Results: About 184 participants in the self-reported and 100 CPPs' actual practices using three SP visits were included. The overall actual practice (17.8%) was found to be significantly different compared with the perceived level of involvement (73.5%) (p-value <0.05). About 94.3% of CPPs dispensed requested medications to the SP without a prescription. Despite most participants being perceived to be involved, more than 76% of CPPs did not counsel the SP for lifestyle modifications, avoiding risky behaviours, adherence to treatment, routine blood glucose checkups, diabetic foot care techniques, or consultation with physicians for further management. Conclusion: A significant discrepancy between actual practices and perceived CPPs' involvement in the management of diabetes was observed. The findings may suggest that exploring possible gaps may be crucial.

5.
SAGE Open Med ; 12: 20503121241229562, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38533203

RESUMO

Objective: This study aimed to assess patient knowledge and satisfaction and associated factors with outpatient pharmacy service at Felege Hiwot comprehensive specialized hospital. Design setting and participants: An institution-based cross-sectional study was conducted at Felege Hiwot comprehensive specialized hospital on patients getting outpatient Pharmacy service from 01 March 2022 to 30 May 2022. The study participants were selected by simple random sampling method. Main outcome measured: Patients' knowledge and satisfaction with pharmacy service was measured by a structured questionnaire and Data were collected, cleared, and coded, then entered into EPI Info (Epidemiological information. version 7.1.5.2) and analyzed using SPSS (version 25). Results: The overall knowledge result of the respondents showed that only 13.3% of individuals have good drug knowledge and 72.01% of respondents were satisfied with the outpatient pharmacy service. Following up on the multivariate analysis of service modality patients by credit (AOR: 5.50 (1.71-17.74), who are with the occupation of merchants (AOR: 0.09 (0.01-0.83)) and labeling (AOR: 3.13 (1.58-6.20) had an association with drug knowledge. Multivariate analysis showed that waiting time, dispensing time and privacy had an association with satisfaction. When we consider waiting time; respondents with 3-6 min, 6.1-9 min and >9 min waiting times are 0.06 times, 0.02 times, and 0.01 less likely satisfied compared with respondents having waiting time <3 min. It shows that as the patient stays without getting serviced for a long time, satisfaction decreases. Conclusions: Overall, around three-fourths of the respondents were satisfied with the outpatient pharmacy services which is approaching the national satisfaction assessment result. Respondents were strongly satisfied with Dose, route, frequency, and duration. However, they were strongly dissatisfied with the name of the drug. After the multivariate analysis privacy, waiting time, and dispensing time had an association with patient satisfaction.

6.
BMC Cancer ; 24(1): 68, 2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38216966

RESUMO

INTRODUCTION: Screening of cancer is the maximum effort and critical element for providing health related care in order to decrease cancer related dealt because of the disease burden is in its advanced stages. Unfortunately, advanced-stage presentation and late diagnosis of cancers endure a problem in low-income countries including Ethiopia. However, there is scarcity of published articles about the problem in Ethiopia. OBJECTIVE: This study aimed to assess the prevalence of advanced-stage -stage presentation of cancer at the time of diagnosis and associated factors among adult cancer patients at Northwest Amhara comprehensive Specialized Hospitals, oncology treatment units, Northwest Ethiopia, 2022. METHODS: An institution based cross-sectional study was conducted in Northwest Amhara public referral hospitals on 422 study participants. A systematic random sampling technique was performed. The data were collected through face to face interview and document review via structured, pretested questionnaires. Epi. Data version 4.6 and Stata version 14.0 software's were used for data entry and analysis respectively. Logistic regression were carried out to recognize factors associated with advanced-stage -stage presentation of cancer at the time of diagnosis. Adjusted odds ratio with a 95% confidence interval were used to measure the strength of association. Variables having p-value less than 0.2 in bivariable analysis were entered in to multivariable analysis; variables with a p-value < 0.05 were declared significantly associated with advanced-stage -stage presentation of cancer at the time of diagnosis. RESULTS: The overall prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be 67.57%. Age ≥ 60 years old patients (AOR = 6.10, 95%: (1.16-32.1)), patients had have a feeling of burden (AOR = 1.82, 95%, CI: (1.04-3.20)), and cancer patients with comorbidity illness (AOR = 2.40, 95%, CI: (1.40-4.12)) were significantly associated with advanced-stage presentation of cancer at the time of diagnosis. CONCLUSION: The prevalence of advanced-stage presentation of cancer at the time of diagnosis was found to be high. Its better, health care providers in oncology treatment facilities need to give special attention to older patients, having feeling of burden and cancer patient with comorbidity to reduce the risk of developing late stage presentation of cancer.


Assuntos
Neoplasias , Adulto , Humanos , Pessoa de Meia-Idade , Etiópia/epidemiologia , Estudos Transversais , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Instalações de Saúde , Hospitais
7.
BMJ Open ; 13(12): e077863, 2023 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-38070913

RESUMO

OBJECTIVE: The study was conducted to assess potential drug-drug interactions (PDDIs) and its determinants among patients with cancer receiving chemotherapy. DESIGN AND SETTING: An institutional-based cross-sectional study was used. This study was conducted from 1 June 2021 to 15 December 2021, in Northwest Ethiopia oncology centres. PARTICIPANTS: All eligible patients with cancer received a combination of chemotherapy. OUTCOMES: The prevalence and severity of PDDIs were evaluated using three drug interaction databases. Characteristics of participants were presented, arranged and summarised using descriptive statistics. The predictors and outcome variables were examined using logistic regression. The cut-off point was a p value of 0.05. RESULTS: Of 422 patients included in the study, 304 patients were exposed to at least one PDDI with a prevalence of 72.1% (95 % CI: 68% to 76%) using three drug interaction databases. There were varied reports of the severity of PDDI among databases, but the test agreement using the kappa index was 0.57 (95% CI: 0.52 to 0.62, p=0.0001) which is interpreted as a moderate agreement among three databases. Patients aged ≥50 years old had the risk to be exposed to PDDI by odds of 3.1 times (adjusted OR (AOR)=3.1, 95% CI (1.8 to 5.3); p=0.001) as compared with patients <50 years old. Similarly, patients with polypharmacy and comorbidity were more likely to be exposed to PDDI than their counterparts (AOR=2.4, 95% CI (1.4 to 4.1); p=0.002 and AOR=1.9, 95% CI (1.1 to 3.4); p=0.02, respectively). CONCLUSION: The main finding of this study is the high prevalence of PDDI, signifying the need for strict patient monitoring for PDDIs among patients with cancer receiving chemotherapy. We suggest the use of at least three drug databases for quality screening. Patients with an age ≥50 years old, polypharmacy and comorbidity were significantly associated with PDDIs. The establishment of oncology clinical pharmacists and computerised reminder mechanisms for PDDIs through drug utilisation review is suggested.


Assuntos
Neoplasias , Polimedicação , Humanos , Pessoa de Meia-Idade , Estudos Transversais , Etiópia/epidemiologia , Interações Medicamentosas , Comorbidade , Neoplasias/tratamento farmacológico
8.
Integr Pharm Res Pract ; 12: 185-193, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37901480

RESUMO

Background: Ecopharmacology, as a form of drug management for the environment, focuses on the impact of drugs on the environment. Pharmacists, and by extension pharmacy students, are expected to play an important role in ecopharmacology. Therefore, this study was conducted to determine the knowledge and attitude towards ecopharmacology and the practice of disposal of leftover or expired medicines among pharmacy students. Methods: This was a descriptive cross-sectional study among pharmacy students in Northwestern Ethiopia. The study took place from May 1 to June 15, 2023. A self-administered questionnaire was used for data collection. Results: Four hundred and forty-five students were included in the study. Only 91 (20%) of the students were aware of the term ecopharmacology, 27% knew that excretion from the human or animal body is the major route by which pharmaceutical agents enter the environment, and 42% were aware of the risk of increased antimicrobial resistance due to antibiotic residues in the environment. In addition, only 27% of respondents reported receiving information about the disposal of pharmaceuticals. The most common method of disposing of medications was throwing them away in household trash (61.8%). Conclusion: Our results suggest that while most pharmacy students in Ethiopia have a positive attitude toward ecopharmacology, they do not know enough about ecopharmacology and dispose of their medicines poorly. More uniform education in ecopharmacology and pharmaceutical pollution might be warranted in the pharmacy curriculum.

9.
Heliyon ; 9(9): e20091, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37810015

RESUMO

Background: Pharmacists in community drug retail outlets (CDROs) have significant involvement in diabetes prevention and management by providing more direct interventions in medication education, preventive measures, and disease management. This study examined the perceived level of involvement of community pharmacy professionals (CPPs) in diabetes management at CDROs in Northwest Ethiopia. Methods: A multicenter cross-sectional study was conducted among CPPs in Northwest Ethiopia between September 1 and 30, 2022. The Statistical Package for Social Science (SPSS) version 26 was used to analyzed the data, which had been gathered using a self-administered structured questionnaire. An independent sample t-test and one-way ANOVA were used to examine the mean perceived involvement score difference between CPPs. The association between CPPs' involvement and other sociodemographic variables was examined using linear regression analysis. At a 95% confidence interval (CI), a p-value <0.05 was considered statistically significant. Results: The study included 184 (94.3%) of 195 CPPs approached. The overall mean perceived involvement score of CPPs in diabetes management was 3.80 ± 0.63 out of 5. CPPs with a bachelor's degree or higher [ß = 3.065, 95% CI: 2.704, 3.641; p < 0.001], CPPs with a higher monthly income (≥5000 ETB) [ß = 0.242, 95% CI: 0.112, 0.596; p = 0.034], and those who provided more than 8 hours of service per day [ß = 0.163, 95% CI: 0.051, 0.332; p = 0.043] had higher perceived involvement in the management of diabetes compared with their counterparts. Conclusions: This study found that most CPPs had a high level of perceived involvement in diabetes management. Higher educational backgrounds, a higher monthly salary, and working longer hours were associated with an increased level of perceived involvement. Promoting the educational background of CPPs may be crucial to enhance their active involvement in the management of diabetes.

10.
BMJ Open ; 13(9): e074731, 2023 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-37666554

RESUMO

OBJECTIVE: Treatment satisfaction is a significant determinant of quality of care, especially for patients with chronic diseases such as diabetes. Identifying factors that contribute to treatment satisfaction may improve patient outcomes. This study examined treatment satisfaction and determinant factors in patients with diabetes. DESIGN AND SETTING: A multicentre hospital-based cross-sectional study was conducted between April and July 2022 at selected hospitals in Northwest Ethiopia. PARTICIPANTS: Eligible adult patients with diabetes were included in the study. MAIN OUTCOME MEASURES: Treatment satisfaction was the main outcome and was measured using the Diabetes Treatment Satisfaction Questionnaire, which was valid and reliable in the current sample. A linear regression analysis was used to determine the association between treatment satisfaction scores and independent variables. RESULTS: Out of the 422 patients approached, 402 (95.3%) participated in the study. Overall, the mean treatment satisfaction score was 17.13 (±3.3) out of 30. Most of the participants had a lower degree of satisfaction with the current treatment (>52%) and its convenience (>63%). More than half of the participants (51.2%) perceived hyperglycaemia most of the time and hypoglycaemia some of the time (64.9%). Treatment satisfaction was influenced by body mass index (BMI) (p<0.01), number of medical conditions and medications (p<0.001), hyperglycaemia perception (p<0.001), healthcare cost coverage (p<0.001), monthly salary (p<0.001), self-monitoring blood glucose (SMBG) (p=0.017), lifestyle modification status (p<0.01), and comorbidity and/or complications (p<0.001). CONCLUSION: Treatment satisfaction was low among patients with a higher BMI, a higher number of medical conditions and medications, comorbidities and/or complications, a frequent perception of hyperglycaemia and a lower monthly salary. Interventions addressing specific independent variables might enhance treatment satisfaction.


Assuntos
Diabetes Mellitus , Hiperglicemia , Adulto , Humanos , Satisfação do Paciente , Estudos Transversais , Etiópia , Diabetes Mellitus/terapia
11.
Front Public Health ; 11: 1234436, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37608985

RESUMO

Background: Technology-based healthcare services have important implications for the diagnosis, prevention, and treatment of diseases, as well as providing access to high-quality care that both the patient and the healthcare practitioner can benefit from. To access medical information, patients have also searched for methods of technology-based healthcare services like telemedicine (TM). However, little is known regarding the perceptions, willingness, and practices of TM among Ethiopian patients, especially in the study setting. Objective: This study assessed the perceptions, willingness, and practice of TM among patients with chronic disease at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methods: A cross-sectional study was conducted from June 1 to July 30, 2022, among patients with chronic diseases who were on follow-up at the UoGCSH. Eligible participants were included in the study using a systematic random sampling technique. A structured questionnaire was used and recorded in the Kobo data collection tool. The collected data were managed and analyzed using the Statistical Package for Social Science (SPSS) version 26. Results: Out of 422 patients approached, 384 (91% response rate) were included in the final analysis. The mean (±SD) age of the participants was 48.07 ± 16.17 years. The overall perceptions mean (±SD) score of the respondents was 3.92 ± 1.06. Generally, near to three-fourths (71.1%) of the participants had a positive perception of TM services, and around two-thirds (63.3%) had a willingness to be involved in the TM service. However, only around one-fourth (24.5%) of the participants were perceived to have a high level of TM practice currently. Conclusion: The findings suggest that although the level of perception and willingness of TM services among patients with chronic diseases was positive, their level of practice was low. Therefore, creating awareness and suitable conditions to improve their utilization of TM could be important.


Assuntos
Telemedicina , Humanos , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Etiópia , Centros de Atenção Terciária , Doença Crônica , Percepção
12.
BMC Res Notes ; 16(1): 191, 2023 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-37653440

RESUMO

OBJECTIVES: Evidence shows that majority of dermatological disorders affect the health-related quality of life (HRQoL) of patients. However, the extent of its negative impact and predictors has not been studied in Ethiopia. Thus, this study looked at assessing the HRQoL and determinants in patients with dermatological disorders (DDs) attending the University of Gondar Comprehensive Specialized Hospital (UoGCSH). RESULTS: Patients with dermatological disorders (n = 400) were included in the final analysis using a systematic random sampling technique. The mean age of the participants was 39.79 (± 17.17) years. The average (± SD) score of EQ-5D-5 L was 1.92 (± 0.74). Regarding domains, pain/discomfort accounted for a higher proportion 59 (22.3%) followed by anxiety/depression 61 (15.3%). Receiving topical preparations (ß = -0.399, 95% CI: -0.6, - 0.19; < 0.001), systemic only medication (ß = -0.378, 95% CI: -0.607, -0.149; p = 0.002), having slight, mild, and moderate skin diseases found to have an inverse association with impaired HRQoL, (ß = -0.654, 95% CI; -1.01, -0.290); p < 0.001), (ß = -0.748, 95% CI: -0.960, -0.538; p < 0.001), and (ß = -0.465, 95% CI: -0.642, -0.283; p < 0.001), respectively. Furthermore, age (ß = 0.011, 95% CI: 0.006, 0.016; p = 0.001), long duration with skin disease (ß = 0.046, 95% CI: 0.015, 0.352; p = 0.013), and presence of comorbidity (ß = 0.251, 95% CI: 0.096, 0.402; p = 0.002) were significant predictors of HRQoL among dermatological disease patients. CONCLUSION: Patients with dermatological disease were found to have a compromised HRQoL. Pain /discomfort problems accounted for a higher proportion compared with other domains. Socio-demographic, clinical and medication-related variables were significantly associated with HRQoL.


Assuntos
Pacientes , Qualidade de Vida , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Depressão , Hospitais Especializados , Dor
13.
Front Med (Lausanne) ; 10: 1183685, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37521356

RESUMO

Objectives: This study assessed health-related quality of life (HRQoL) and its determinants among patients with psoriasis having follow-ups at the University of Gondar Comprehensive Specialized Hospital (UoGCSH). Design setting and participants: A cross-sectional institutional-based study was conducted at the dermatologic clinic of UoGCSH from June to August 2022. Four hundred eligible patients with psoriasis were included in the study using a systematic random sampling technique. The main outcome measured: The Dermatology Life Quality Index (DLQI) measurement scale was used to assess HRQoL. The relationship between HRQoL and independent predictor variables was investigated using bivariable and multivariate logistic regression analyses. Statistical significance was defined as a p-value of <0.05 at the 95% CI. Results: Of the 422 study subjects approached, 400 respondents with psoriasis were included in the final analysis. The mean (±SD) age was 39.8 (±17.2) years, and 56% were women. The most commonly prescribed medications were topical corticosteroids (68.3 %). The mean (±SD) DLQI was 13.05 (7.82). More than three-fourths (78.5%) of the patients' HRQOL was affected, and its severity ranged from very large to extremely large. Being male (adjusted odd ratio) (AOR) = 0.373, 95% CI (0.171, 0.773), the use of alternative therapy (AOR) = 0.237, 95% CI (0.114, 0.494), duration of diseases (AOR) = 0.184, 95% CI (0.061, 0.557), duration on medication (AOR) =3.75, 95% CI (1.32, 10.73), presence of comorbidity (AOR) = 6.199, 95% CI (1.921, 20.00), and income were found to have a significant association with poor HRQoL. Conclusion: Psoriasis patients had reduced HRQoL, which was lower than that of the normal population. The study identified that several variables contributed to this reduced HRQoL. Predictors that take into account interventions were essential for preserving patients' HRQoL.

14.
BMJ Open ; 13(6): e073777, 2023 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-37280017

RESUMO

OBJECTIVES: The purpose of this study was to assess the clinical and economic impact of adverse drug reactions (ADRs) among patients admitted to the University of Gondar Comprehensive Specialized Hospital (UoGCSH). DESIGN AND SETTING: A prospective nested case-control study was conducted at the UoGCSH among admitted adult patients with (cases) and without ADRs (controls) between May and October 2022. PARTICIPANTS: All eligible adult patients admitted in the medical ward of the UoGCSH during the study period were included in this study. MAIN OUTCOME MEASURES: The outcome variables were the clinical and economic outcomes. Length of hospital stay, visits to intensive care units (ICU) and in-hospital mortality were used to measure and compare clinical outcomes in patients with and without ADRs. The economic outcome was also assessed using direct medical-related costs and compared for the two groups. Paired samples t-test and McNemar tests were used to compare measurable outcomes between the two groups. A p value <0.05 at the 95% CI was considered statistically significant. RESULTS: Out of a total of 214 eligible enrolled patients, 206 (103 with and 103 without ADRs) with a 96.3% response rate were included in the cohort. The length of hospital stay was much longer in patients with ADRs than without ADRs (19.8 vs 15.2 days, p<0.001). Similarly, ICU visits (11.2% vs 6.8%, p<0.001) and in-hospital mortality (4.4% vs 1.9%, p=0.012) were significantly higher in patients with ADRs compared with those without ADRs. Patients with ADRs were significantly charged with higher direct medical costs compared with those without ADRs (6237.2 vs 5256.3 Ethiopian birr; p<0.001). CONCLUSION: This study concluded that ADRs had a significant impact on patients' clinical and medical costs. Healthcare providers should strictly follow the patients to minimise ADR-related clinical and economic adverse outcomes.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Adulto , Humanos , Estudos Prospectivos , Etiópia/epidemiologia , Estudos de Casos e Controles , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Hospitalização
15.
J Pharm Policy Pract ; 16(1): 47, 2023 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-36945071

RESUMO

BACKGROUND: Self-medication with antibiotics has become an important factor driving antibiotic resistance and it masks the signs and symptoms of the underlying disease and hence complicates the problem, increasing drug resistance and delaying diagnosis. This study aimed to assess the extent of self-medication practice with antibiotics and its associated factors among adult patients attending outpatient departments (OPD) at selected public Hospitals, in Addis Ababa, Ethiopia. METHODS: Facility-based cross-sectional study was employed. A systematic random sampling technique was used to include the study participants. Self-administered with structured questionnaires were applied among patients who visited outpatient departments at selected public Hospitals, in Addis Ababa. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26. Descriptive statistics such as frequencies and percentages were used for the present categorical data. The data are presented in pie charts, tables, and bar graphs. Furthermore, bivariable and multivariable binary logistic regression analyses were used to identify significant associations. Statistical significance was declared at p value < 0.05. RESULTS: Out of 421 respondents interviewed, 403 (95.7%) participants completed questionnaires. Among the respondents, 71% had generally practiced self-medication. Among these, 48.3% had self-medication with antibiotics, while 51.7% had used other drugs. The most commonly cited indication for self-medication practice was abdominal pain 44.9%, followed by Sore throat 21% commonly used antibiotics are amoxicillin (57%), ciprofloxacin (13%), amoxicillin/clavulanic (10%), erythromycin (8%), cotrimoxazole (7%), and doxycycline (5%). CONCLUSIONS: Self-medication with antibiotics was common among the study participants. The prevalence of general self-medication was 71%, whereas that of self-medication with antibiotics was 48.3%. In general, the potentially dangerous effects of SMP seem to be underestimated by patients with OPD patients.

16.
PLoS One ; 18(2): e0282096, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36827307

RESUMO

BACKGROUND: Adverse drug reactions (ADRs) have continued to be a public health challenge with significant clinical and healthcare costs. However, little is known regarding the incidence of ADR in Ethiopia, particularly in the study setting. Thus, this study aimed to assess the incidence and patterns of ADRs in patients admitted to the University of Gondar comprehensive specialized hospital (UoGCSH). METHODS: A prospective observational follow-up study was conducted on admitted patients at the medical ward in the UoGCSH from May to August 2022. A multifaceted approach involving daily chart review and patient interviews was employed to collect the data. A standard Naranjo ADR Probability Scale measuring tool was used to characterize the probability of existing ADR. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Logistic regression analysis was employed to determine the association between the occurrence of ADRs and other variables. A p-value at the 95% confidence interval was considered statistically significant. RESULTS: This study included 237 participants in total. The average length of follow-up was 16.4 (±5.2) days. Overall, 65 ADRs were identified, resulting an incidence rate of 27.4 (95% CI: 19.8-30.4) per 100 admissions. The most common ADRs were hypokalemia (10.7%), followed by constipation, diarrhea, hypotension, and rash (9.2% each). The majority of these ADRs (73.8%) were classified as "definite" by the Naranjo ADR probability scale. Gastrointestinal tract (GIT) (41.5%) and metabolic (18.6%) were the most frequently exposed systems for ADR. Antibiotics (26.2%) and cardiovascular medications (24.7%) were the most frequently implicated medications in existing ADRs. ADRs were significantly associated with age (p = 0.035), the presence of comorbidities (p = 0.021) and complications (p = 0.008), and receiving a higher number of medications (p = 0.04). CONCLUSION: In this study, ADR was identified in about one-fourth of the participants. Older patients, patients with comorbidities and complications, and patients who received a higher number of medications were more likely exposed for ADRs. Healthcare providers should strictly follow the admitted patients to minimize ADRs.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Adulto , Seguimentos , Incidência , Fatores de Risco , Estudos Prospectivos , Hospitalização , Hospitais
17.
PLoS One ; 18(2): e0281742, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36787327

RESUMO

BACKGROUND: Patients with asthma have a compromised health-related quality of life (HRQoL) due to factors related sociodemographic, clinical, and environmental factors. This study assessed the HRQoL and its determinants in patients with asthma in selected public referral hospitals in Northwest Ethiopia. DESIGN, SETTING, AND PARTICIPANTS: A multicenter facility-based cross-sectional study was conducted in selected hospitals in Northwest Ethiopia from August to October 2021. Participants were enrolled in the study using a systematic random sampling technique. MAIN OUTCOME MEASURES: HRQoL was assessed using the asthma-specific quality of life tool Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ). Simple and multivariable linear regression analyses were conducted to determine the association between independent variables and HRQoL. A p-value of < 0.05 at 95% CI was considered statistically significant. RESULTS: A total of 409 patients were included in the final analysis, and more than half (59.2%) of the subjects had a good health-related quality of life. Regarding HRQoL determinants, asthma control score (ß = 0.14, 95% CI: 0.09, 0.17; p 0.001), insurance user (ß = 0.15, 95% CI: 0.01, 0.29); p = 0.042), the high role of patient enablement (ß = 0.39, 95% CI: 0.25, 0.54; p 0.001), belief in asthma medication (ß = -0.23, 95% CI: -0.36, -0.10;p = 0.001), non-adherence to guidelines (ß = -0.30, 95% CI: -0.47, -0.15; p < 0.001), and being homemaker (ß = -0.21, 95% CI: -0.39, -0.01; p = 0.040) were the significant predictors of HRQoL. CONCLUSION: Overall, more than half of the study participants were found to have good HRQoL. HRQoL among adults with asthma was largely dependent on the level of asthma control. Socio-demographic, clinical, healthcare-related, and medication-related variables were significantly associated with health-related quality of life. Therefore, healthcare providers should include comprehensive asthma education along with an integrated treatment plan to improve asthma control and the HRQoL of patients.


Assuntos
Asma , Qualidade de Vida , Adulto , Humanos , Estudos Transversais , Etiópia/epidemiologia , Hospitais , Encaminhamento e Consulta , Asma/epidemiologia
18.
J Pharm Policy Pract ; 16(1): 28, 2023 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-36829213

RESUMO

BACKGROUND: Critical actions are required for the proper administration of medications to patients with cardiovascular diseases. However, there has been an increase in irrational use of cardiovascular drugs. The purpose of this study was to determine the extent of non-prescription cardiovascular medicine dispensing practices at community drug retail outlets (CDROs) in Gondar, Northwest Ethiopia. METHODS: A cross-sectional survey and simulated patient-based visits were employed at the CDROs in Gondar City, Northwest Ethiopia between June 1 and July 20, 2022. The cross-sectional component that assessed the self-reported practices used a standardized self-reported questionnaire. A simulated patient (SP) case scenario, using different tracer prescriptions only for cardiovascular medications, allowed for the observation of real-world dispensing procedures. SPSS version 22 was used for the data entry and analysis. RESULTS: The cross-sectional study approached 76 CDROs, and 71 of them agreed to take part (93.4% response rate). More than half of the respondents (53.5%) were males, with a mean (SD) age of 33.5 ± 9.1 years. Overall, the current self-reported survey showed that 59.2% of the participants provided cardiovascular drugs without a prescription. A total of 213 simulated visits were conducted. Considering all SP scenarios, the percentage of cardiovascular drugs dispensed without a prescription increased to 88.7%. Besides, more than 90% of pharmacists did not demand the SP to have a prescription, did not advise them to visit doctors or clinics, and did not inquire as to whom the medication was required. CONCLUSION: A significant proportion of CDROs dispensed cardiovascular medications without a prescription. The findings highlight the disparity between self-reported and actual CDRO practices. Additionally, nearly all of the CDROs approached made it simple to obtain cardiovascular medications. Stakeholders could adherently follow the CDROs' practices to improve their proper dispensing procedures.

19.
PLoS One ; 18(1): e0280204, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36634103

RESUMO

BACKGROUND: Misunderstanding dosage instructions in terms of dose, frequency, duration, or any other instruction with patients on polypharmacy is a common problem that leads to the irrational use of medications. This study aimed to assess the level of misunderstanding of dosing instructions among patients with chronic diseases receiving polypharmacy at the chronic outpatient pharmacy of the University of Gondar Compressive Specialized Hospital (UoGCSH). METHODS: An institutional-based cross-sectional survey was conducted from September to November 2021 at the UoGCSH chronic outpatient pharmacy in Northwest Ethiopia. Study subjects were selected by a systematic random sampling method. Drug-drug and drug-food interactions were also checked by Medscape and drug.com to evaluate the significance of interactions. Frequency, percentage, and mean standard deviation (SD) were used to describe the distributions of variables. With a statistical significance level of p < 0.05, the Chi-square test was used to assess the association of variables with the primary outcome. RESULTS: From a total of 400 participants, more than half (59%) were females, with a mean (SD) age of 57 (±16.3) years old. The study revealed that almost half (50.8%) of the participants misunderstood at least one dosage instruction, and around two-fifths (38.5%) misunderstood the frequency of drug administration. More than 90% of patients had no understanding of drug-drug interactions (DDIs). Sex (X2 = 16.837; P<0.0001), educational level (X2 = 50.251; P < 0.0001), residence (X2 = 5.164; P < 0.023) and duration of stay on medication (X2 = 13.806; P < 0.0003) were significantly associated with misunderstanding of dosage regimen instructions. CONCLUSION: The study showed that a significant number of patients did not understand their medication dosage regimen instructions. To address these significant drug-related issues, healthcare providers could effectively engage in interventions such as written instructions accompanying patients and additional counseling.


Assuntos
Pacientes , Polimedicação , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Estudos Transversais , Doença Crônica , Hospitais
20.
BMJ Open ; 13(1): e068518, 2023 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-36697040

RESUMO

OBJECTIVES: This study assessed the health-related quality of life (HRQoL) and its determinants in patients with diabetes. DESIGN AND SETTING: An institutional-based multicentre prospective cross-sectional study design was conducted in diabetes follow-up clinics of selected hospitals in Northwest Ethiopia from April to July 2022. PARTICIPANTS: All eligible adult patients with diabetes at the selected facilities. MAIN OUTCOME MEASURES: HRQoL was measured using EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the EuroQol-Visual Analogue Scales (EQ-VAS) instruments. A lower EQ-5D-5L utility mean score for each dimension and/or an overall lower utility score of EQ-5D-5L and EQ-VAS scores are intended to show poor HRQoL. Linear regression analysis was used to identify the association of HRQoL and other variables. RESULTS: Out of the 422 samples approached, 402 (95.3%) participated in the study. Most of the participants (>85%) reported having moderate-to-severe problems in all five EQ dimensions. The overall EQ-5D-5L utility and EQ-VAS scores were 0.56 (±0.11) and 56.7 (±10.1), respectively. A higher body mass index (BMI) (p < 0.001), a higher number of medications (p = 0.037), a high level of blood glucose (p < 0.001), the presence of comorbidities and/or complications (p = 0.031), hypoglycaemia (p = 0.043) and taking insulin (p < 0.001) were associated with worsened HRQoL, whereas practicing self-monitoring of blood glucose (p = 0.002) and taking aspirin (p = 0.008) had a significant association with increased HRQoL. CONCLUSION: This study concluded that the HRQoL of patients was compromised in all five measuring dimensions. The EQ-5D-5L utility and EQ-VAS scores were far lower than other findings. Clinical and medication-related variables, such as a higher BMI, a higher number of medications, the presence of comorbidities and/or complications, hypoglycaemia and insulin use were associated with poor HRQoL in patients with diabetes. As a result, interventions should be individualised and focused on determinant factors.


Assuntos
Diabetes Mellitus , Hipoglicemia , Insulinas , Adulto , Humanos , Qualidade de Vida , Estudos Transversais , Estudos Prospectivos , Glicemia , Etiópia/epidemiologia , Diabetes Mellitus/epidemiologia , Hipoglicemia/epidemiologia , Inquéritos e Questionários , Nível de Saúde
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