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OBJECTIVE: A pronounced burden is evident in individuals with asthma, with approximately half of them not adhering to their prescribed medication. Therefore, this study aimed to assess the pooled prevalence of anti-asthma medications non-adherence in Ethiopia. DATA SOURCES: A comprehensive search was conducted across multiple electronic databases including PubMed, Africa Index Medicus, Science Direct, Hinari, and a search engine, Google Scholar from October 5 to 20, 2023. In addition, digital research repositories from Addis Ababa and Bahir Dar University were accessed. DATA SELECTION: The eligibility criteria was employed to screen studies after uploading search results to EndNote software to remove duplicates first. Then, two investigators, CT and BBT, independently assessed titles, abstracts, and the full text of all retrieved references to identify potentially eligible studies. RESULT: This meta-analysis, which was conducted in Ethiopia, and included 11 full-text articles, revealed a pooled asthma medication non-adherence level of 51.20% (95% CI 35.20%, 67.20%) with substantial heterogeneity (I2 = 99.08%). The review has also identified factors predicting non-adherence among asthmatic patients: free (health service) (AOR: 0.31, 95% CI 0.18-0.54), poor knowledge (AOR: 2.85, 95% CI 1.61-5.05), absence of formal education (AOR: 3.01, 95% CI 1.72-5.25), history of previous ADR (AOR: 8.57, 95% CI 1.12-65.3), and the presence of Co- morbidity(AOR: 3.28, 95% CI 2.014-5.68), had shown association with asthma medication non-adherence. CONCLUSION: Asthma medication non-adherence is notably high in Ethiopia. Addressing medication non-adherence requires a comprehensive approach, including clear communication between healthcare providers, patient education, and addressing financial barriers to ensure better adherence in asthma patients.
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Background: Opioid use is a major global public health problem, affecting 16 million individuals worldwide. According to a 2023 WHO report, out of the 600,000 substance-related deaths worldwide, 80% were attributed to opioid use. Pharmacists play a vital role in reducing unnecessary opioid exposure while facilitating access to non-opioid alternatives. To do so, pharmacists should have sufficient knowledge regarding opioid-containing medications and a positive attitude about opioid use problems. Objective: This study aimed to evaluate community pharmacists' knowledge of opioid-containing medications and their attitude toward opioid use problems. Materials and methods: A cross-sectional study was conducted using a self-administered, structured questionnaire distributed to 105 community pharmacists from July 1-30, 2023 in Bahir Dar City, Ethiopia. The tool included demographic information and questions designed to assess participants' knowledge and attitudes. Results: Out of the 105 pharmacists included in this study, majority were males (54.3%), nearly half held a bachelor's degree (49.5%), and slightly above one-third had over a decade experience (39%). Regarding knowledge and attitude towards opioids, 62 individuals (59%) exhibited good knowledge, and 64 (61%) demonstrated less stigma toward opioid usage. Factors affecting knowledge include: education level (AOR (95% CI): 8.43 (1.76-40.35) and 9.93 (1.04-85.33) for bachelors and postgraduates respectively and age 1.45 (1.20-1.77)]. Meanwhile, experience [AOR (95% CI): 4.64(1.20-17.90) and 4.29 (1.23-15.05)] for 5-9 years and ≥10 years respectively and education level [AOR (95% CI): 4.08 (1.40-11.93) for bachelors and 6.40 (1.42-28.96)] for postgraduates were linked to attitude. Conclusion: A gap in knowledge and more stigmatizing behavior was observed among community pharmacists. These findings imply the importance of tailored educational interventions to address knowledge gaps and promote positive attitudes toward opioid usage among community pharmacists. Therefore, it is imperative to deliver up-to-date information on opioids, emphasizing their high addiction potential, to ensure pharmacists are well-equipped with the latest information.
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Background: Medicines are maintained at home for several reasons. However, irrational household storage of medicines is a universal public health problem, causing significant harm to health and the healthcare system. Objective: This study aimed to assess home drug use and storage practices among the residents of Bahir Dar. Town, Ethiopia. Method: A cross-sectional household study was conducted in three sub-cities of the town of Bahir Dar from July to October 2022. Multistage stratified sampling was used to select the households included in the study. Data on the prevalence of home drug storage, storage place, and self-medication practice, among others, were collected using a semi-structured questionnaire and analyzed using Statistical Package for Social Science version 20. Results: More than half (57.9%) of the respondents stored medicines at home, mostly in drawers (35%). In this study, the widespread use of self-medication (44.6%) and drug-sharing practices (25%) were observed. Most of the leftover medicines (67.3%) were disposed of in the trash. Education status (AOR=3.8, 95% CI: 1.6-9.1), occupation (AOR=2.9, 95% CI: 1.2-7.2), income (AOR=1.73, 95% CI: 1.01-3.0), and the presence of chronic disease (AOR=3.2, 95% CI: 1.7-5.9) showed a significant association with home drug storage. Conclusion: Many study participants stored medications at home and bought them from pharmacies without consulting physicians. Disposing of medications into waste and practice of medication sharing were found to be high in the current study, suggesting that there is a lack of home drug utilization and storage practices by the general public.
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Introduction: The concept of quality in higher education is highly complex, difficult to define, and multi-dimensional and education is a cornerstone of a nation's development and quality is at the heart of education. Thus, the study aimed to assess the quality of education at Bahir Dar Health Science College, BahirDar, Ethiopia, 2021. Methods: A mixed method approach was employed from May 1- June 30, 2021. Systematic random sampling and purposive sampling methods were used to collect quantitative and qualitative data respectively. Self-administered questionnaires and in-depth key informant interviews were conducted. The data were analyzed via stata 14 and presented by descriptive frequencies and tables. Thematic analysis was employed for qualitative data. Results: Most instructors 26 (59.1%) are not satisfied with library services and 33 (75%) of them did not conduct a research project or participate in any community services. The findings also stated that the college has made its level best to improve the quality of education via the implementation of continuous assessment, active learning approach, remedial and affirmative action and training. Regarding students, half of them 166 (50.6%) are not comfortable with the college environment. Students were also greatly grouchy the services delivered in the college such as cafeteria, dormitory, student clinic and guidance and counseling. Conclusion: The study found out that there is a relatively low level of satisfaction among both groups and the quality of education is below the acceptable level. Therefore, the college should create an opportunity to engage in national and regional networks to share best practices in quality education and it requires the office to develop the capacity of their services.
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Introduction: Low-dose aspirin or clopidogrel, statins, renin-angiotensin system inhibitors, and beta blockers are the cornerstone therapy for cardiovascular prevention in patients with coronary heart disease. Using only single-antiplatelet therapy for secondary prevention in patients with stable coronary artery disease (SCAD) and/or peripheral artery disease (PAD) has a significant risk of recurrent thrombotic complications. Objective: This systematic review aimed to compare aspirin alone and its combination with rivaroxaban for secondary cardiovascular prevention in patients with SCAD and/or PAD. Methods: The literature search was conducted on PubMed, ClinicalTrials.gov, Cochrane Library, and Google Scholar for articles published from November 2011 to September 2021. An advanced search strategy was used to retrieve relevant studies related to aspirin and/or rivaroxaban use for secondary cardiovascular prevention in patients with SCAD and/or PAD. Records identified from the databases were extracted using a data-abstraction format prepared in Microsoft Excel. Studies' methodological quality was assessed using the Cochrane risk-of-bias tool for randomized trials. This systematic review is registered in PROSPERO (CRD42022306598) and was prepared based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Results: A total of five randomized controlled trials (RCTs) with 33,959 participants were included for final analysis. These studies showed that rivaroxaban with aspirin was more effective than the standard therapy of aspirin alone in the prevention of secondary cardiovascular events (major adverse cardiovascular events (MACEs) and/or major adverse limb events (MALEs), but the combination increased major bleeding. Conclusion: The combination of rivaroxaban with aspirin is more effective than aspirin alone in the prevention of both MACEs and MALEs in patients with stable CAD and/or PAD. However, the combination treatment is associated with increased of major bleeding. Therefore, the combination of rivaroxaban and aspirin is superior to monotherapy in the management of patients with a high risk of developing MACEs and MALEs.
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INTRODUCTION: Irrational medicine use is a global problem, and one of its manifestation is inappropriate prescribing that occurs when medicines are not prescribed in accordance with the guideline. OBJECTIVE: The aim of the study was to assess prescription completeness and drug use pattern of the hospital using the WHO core drug use indicators. METHODS: 1000 prescriptions were collected retrospectively from prescriptions written for 1 year from outpatient pharmacies of the hospital. Exit interview was employed to assess patient care indicators. The health facility indicators were checked by assessing the presence of drug formulary and availability of key medicines at the facility. Data were analyzed using SPSS version 20. RESULTS: It was found that only name of the patients was filled in all the prescriptions. Other informations were below the standard. The average number of drugs per prescription was 1.65. Percentages of encounter by generic name, with antibiotic and injections, were 85.78%, 41%, and 25%, respectively. The percentage of drugs prescribed from an essential drug list was 98.48%. The mean consultation time and dispensing time were 14.49 and 2.16 minutes, respectively. More than half patients had knowledge on drug dispensed to them (68%). The percentage of drugs actually dispensed was 65%, but none of the drugs dispensed were adequately labelled. A copy of EDL and 84% of the key drugs were available in the hospital. CONCLUSION: From the results of our study, it can be concluded that all prescriptions were not complete, and except the average number of drugs prescribed per encounter, the other drug use pattern indicators were out of the WHO recommendation. Therefore, effective intervention program, like training, for promotion of rational drug use practice was recommended.