Objective and background In 2015 approximately 5.0 million people were estimated to have died from diabetes. Poor glycemic control is the most determinant of diabetes-related complication and death. The percentage of patients whose blood glucose level are not well controlled remains high yet. The aim of this study is to identify the determinants of poor glycemic control at the diabetes clinic of the Jimma University Medical Center from April 01 to June 30/2017. Methods Facility-based case-control study design was conducted on patients with type 2 diabetes mellitus on follow-up at the diabetes clinic of Jimma University medical center. The consecutive sampling technique was employed and data were collected from April to June 2017. The data were entered using Epidata manager version 4.0.2 and exported to SPSS Version 21 for analysis. Logistic regression analysis was performed and variables with the p -value of less than 0.05 were considered as statistically significant determinants of poor glycemic control. Result The study was conducted on 410 patients, of which 228 males and 182 females. The determinants of poor glycemic control were comorbidities [Adjusted odd ratio(AOR) = 2.56, 95%CI = 1.10–5.96], lack of self-monitoring blood glucose [AOR = 3.44,95%CI = 1.33–8.94], total cholesterol level of 200 mg/dl or more [AOR = 3.62, 95%CI = 1.46–8.97], diabetes duration of greater than 7 years [AOR = 3.08, 95%CI = 1.33–7.16], physical activity of three or less than three days [AOR = 4.79, 95%CI = 1.70–13.53], waist to hip ratio of 0.9 or greater for male and 0.85 or greater for female [AOR = 3.52, 95%CI = 1.23–10.11], being on metformin plus insulin [AOR = 9.22, 95%CI = 2.90–29.35] and being on insulin [AOR = 4.48, 95%CI = 1.52–13.16]. Conclusion Lack of Self-monitoring blood glucose, presence of comorbidities, duration of diabetes mellitus, physical activity of three or less than three days, total cholesterol of 200 mg/dl or more, waist to hip ratio of 0.9 or greater for male and 0.85 or greater for female, and types of antidiabetic medication were the independent predictors of poor glycemic control. Effort should be made towards reducing these factors by the concerned body.
Background. Epilepsy is among the most common neurological disorders which is highly treatable with currently available antiepileptic drugs at a reasonable price. In Ethiopia, despite a number of studies revealed high prevalence of epilepsy, little is known on predictors of poorly controlled seizures. us, the aim of this study was to assess epilepsy treatment outcome and its predictors among patients with epilepsy on follow-up at the ambulatory care unit of Mizan-Tepi University Teaching Hospital, Southwest Ethiopia. Methods. A hospital-based cross-sectional study involving patient interview and chart review was conducted from March 10 to April 10, 2018. Drug use patterns and sociodemographic data of the study participants were accustomed to descriptive statistics. Backward logistic regression analysis was done to identify predictors of poor seizure control. Statistical significance was considered at p value <0.05. Results. From a total of 143 studied patients with epilepsy, 60.8% had uncontrolled seizures. Monotherapy (79%) was commonly used for the treatment of seizures, of which phenobarbital was the most commonly utilized single anticonvulsant drug (62.9%). e majority (72.7%) of the patients had developed one or more antiepileptic-related adverse effects. Medium medication adherence (adjusted odds ratio (AOR) � 5.4; 95% CI � 1.52-19.23; p � 0.009), poor medication adherence (AOR � 8.16; 95% CI � 3.04-21.90; p � 0.001), head injury before seizure occurrence (AOR � 4.9; 95% CI � 1. 25-19.27; p � 0.02), and seizure attacks ≥4 episodes/week before AEDs initiation (AOR � 8.52; % CI � 2.41-13.45; p � 0.001) were the predictors of uncontrolled seizure. Conclusions. Based on our findings, more than half of the patients with epilepsy had poorly controlled seizures. Nonadherence to antiepileptic drugs, high frequency of seizure attack before AEDs initiation, and history of a head injury before the occurrence of seizure were predictors of uncontrolled seizure. Patient medication adherence should be increased by the free access of antiepileptic drugs and attention should be given for the patients with a history of head injury and high frequency of seizure attacks before AEDs initiation.
Objective The aim of this study was to assess determinants of poorly controlled asthma among asthmatic patients on follow up at Jimma University Medical Center, Southwest Ethiopia. A facility based case control study involving chart review and patient interview was conducted from April 01/2017 to May 30/2017. Consecutive sampling method was used to select 121 cases and 121 controls. Descriptive statistics were used to present socio demographic data and drug prescription pattern while logistic regression was used to identify predictors of poorly controlled asthma. Results From a total of 242 studied asthmatic patients, 52.9% of controls and 44.6% of cases were males. Poor knowledge about asthma [Adjusted odd ratio(AOR) = 7.30; 95% confidence interval (CI) 1.72–30; P = 0.007], negative attitude about asthma [AOR = 5.10; 95% CI 1.40–18.7; P = 0.014], moderate asthma [AOR = 13.47; 95% CI 2.69–47.23; P = 0.002] and non-adherence to inhaled corticosteroid (ICS) [AOR = 8.52%; 95% CI 2.41–13.45; P = 0.001] were determinants of poorly controlled asthma. Electronic supplementary material The online version of this article (10.1186/s13104-019-4571-y) contains supplementary material, which is available to authorized users.
Background: Drug therapy problems (DTPs) are of major concern in health care because of the associated increased cost of treatment, morbidity, and mortality. Thus, clinical practice should constitute the mainstream practice of clinical pharmacy in every ward. However, nothing is known about DTPs and the role of clinical pharmacist in the surgical ward of Ethiopia (the neglected ward). Objective: To assess the prevalence of DTP among patients hospitalized at the surgical ward and the role of clinical pharmacists in their identification and resolution. Methods: Hospital-based prospective observational and interventional study design was used with daily patients' chart review using a semi-structured questionnaire among hospitalized adult patients at the surgical ward. After identification of DTP, verbal communication was used as a means of intervention with the treating physician. Acceptance of clinical pharmacist's intervention was considered only if a change was made to the patients' medication order. To identify determinants of DTPs, multiple stepwise forward logistic regression analysis was done by SPSS version 20.0. Statistical significance was considered at p-value < 0.05. Written informed consent was sought and the data were secured. Results: The response rate was 97.1% (300) for the final analysis. The mean (±SD = standard deviation) age of the participants was 42.62 ±18.29 with male (67%) predominance. DTP was identified in 76% of study participants. A total of 449 DTPs were identified, which equates with an average of 1.97 per patient. Dose too low 124/449 (27.6%) and dose too high 81/449 (18.0%) were found to be the most common types of DTPs. The intervention rate was 86.0% (196/228 per patients) and 86.2% (387/449 DTPs), with the acceptance rate of 85.2% (167/196 per patients) and 78% (302/387 per DTP) which mean (67.3%) 302/449 of the problems were fully resolved by the clinical pharmacist. Poly-pharmacy [AOR, 7.23; 95% CI, 2.29-22.13: P-value < 0.001] and hospital stay > 20 days [AOR, 5.42; 95% CI, 2.74-10.70; p < 0.001] were the only independent predictors for DTPs. Conclusion and Recommendation: This study identified a high prevalence of DTP which was independently predicted by the presence of poly-pharmacy and >20 days of hospital stay. The rate of intervention provided and acceptance from the physician was high, which is one indicator that the role of clinical pharmacists in the identification and resolution of DTP was paramount in the surgery ward and should be implemented as a must not as optional.
Background: Over the past two decades, the prevalence of diabetes has increased faster in low-and middle-income countries than in high-income countries. Regardless of the instant growth in the prevalence of diabetes in Ethiopia, up-to-date data regarding glycemic control and related complications of diabetes is inadequate. This study aimed to identify glycemic control and chronic complications and their determinants among ambulatory diabetic patients at Mizan-Tepi University Teaching Hospital (MTUTH). Methods: We conducted facility-based cross-sectional study from February 25 to March 25, 2019, at Mizan-Tepi University Teaching Hospital. Patients' demographic data, diabetes complications, and treatments were collected using pretested questionnaire and data abstraction format. Data was entered by using Epidata manager 4.0.2.101, and statistical analysis was done by SPSS version 21. Bivariate logistic regression was done to see the association between independent variables and glycemic control and complication. Multivariable logistic regression analyses using backward selection were done to identify the predictors of poor glycemic control and complication at a P-value of <0.05. Results: One hundred ambulatory diabetic patients were included in this study. The mean duration of diabetes and the mean age of the participants were 3.95±5.85 and 46.66±15.53 years, respectively. About 71 (71%) of the studied diabetic patients had uncontrolled fasting blood glucose (FBG) level. More than half of the diabetic patients (59%) developed chronic complications of diabetes. Low medication adherence (adjusted odds ratio (AOR)=11.78, 95%CI: 1.09-17.17) and inappropriate doses in the first, second, and third clinic visits (AOR=7.70, 95%CI: 1.79-33.01; AOR=8.09, 95%CI: 1.90-34.33; AOR=4.34, 95%CI: 1.-09-17.17), respectively, were independent predictors of uncontrolled FBG. No variable was found to be an independent predictor of chronic diabetic complication on multivariable logistic regression analyses. Conclusion: Poor glycemic control and diabetes complications among ambulatory diabetic patients were high. Low medication adherence and inappropriate doses in the first, second, and third clinic visits were independent predictors of poor glycemic control.
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