Background Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients often excluded from premarketing trials that can further increase the occurrence of DRPs. This study aimed to identify drug related problems and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization. Methods A prospective interventional study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems. Results A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR] = 4.350, 95% C.I: 1.212–9.260, p = 0.020) and number of comorbidities (AOR = 1.588, 95% C.I: 1.029–2.450, p = 0.037). Conclusions Drug related problems were substantially high among geriatric inpatients. Patients with polypharmacy and co-morbidities had a much higher chance of developing DRPs. Hence, special attention is needed to prevent the occurrence of DRPs in these patients. Moreover, clinical pharmacists’ intervention was found to reduce DRPs in geriatric inpatients. The prescriber acceptance rate of clinical pharmacists’ intervention was also substantially high.

ObjectiveThis study aimed to assess the knowledge, attitude and practice of adverse drug reactions (ADRs) reporting and identify factors associated with ADRs reporting among healthcare professionals (HCPs) working in Tigray region, Ethiopia.Materials and methodsA cross-sectional study was conducted between January and March of 2019 in a tertiary care hospital in Tigray region, Ethiopia. A self-administered, pretested questionnaire was administered to HCPs. Data were summarised using descriptive statistics. Logistic regression analysis was used to identify factors associated with poor ADRs reporting practices.ResultsIn total, 362 questionnaires were distributed, and the response rate was 84.8% (n=307). Of all respondents, 190 (61.9%) were nurses, 63 (20.5%) were pharmacist and 54 (17.6%) were physicians. About 58.3% of HCPs had poor knowledge of ADRs reporting. The majority of the respondents had a positive attitude (59.9%), and only a few (32.1%) respondents have good ADRs reporting practices. Poor knowledge (adjusted OR (AOR)=2.63, 95% CI: 1.26 to 5.45) and lack of training on ADRs reporting (AOR=7.31, 95% CI: 3.42 to 15.62) were both negatively associated with ADRs reporting practice, whereas higher work experience (≥10 years) (AOR=0.36, 95% CI: 0.13 to 0.97) was positively associated with ADRs reporting practice.ConclusionsThe majority of HCPs had poor knowledge and practice, but a positive attitude towards ADRs reporting. Poor knowledge, less work experience and lack of training were associated with poor ADRs reporting practice. Hence, strategies to improve the knowledge and practice of ADRs reporting should be implemented, particularly for untrained and less experienced HCPs.

Introduction Healthcare-associated infections (HAIs) have become a serious public health problem. Despite the fact that implementing evidence-based infection control strategies could prevent HAIs and save billions of dollars, Ethiopia lacks national surveillance studies on the rate, economic, and clinical burden of HAIs. Objective To assess the clinical and economic burden of HAIs in hospitalized patients at Ayder comprehensive specialized hospital. Materials and methods A prospective cohort study design was conducted in patients with and without HAIs. A review of medical records, interviews, and patient bills was used to extract necessary information. The patients in the two arms were matched based on age, sex, Charlson comorbidity index, and ward type. Measurable factors were compared between infected and uninfected patients using the paired ttest or McNemar’s test, as appropriate. Logistic regression was used to identify predictors of in-hospital mortality. Stata 14.1 was used to conduct all analyses. Results A total of 408 patients, 204 with HAIs and 204 without HAIs were included in the study. In-hospital mortality was higher in patients with HAI (14.7% vs 7.8%, P = 0.028). Patients with HAI stayed an average of 8.3 days longer than controls (18.85 vs 10.59, P<0.001). The average direct medical costs for patients with HAI were 3033 Ethiopian birrs (ETB) higher than controls (4826 vs 1793, P<0.001). The presence of HAIs (AOR: 2.22, 95% CI: 1.13–4.39) and admission to intensive care units (AOR: 3.39, 95% CI: 1.55–7.40) were significant predictors of in-hospital mortality. Conclusion HAIs have a significant impact on in-hospital mortality, the length of extra hospital stays, and extra costs for medical care. Patients admitted to intensive care units and those with HAIs were found to be significant predictors of in-hospital mortality. Interventions must be implemented to prevent HAIs, especially in patients admitted to intensive care units.

Background : Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization.Methods : A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems.Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037).Conclusions : Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.

Background. Visceral leishmaniasis (VL), one of the most neglected tropical diseases, is placing a huge burden on Ethiopia. Despite the introduction of antileishmanial drugs, treatment outcomes across regions are variable due to drug resistance and other factors. Thus, understanding of VL treatment outcomes and its contributing factors helps decisions on treatment. However, the magnitude and the risk factors of poor treatment outcome are not well studied in our setting. Therefore, our study was designed to assess treatment outcomes and associated factors in patients with VL. Materials and Methods. A cross-sectional study was conducted in VL patients admitted between June 2016 and April 2018 to Ayder Comprehensive Specialized Hospital, Tigray, Northern Ethiopia. Data was collected through chart review of patient records. Logistic regression analysis was used to identify factors associated with poor treatment outcome. Results. A total of 148 VL patients were included in the study. The mean age (SD) of the patients was 32.86 (11.9) years; most of them (94.6%) were male patients. The proportion of poor treatment outcome was 12.1%. Multivariable logistic regression analysis showed that long duration of illness (> four weeks) (adjusted odds ratio (AOR): 6.1 [95% confidence interval (CI); 1.3-28.6], p=0.02) and concomitant tuberculosis (TB) infection (AOR 4.6 [95% CI; 1.1-19.1], p=0.04) were the independent predictors of poor treatment outcome. Conclusions. Poor treatment outcome was observed in a considerable proportion of VL patients. Long duration of illness and coinfection with TB were associated with poor VL treatment outcome. Hence, early diagnosis and effective prompt treatment are important to improve treatment outcomes among VL patients. Special attention should also be given in the treatment of VL/TB coinfected patients in our setting.