Background: Drug-drug interaction is an emerging threat to public health. Currently, there is an increase in comorbid disease, polypharmacy, and hospitalization in Ethiopia. Thus, the possibility of drug-drug interaction occurrence is high in hospitals. This study aims to summarize the prevalence of potential drug-drug interactions and associated factors in Ethiopian hospitals. Methods: A literature search was performed by accessing legitimate databases in PubMed/MEDLINE, Google Scholar, and Research Gate for English-language publications. To fetch further related topics advanced search was also applied in Science Direct and HINARI databases. The search was conducted on August 3 to 25, 2019. All published articles available online until the day of data collection were considered. Outcome measures were analyzed with Open Meta Analyst and CMA version statistical software. Der Simonian and Laird's random effect model, I 2 statistics, and Logit event rate were also performed. Results: A total of 14 studies remained eligible for inclusion in systematic review and meta-analysis. From the included studies, around 8717 potential drug-drug interactions were found in 3259 peoples out of 5761 patients. The prevalence of patients with potential drug-drug interactions in Ethiopian hospitals was found to be 72.2% (95% confidence interval: 59.1, 85.3%). Based on severity, the prevalence of major, moderate, and minor potential drugdrug interaction was 25.1, 52.8, 16.9%, respectively, also 1.27% for contraindications. The factors associated with potential drug-drug interactions were related to patient characteristics such as polypharmacy, age, comorbid disease, and hospital stay. Conclusions: There is a high prevalence of potential drug-drug interactions in Ethiopian hospitals. Polypharmacy, age, comorbid disease, and hospital stay were the risk factors associated with potential drug-drug interactions.
Poor prescribing pattern is observed and become a serious problem in the world including developing countries. In Ethiopia, several studies showed that health care institutions did not meet WHO prescribing indicators and the prescribing pattern is not satisfactory in the health care institutions. This study aimsto review the prescribing pattern of medications prescribed to outpatients based on WHO prescribing indicators in Ethiopia. Literature search was performed through PubMed/MEDLINE, Google Scholar, and Research Gate from July 5-30, 2019. A standard data extraction format was used to collect important data from the included studies. Open meta analyst advanced software was used for analyses of the pooled estimate of outcome measures and subgroup analysis. Der Simonian and Laird's random-effect models were applied for the analyses at 95% confidence level. I 2 statistics were used to assess heterogeneity of studies. The presence of publication bias was assessed with comprehensive meta-analysis version 3 software and presented with a funnel plot. P-value of less than 0.05 was considered as statistically significant. The results revealed that a total of 13 studies with 33,567 drugs from 15,305 prescriptions were included for systematic review and meta-analysis. The results of prescribing indicators were 1.96, 93.0, 36.2, 18.3 and 94.8% for average number of drugs per prescription, percentage of drugs prescribed by generic name, percentage of drugs encounter with antibiotics, percentage of drugs encounter with injection and for the percentage of medicines prescribed from essential drug list respectively. Therefore, the prescribing pattern of Ethiopia is below WHO standard level.
Objectives In Africa, antipsychotic polypharmacy is growing high due to a high antipsychotic dose prescribing, repeated psychiatric hospitalization, uncontrolled psychotic symptoms, and greater side effect burden. Therefore, the aim of this review and meta-analysis is to assess the prevalence and correlates of antipsychotic polypharmacy among patients with schizophrenia in Africa Methods A systematic search was performed from August 1 to 31, 2020 on PubMed, MEDLINE, Google Scholar and Science Direct databases to select articles based on the inclusion criteria. Meta-Analysis of Observational studies in Epidemiology (MOOSE) guidelines were employed. Cross-sectional observational studies which report antipsychotic polypharmacy and/or its correlates in schizophrenia patients in English language published in a peer reviewed journals without time limits were included in the review. The quality of included articles was assessed using Newcastle-Ottawa quality assessment tool. Prevalence and correlates of antipsychotic polypharmacy were the outcome measures of this review and meta-analysis. Open Meta Analyst and RevMan version 5.3 software were used for meta-analysis. A random effect model was used to synthesize data based on the heterogeneity test. Results Six studies which involve 2,154 schizophrenia patients met the inclusion criteria in this review and meta-analysis. The quality of included studies ranges from 6.5 to 10 based in Newcastle-Ottawa quality assessment tool. The pooled prevalence of antipsychotic polypharmacy among patients with schizophrenia was 40.6% with 95% confidence interval: 27.6% to 53.7%. Depot First Generation Antipsychotics and oral First Generation Antipsychotics were the most commonly prescribed antipsychotic polypharmacy combinations. Socio-demographic, clinical and antipsychotic treatment characterstics were significantly associated with antipsychotic polypharmacy. There was a wide variation in the correlates of antipsychotic polypharmacy assessed by studies and the way that association/correlations was determined and reported. Conclusions Antipsychotic polypharmacy is common and highly prevalent. Advanced age, male gender, longer duration of schizophrenia, hospital admission and longer antipsychotic treatment were correlates of antipsychotic polypharmacy in Africa.
Background Currently, the private healthcare sector's role in healthcare delivery is growing in Ethiopia. However, there are limited studies on private healthcare sector drug use patterns. This study aimed to evaluate the private healthcare sector prescribing practices and adherence to prescription format, using some of the World Health Organization (WHO) core drug use indicators in Addis Ababa, Ethiopia. Methods A retrospective cross-sectional study design was used to collect quantitative data from prescriptions prescribed and dispensed by private healthcare sectors in the Lemi-Kura sub-city, Addis Ababa. The study was conducted from June to July 2021. The WHO criteria were used to evaluate prescribing and prescription completeness indicators. Prescriptions, kept for the last 1 year that were prescribed between January 1, 2020, to January 1, 2021, by private drug outlets, were analyzed. Simple random and systematic sampling procedures were employed in selecting drug outlets and prescriptions, respectively. Results Of a total of 1,200 prescriptions, 2,192 drugs were prescribed and the average number of drugs per prescription was 1.83. Generic names, antibiotics, injections, and drugs on the Ethiopian essential medicines list accounted for 77.4, 63.8, 11.5, and 80.6% of all prescriptions, respectively. Among the patient identifiers, the patient card number (54.3%), weight (2.3%), and diagnoses (31.7%) were less likely to be completed. In terms of the drug-related information, the dosage form (35.5%) was the least likely to be completed. Only 36.6 and 25.8% of prescriptions contained the names and qualifications of the prescribers, respectively. It was difficult to obtain prescription papers with the dispenser identifier. Conclusion The study findings indicated prescribing and prescription completeness indicators all considerably deviated from WHO standards and hence unsuitable. This situation could be critical since a similar pattern is reported from public healthcare sectors, which might imply the extent of non-adherence to WHO core drug use standards. Consequently, it could play a considerable role in increasing irrational medicine use in Ethiopia.
Objective: There is a high prevalence of inadequate dose adjustment among inpatients with renal insufficiency worldwide. There is, however, a paucity of studies that summarizes the topic in the African context. Therefore, this study aims to summarize the prevalence of inappropriate drug dose adjustment (IDDA) and associated factors among inpatients with renal impairment in Africa. Methods: A literature search for English-language articles was conducted using reputable databases such as PubMed/MEDLINE, Google Scholar, and Science Direct. The search was carried out between 3 February and 3 March of 2022. All published articles that were online at the time of data collection were considered. Observational studies that examined the prevalence of IDDA for any type of drug in renal impairment as a primary or secondary outcome were included in our analysis. Statistical software such as Open Meta Analyst and Review Manager were used to examine outcome measures. I2 statistics, Logit event rate, and Der Simonian and Laird’s random effect models were also used. Results: Seven articles were qualified for the systematic review and meta-analysis. All included studies comprised a total of 1918 patients. A total of 5072 prescriptions were assessed, and 1879 (37%) of them had at least one drug that required a dose adjustment. The pooled prevalence of IDDA among adult patients with renal impairment was 13.7% (95% confidence interval (CI) = 7.9%–19.5%) in Africa. Based on the number of prescriptions containing medications that required dose adjustment, the pooled prevalence accounts for 39.3% (95% CI = 24.1%–54.4%) (932/1879). Factors associated with inappropriate drug prescribing and usage concerning renal function were the number/types of prescribed medicines (most common), age, stage of renal impairment, comorbidity, and unemployment. Conclusions: In this study, IDDA practice appears to be a common challenge among inpatients with renal insufficiency in Africa. The number and type of medications prescribed, age, stage of renal impairment, comorbidity, and unemployment were factors associated with inappropriate drug prescribing and use. In addition to expanding such studies, hospitals across Africa must conduct research on the clinical outcomes of IDDA practices in patients with renal impairment.
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