Drug‐Related Hospital Admissions and Associated Factors among Adults Admitted to Felege Hiwot Comprehensive and Specialized Hospital, North West Ethiopia

Abstract

Background. A drug-related problem (DRP) is an event involving drug therapy that actually or potentially interferes with the desired therapeutic outcome. Drug-related hospital admission (DRHA) is hospitalization due to one or more DRPs. Objective. This study was aimed at assessing the prevalence of DRHA and factors associated with it among adults admitted to the internal medicine wards of Felege Hiwot Comprehensive Specialized Hospital. Methods. A prospective cross-sectional study was conducted using a previously validated tool, AT-HARM 10. Data were collected by two clinical pharmacists from July 1 to September 15, 2020. The data were entered into EpiData software (version 4.2.0.0) and then transported to Statistical Package for Social Sciences (SPSS®) software (version 24) (IBM Corporation) for analysis. Descriptive statistics were presented using frequency and proportion. Binary logistic regression was applied to identify factors associated with DRHAs with a 95% confidence level, and significance was declared at a p value <0.05. Results. The prevalence of DRHAs was 31.9% (95% CI = 27.7%–36.4%). From this, noncompliance (37.8%) (95% CI = 29.6–45.9), untreated indication (31.9%) (95% CI = 23.7–40), and adverse drug reaction (15.6%) (95% CI = 9.6–21.5) cause the majority of DRHAs. More than a quarter (28.8%) of all admissions were preventable. Most DRHAs were moderate (76.3) and preventable (80.7%). Lower to medium Charlson comorbidity index scores, longer duration of therapy, and not having health insurance were significantly associated with DRHAs. Conclusion. The prevalence of DRHAs was considerably high. Noncompliance, untreated indications, and adverse drug reactions were the commonest DRPs that caused DRHAs. Lower to medium Charlson comorbidity index scores, longer duration of therapy, and not having health insurance were significantly contributing factors of DRHAs. Therefore, all healthcare providers should prevent, identify, and resolve DRPs to decrease DRHAs in the hospital.

Un miembro del personal de la Building Foundation for Development ayuda a preparar suministros para su entrega a instalaciones sanitarias y campos de desplazados en Al Jazirah (Sudán), que actualmente acoge a desplazados internos que huyen del conflicto en Jartum (Sudán).

“… 20 Diabetes was classified using random glucose measurement (≥ 200 mg/dL) in one study, 58 and ascertained from medical notes in all other studies ( Table 1 ). Diabetic emergencies were observed in 4.8% (95% CI: 2.7–8.4; eight studies) 48 , 60 , 81 , 86 , 87 , 92 , 94 , 95 of medical patients and 3.4% (95% CI: 1.3–8.7; five studies) 58 , 75 , 83 , 97 , 98 of emergency department patients ( Fig. 2 ).…”

“…The prevalence of stroke admissions was 6.8% (95% CI: 4.7–9.6; 17 studies) 41 , 48 , 53 , 55 , 57 , 59 , 70 , 73 , 74 , 81 , 84 – 87 , 91 , 94 , 95 in medical settings, and 5.4% (95% CI: 2.8–10.2; five studies) 54 , 75 , 88 , 93 , 98 in emergency departments. Of these 22 studies, eight used radiological imaging to confirm the diagnosis.…”

Medication-Related Hospital Admission Among Patients Admitted to the Emergency Ward at the University of Gondar, North West Ethiopia: A Cross Sectional Study

“…MRHA: If patient’s medical record at admission was stated as medication-related or if the patient is admitted due to one or more DRPs including (non-compliance, untreated indications, improper drug selection, subtherapeutic dosage, failure to receive drugs, overdosage, ADRs, drug interactions, and drug use without indication. 17 , 18 Non-MRHA: If the admission was caused by an infection or a previously undiagnosed disease, progression of a previously diagnosed disease that is not medication-related, physical trauma, substance intoxication and social circumstances or allergies that are not medication-related. 19 …”

“…Not preventable: If the mediation-related event could not have been avoided by any reasonable means, or it was an uncertain occurrence in the course of treatment fully in congruence with good medication utilization. 18 , 20 …”

Drug-related problems among esophageal, gastric and colorectal cancer patients at the National and referral hospital in Kenya

“…4 However, a substantial proportion of DRPs are potentially preventable. [5][6][7][8] A previous study by Chan et al 9 demonstrated that most (94.5%) DRP-related hospital admissions were due to adverse drug reactions. The average mortality rate among hospitalised patients due to DRPs is 2.7%.…”