Drug-Related Problems and Associated Factors among Patients Admitted with Chronic Kidney Disease at Jimma University Medical Center, Jimma Zone, Jimma, Southwest Ethiopia: A Hospital-Based Prospective Observational Study

Abstract

Background There is an alarming rise of chronic kidney disease prevalence globally associated with significant morbidity and mortality necessitating special attention as one of the major growing public health problems. Medication-related problems are common in hospitalized patients including chronic kidney disease and may lead to increase hospital stay and health care cost and augment the risk of morbidity and mortality. Objective To determine prevalence of medication-related problems and associated factors among chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Methods A hospital-based prospective observational study was conducted among 103 chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Data regarding patient characteristics, medications, diagnosis, length of hospitalization, and laboratory results were collected through review of patients' medical charts. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version 21.0. Univariate and multivariate logistic regression was utilized to assess the associations between dependent and independent variables. Statistical significance was considered at p value <0.05. Results Out of 103 chronic kidney disease patients, 81 (78.6%) of patients had MDRs, on average 1.94 ± 0.873 per patient. The rate of overall MRPs was 30.95 per 100 medication orders. The most common MRPs among CKD patients were need additional drug therapy (62 (31%)), nonadherence (40 (20%)), and dose too low (36 (18%)). The most common cause of need additional drug therapy (52 (26%)) was untreated medical conditions; nonadherence (19 (9.5%)) was mostly due to that the patient/caregiver forgets to take/give the medication, and dose too low (29 (14.5%)) was mostly due to that the dose is too low to produce the desired response. Polypharmacy (AOR = 4.695, 95% CI: 1.370–16.091), number of comorbidities (AOR = 3.616, 95% CI: 1.015–1.8741), and stage of CKD (AOR = 3.941, 95% CI: 1.221–12.715) were independent predictors for MRPs. Conclusions We have demonstrated that medication-related problems are high among chronic kidney disease patients. Marital statuses, stage of CKD, polypharmacy, and comorbidity were independent predictors for MRPs. Interdisciplinary health professionals should work to decrease the high prevalence of MRPs among chronic kidney disease patients.

Medication‐related problems and adverse drug reactions in Ethiopia: A systematic review

“…In addition, two‐thirds of the studies used prospective designs except for Haymen et al, 27 Yohanes et al, 28 Abadir et al, 39 and Hailu et al 29 studies. More than half (n = 10) of the included studies investigated one or more cardiovascular disease conditions, 15,28,32,35,36,39‐42 while Gebre et al, 43 Aster et al 44 and Beshir et al 18 studied ambulatory diabetic patients, hospitalized chronic kidney disease patients, and ambulatory epileptic patients, respectively. Moreover, Haymen et al 27 and Hailu et al 29 targeted ambulatory type II diabetes mellitus patients.…”

“…Only two studies, Mohammednur et al 41 and Beshir et al, 18 reported clinical outcomes of MRPs (Table 2). Further, seven studies 27‐29,42‐45 reported the specific causative agents (drugs) responsible for MRPs.…”

“…Considering disease‐related variables, the number of diagnoses 24,35 and presence of comorbidity 29,32,39,40,44 in specific patients were the commonly identified risk factors of MRPs. In addition, the number of drugs in both nonspecific 20‐22,24,25,35 and specific patients 18,29,36,39,41,42,44 were the frequently reported risk factor of MRPs, while taking zidovudine regimen 16,33,47 was the frequent risk factor of ADRs.…”

Drug-related problems and associated factors in Ethiopia: a systematic review and meta-analysis

“…Of the total included studies, eight studies were conducted in Jimma University Medical Center (JUMC) [26][27][28][29][30][31][32][33], seven were conducted in Tikur Anbesa Specialized Hospital [25,[34][35][36][37][38][39]. Three studies were conducted in Hiwot Fana Specialized University Hospital [40]- [42] and two studies were conducted in Dessie Referral Hospital [43,44].…”

<p>Antimicrobial Drug Therapy Problems Among Patients in the Outpatient Department of Ataye Hospital, Northeast Ethiopia</p>

“…On the other hand, the educational intervention of patients by clinical pharmacists can improve patients' adherence to drug therapy. 11,19 Hence, improving drug therapy has an important effect on the patients' health, treatment costs, and enhancing patients' quality of life. 18 In developing countries, including Ethiopia, antimicrobials are used more frequently than any other drugs for both bacterial and non-bacterial infections.…”