Drug therapy problems and predicting factors among ambulatory epileptic patients in Jimma Medical Center, Southwest Ethiopia

Abstract

BackgroundThe care of epileptic patients is complicated by the cognitive adverse effect of the drug, disease, pharmacokinetics, and pharmacodynamics properties of antiepileptic drugs which in turn intensify the risk of drug therapy problems among epileptic patients.ObjectiveTo assess drug therapy problems and predicting factors among ambulatory epileptic patients at Jimma University Medical Center, Southwest Ethiopia, from September 2020 to May 2021.MethodologyA hospital-based prospective observational study was conducted. A semi-structured questionnaire was used to collect data from patients as well as from charts. Drug therapy problems were identified using Cipolle’s, Morley, and Strand drug therapy problem identification and classification method. Data were entered into Epi data manager version 4.6 and exported to statistical software package for social science version 23.0 for analysis. Multiplestepwise backward logistic regression analysis was carried out to identify predictors of drug therapy problems. The 95% CI was used to show an association between the dependent and independent variables. P-value < 0.05 was considered as statistically significant.ResultsOf the total 320 epileptic patients 224(70.0%) patients had at least one drug therapy problem. A total of 395 drug therapy problems were identified among two hundred twenty-four patients with an average of 1.2 drug therapy problems per patient. The frequently identified drug therapy problems were non-compliance 115(29.11), adverse drug reaction 110(27.84%), and dose too low 103(26%). Getting of a drug by purchasing [AOR = 4.6,95%CI:(2.05–10.7)], poorly involvement of the patients in therapeutic decision making [AOR = 3.02,95%CI:(1.5–6.06)], the number of medications ≥ two [AOR = 5.3,95%CI:(1.2–22.9)] and having had uncontrolled seizure [AOR = 10.9,95%CI:(4.9–24.2)] were independent predictors of drug therapy problems.ConclusionsDrug therapy problems were common among epileptic patients in the study area. Patients who were getting their drugs by purchasing, poorly involved in therapeutic decision making, having had an uncontrolled seizure, and taking two and above drugs were more likely to experience drug therapy problems. Therefore, due attention should be given to patients with the aforementioned problems to decrease the occurrence of drug therapy problems and improve overall outcomes among epileptic patients.

Variation of adverse drug events in different settings in Africa: a systematic review

“…These studies were carried out in 14 African countries, including Nigeria (8), Morocco (1), Uganda (6), South Africa (3), Tanzania (1), Ethiopia (15), Ghana (2), Kenya (3), Cameroon (4), Mali (2), Malawi (1), Namibia (2), Zimbabwe (1) and Eritrea (2). Thirty-two studies [ 45 – 48 , 50 , 52 , 54 , 56 , 58 , 59 , 62 , 64 – 70 , 72 , 74 , 78 , 80 , 82 – 86 , 88 , 90 , 91 , 93 , 94 ] were carried out at a single center, 15 studies [ 49 , 51 , 55 , 57 , 60 , 61 , 63 , 71 , 73 , 76 , 79 , 87 , 89 , 92 , 95 ] were conducted at a multi-center, and four studies [ 53 , 75 , 77 , 81 ] were conducted in the community setting. The community setting comprised home settings, community health facilities, and drug outlets.…”

“…The community setting comprised home settings, community health facilities, and drug outlets. Sixteen studies [ 48 , 53 , 56 , 57 , 60 , 65 , 69 , 72 , 75 , 79 , 82 – 84 , 88 , 91 , 92 ] were conducted prospectively, 20 studies [ 45 – 47 , 49 , 51 , 61 , 62 , 64 , 66 , 67 , 71 , 73 , 78 , 80 , 81 , 85 , 87 , 89 , 93 , 94 ] were conducted retrospectively, and 12 studies [ 50 , 52 , 55 , 58 , 59 , 68 , 70 , 76 , 77 , 86 , 90 , 95 ] used the cross-sectional study design. Gudina et al [ 63 ] used both retrospective and prospective study designs, Bahta et al [ 54 ] used both cross-sectional and analytical study designs while Namulindwa et al [ 74 ] used mixed design study.…”

“…In addition, three studies [ 53 , 75 , 77 ] focused on malaria patients. Beyene et al [ 56 ] and Shegena et al [ 88 ] targeted epileptic patients and heart failure patients, respectively. A Ugandan study [ 65 ] examined antibiotic-associated suspected ADR among hospitalized patients, while a Nigerian study [ 81 ] evaluated ADE to ivermectin.…”

Pattern of anti-epileptic medications nonadherence and associated factors at ambulatory clinic of Jimma Medical Center, Southwestern Ethiopia: A prospective observational study

“…In Ethiopia, the most frequently used AEDs are old generations like Phenytoin and Phenobarbital which are associated with higher ADR that may lower the level of adherence. 35 …”

Antiseizure adverse drug reaction and associated factors among epileptic patients at Jimma Medical Center: a prospective observational study

“…Data were collected through the patient interview and medication chart review. The data collection tools were prepared after reviewing relevant kinds of literature and modified to address the objectives of this study 9 , 23 – 26 . Patients were interviewed after leaving the physician’s office for medication refills.…”