Exit-Knowledge of Ambulatory Patients About Medications Dispensed in Government Hospital in Eastern Ethiopia: The Need for Focused Patient Counseling

Abstract

Background: In the counseling process, a multi-cultural competence of dispenser is among the key factors affecting his/her successful communication with patients for achieving optimal use of medications. For patients to use dispensed drugs appropriately, it is a must for them to understand the medication related information provided by the dispenser. Hence, the objective of this study was to identify parameters that likely affect ambulatory patients' knowledge of medication(s) provided at the exit of outpatient pharmacy of Federal Harar Police Hospital, Eastern Ethiopia.Methods: Cross-sectional study design was employed to conduct this study. An interview of patients was made at the exit of hospital pharmacy using a semi-structured questionnaire. The interview tool primarily assessed the knowledge of the patients for a maximum of three medications provided. Statistical Package for Social Sciences (SPSS), Version 20.0, was employed for analysis of the data. Chi-squared test was done to retain parameters with potential to have association; and the retained parameters were adjusted by performing bivariate and multivariate logistic regression analyses.Results: The result showed that only 37.2, 33.4 and 28.7% of the patients were able to recall the name of the drug(s), common side effects, and actions to be taken for missed doses, respectively. The likelihood of patients' knowledge for dispensed medications was high among patients aged 19–39 years (adjusted odds ratio [AOR]: 5.0; 95% CI: 1.04–24.2) and who thought their communication with dispenser had been polite (AOR: 4.62; 95% CI: 1.48–14.4). However, the knowledge status was found low among patients who were Afan Oromo speakers (AOR: 0.58; 95% CI: 0.35–0.95) and who came from rural residence (AOR: 0.48; 95% CI: 0.25–0.90).Conclusion: A high proportion of patients were unable to recall the drug (s) name, associated common toxicities, and actions to be taken in case of missed dose. In addition, patients who were at early adulthood and who were positive for the politeness of dispenser had better exit-knowledge of their medication. Therefore, for the patients' clear understanding of medications provided, it is mandatory to optimize patient–dispenser communication possibly by adapting multi-cultural communication skills and by providing focused training for dispensers to address factors that likely affect patient-dispenser interactions.

<p>Exit-Knowledge About Dispensed Medications and Associated Factors Among Ambulatory Patients Attending Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia</p>

“…18,27 Overall, 81% of patients had sufficient exit-knowledge regarding their dispensed medications. This finding was higher than the studies conducted; in Eastern Ethiopia 38.6% 26 and in Hiwot Fana University Specialized Hospital 46%. 27 Additionally, a study conducted in Gondar, Ethiopia revealed that 38.3% of patients were found to have good knowledge on their medications 25 and a study from the rural Gambia showed that 16.1% of patients had good knowledge on their dispensed drugs.…”

“…Our finding is relatively comparable with a study conducted in Eastern Ethiopia, which showed that majority of the participants (89.2%, 82.5%, 72.3%, 63%, 54.9%, and 54.7%) recalled frequency, route, medication instruction, expected therapeutic outcome, proper storage conditions, and drug interactions, respectively. 26 Likewise, the study from Eastern Ethiopia revealed that 37.2%, 37.2%, and 28.7% recalled the name, major side effects, and actions to be taken when a dose is omitted, respectively. In the same way, our finding showed that less than half of the participants recalled the name (44.5%) and major side effects (31.2%) of their dispensed medications.…”

“…A medication knowledge scaling questionnaire was adopted from previously conducted studies. 26,27 The questionnaire was translated into the local language which is a Tigrigna language. The structured questionnaire using patient interviews was used to record sociodemographic variables such as; sex, age, residency, ethnicity, religion, marital status, educational status, and occupation, service provision of the pharmacist, and exit-knowledge of dispensed medications.…”

“…Exit-knowledge was deemed to be sufficient when a participant responded a positive answer for at least two-thirds of the questions, which is at least eight questions out of 12 for his/her dispensed medications. 26…”

“…The study revealed that 38.3% of patients were found to have good knowledge of their medications and 39.3% were adherent to their dispensed medications. 25 Other studies conducted in Ethiopia revealed that the exitknowledge on dispensed medication was 38.6% in Eastern Ethiopia 26 and 46% in Hiwot Fana University Specialized Hospital. 27 Furthermore, a study from the rural Gambia showed that 83.9% of patients had poor knowledge of their dispensed drugs.…”