Prevalence and factors associated with adverse drug reactions among heart failure patients hospitalized at Mbarara Regional Referral Hospital, Uganda

Shegena, Efrata Ashuro; Nigussie, Konjit Abebe; Tamukong, Robert; Lumori, Boniface Amanee Elias; Yadesa, Tadele Mekuriya

doi:10.1186/s12872-022-02937-7

Cited by 6 publications

(14 citation statements)

References 51 publications

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“…The second most common DTP related to cardiovascular agents in this study was "needs additional drug therapy" (27.2%). This proportion is consistent with many studies involving CVD patients, i.e., 27.4 -45.5% [15,26,28,[33][34][35][36].…”

Section: Discussionsupporting

confidence: 91%

Drug therapy problems related to cardiovascular agents and associated factors among heart failure patients: a prospective observational study of a tertiary inpatient setting

Shegena,

Kyomya,

Babirye

et al. 2024

JCTR

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Background: Heart failure (HF) is a clinical syndrome that is treated with multiple medications, putting patients at risk of drug therapy problems (DTPs). DTPs are a great concern in health care due to their significant impact on morbidity, mortality, and higher costs associated with health care. Aims: This study aimed to assess the prevalence and factors associated with DTPs related to cardiovascular agents among HF patients hospitalized at the Mbarara Regional Referral Hospital. Methods: A prospective observational study was conducted among hospitalized HF patients from November 2021 to January 2022. A total of 118 patients diagnosed with HF were recruited. Patient file reviews and interviewer-administered questionnaires were used for data collection. Univariate and multivariate logistic regressions were employed to determine factors associated with the DTPs. Result: A total of 118 HF patients with a median age of 43 years were included in this study. Among them, 57 participants experienced a total of 81 DTPs with a prevalence of 48.3%. “Dosage too high” was the most common DTP (23, 28.3%) followed by “needs additional drug therapy” (22, 27.2%). Hospitalized HF patients aged 60 years and above (adjusted odds ratio [AOR]: 4.1; 95% confidence interval [CI]: [1.5 – 10.3]; P = 0.012) and taking more than five medications during their hospital stay (AOR: 2.92; 95% CI: [1.5 – 7.6]; P = 0.029) were significantly associated with experiencing at least one DTP. Conclusion: Almost half of the hospitalized HF patients experienced at least one DTP during their hospital stay. “Dosage too high” and “needs additional drug therapy” were the most common DTPs. Hospitalized HF patients with poly-pharmacy (taking more than five cardiovascular agents) and aged above 60 were more likely to have DTPs. It is noted that patient groups who are at risk require follow-ups to improve the treatment outcome, and incorporation of clinical pharmacy service could be part of the solution. Relevance for Patients: This study identifies the factors associated with the development of DTP to facilitate the development and implementation of prevention strategies for the commonly identified DTPs.

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Section: Discussionsupporting

confidence: 91%

Drug therapy problems related to cardiovascular agents and associated factors among heart failure patients: a prospective observational study of a tertiary inpatient setting

Shegena,

Kyomya,

Babirye

et al. 2024

JCTR

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“…Of 78 studies, 27 studies [ 18 – 44 ] were carried out among general patients, while the remaining studies [ 45 – 95 ] were carried out among specific patients. Seventeen studies [ 18 – 22 , 24 , 26 , 31 , 33 – 35 , 38 , 39 , 41 – 43 , 51 ] reported the prevalence of ADEs leading to hospital admissions, while 30 studies [ 18 , 19 , 22 – 33 , 35 , 37 – 41 , 43 , 44 , 65 , 80 , 85 – 88 , 91 , 95 ] reported the prevalence of ADEs during hospitalization. Twelve studies [ 18 , 19 , 22 , 24 , 26 , 31 , 33 , 35 , 38 , 39 , 41 , 43 ] reported ADE occurrence in both settings.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, 38 studies [ 45 – 50 , 52 , 54 – 64 , 66 – 74 , 76 , 78 , 79 , 82 – 84 , 89 , 90 , 92 – 94 ] reported the occurrence of ADEs in the outpatient setting, and four studies [ 53 , 75 , 77 , 81 ] reported ADEs in the community setting. Majority of included studies [ 18 – 22 , 27 – 29 , 32 – 34 , 36 , 37 , 40 , 41 , 43 , 45 – 48 , 52 , 54 – 60 , 62 – 65 , 67 , 70 , 72 – 74 , 76 , 79 , 81 , 82 , 89 , 90 , 92 – 94 ] were carried out on adult population (aged ≥ 18 years) ( n = 46), while 18 studies were conducted among all age groups (aged 0–100 years) [ 23 , 24 , 30 , 50 , 51 , 61 , 66 , 68 , 69 , 71 , 75 , 77 , 78 , 84 – 88 ], 12 studies [ 25 ...…”

Section: Resultsmentioning

confidence: 99%

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

Nyame,

Hu,

Xue

et al. 2024

Eur J Med Res

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Background Adverse drug events (ADEs) represent challenges affecting Africa’s healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs. Objectives We aimed to systematically review published studies on ADEs and synthesize the existing evidence of ADE prevalence in Africa. Methods Studies reporting on ADE occurrence in African settings and published from Jan 1, 2000 to Oct 1, 2023 were identified by searching PubMed, EBSCO, Science Direct, and Web of Science. Studies that either articulately investigated ADEs caused by clinical condition (such as HIV patients) or ADEs caused by exposure to specific drug(s) (such as antibiotics) were considered specific and the remaining were general. Grouped ADE prevalence rates were described using median and interquartile range (IQR). PROSPERO registration (CRD42022374095). Results We included 78 observational studies from 15 African countries that investigated the prevalence of ADEs leading to hospital admissions (17 studies), developed during hospitalizations (30 studies), and captured in the outpatient departments (38 studies) or communities (4 studies). Twelve studies included multiple settings. The median prevalence of ADE during hospitalization was 7.8% (IQR: 4.2–21.4%) and 74.2% (IQR: 54.1–90.7%) in general and specific patients, respectively. The ADE-related fatality rate was 0.1% and 1.3% in general and specific patients. The overall median prevalence of ADEs leading to hospital admissions was 6.0% (IQR: 1.5–9.0%); in general, patients and the median prevalence of ADEs in the outpatient and community settings were 22.9% (IQR: 14.6–56.1%) and 32.6% (IQR: 26.0–41.3%), respectively, with a median of 43.5% (IQR: 16.3–59.0%) and 12.4% (IQR: 7.1–28.1%) of ADEs being preventable in general and specific patients, respectively. Conclusions The prevalence of ADEs was significant in both hospital and community settings in Africa. A high ADE prevalence was observed in specific patients, emphasizing important areas for improvement, particularly in at-risk patient groups (e.g., pediatrics, HIV, and TB patients) in various settings. Due to limited studies conducted in the community setting, future research in this setting is encouraged.

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“…Being a woman, higher number of administered drugs, comorbidities and the use of antiretroviral therapy are associated with ADR-related hospital admissions in South Africa. 15 Studies conducted in Uganda have reported female gender and history of tobacco use as predictors of medication-related emergency admission among cardiovascular disease patients 12 ; being aged 19–59 years, herbal medicine use, polypharmacy and drug-drug interactions are associated with ADRs among heart failure patients 16 ; and preadmission use of herbal medicines and treatment with six or more conventional medicines during hospitalization are the common risk factors for hospital-acquired suspected ADRs. 17 These studies document the epidemiology of hospital-acquired ADRs and ADRs in the elderly who do not represent the general population.…”

Section: Introductionmentioning

confidence: 99%

“… 17 These studies document the epidemiology of hospital-acquired ADRs and ADRs in the elderly who do not represent the general population. 11 , 12 , 15 – 17 Thus, the burden and associated factors of ADRs linked to hospital admission are not well investigated among inpatients in SSA, particularly in Uganda, where the risk of ADR-related hospitalizations could be heightened by the colliding epidemics of infectious and non-infectious diseases. 18 This study sought to determine the burden, characteristics, contributing factors and patient outcomes of ADRs documented as the primary diagnosis linked to hospital admission among adult inpatients at a tertiary care hospital in Uganda.…”

Section: Introductionmentioning

confidence: 99%

Hospital admissions attributed to adverse drug reactions in tertiary care in Uganda: burden and contributing factors

Asio,

Nasasira,

Kiguba

2023

Therapeutic Advances in Drug Safety

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Background: Adverse drug reactions (ADRs) contribute to the burden of disease globally and of particular concern are ADR-related hospital admissions. Objectives: This study sought to determine the burden, characteristics, contributing factors and patient outcomes of ADRs that were the primary diagnosis linked to hospital admission among inpatients in Uganda. Design: We conducted a cross-sectional secondary analysis of data from a prospective cohort study of adult inpatients aged 18 years and older at Uganda’s Mulago National Referral Hospital from November 2013 to April 2014. Methods: We reviewed clinical charts to identify inpatients with an ADR as one of the admitting diagnoses and, if so, whether or not the hospital admission was primarily attributed to the ADR. Logistic regression was used to determine factors associated with hospital admissions primarily attributed to ADRs. Results: Among 762 inpatients, 14% had ADRs at hospital admission and 7% were primarily hospitalized due to ADRs. A total of 235 ADRs occurred among all inpatients and 57% of the ADRs were the primary diagnosis linked to hospital admission. The majority of ADRs occurred in people living with HIV and were attributed to antiretroviral drugs. HIV infection [aOR (adjusted odds ratio) = 2.97, 95% confidence interval (CI): 1.30–6.77], use of antiretroviral therapy (aOR = 5.46, 95% CI: 2.56–11.68), self-medication (aOR = 2.27, 95% CI: 1.14–4.55) and higher number of drugs used (aOR = 1.13, 95% CI: 1.01–1.26) were independently associated with hospital admissions attributed to ADRs. Conclusion: Antiretroviral drugs were often implicated in ADR-related hospital admissions. HIV infection (whether managed by antiretroviral therapy or not), self-medication and high pill burden were associated with hospital admissions attributable to ADRs. The high HIV burden in Sub-Saharan Africa increases the risk of ADR-related hospitalization implying the need for emphasis on early detection, monitoring and appropriate management of ADRs associated with hospital admission in people living with HIV.

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Prevalence and factors associated with adverse drug reactions among heart failure patients hospitalized at Mbarara Regional Referral Hospital, Uganda

Cited by 6 publications

References 51 publications

Drug therapy problems related to cardiovascular agents and associated factors among heart failure patients: a prospective observational study of a tertiary inpatient setting

Drug therapy problems related to cardiovascular agents and associated factors among heart failure patients: a prospective observational study of a tertiary inpatient setting

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

Hospital admissions attributed to adverse drug reactions in tertiary care in Uganda: burden and contributing factors

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