Background: Drug therapy in the elderly needs an emphasis on age-related changes in drug pharmacokinetics and pharmacodynamics profile. Hospitalized elderly patients are at risk of more than one disease and polypharmacy associated with these; they are at risk of drug-related problems. This study aimed to assess the role of clinical pharmacy on identifying and resolution of drug-related problems among elderly patients admitted to medical ward of Northwest Ethiopia comprehensive specialized hospitals. Methods: A multicenter prospective observational study was conducted. A systematic sampling technique was used. The identified drug-related problem was recorded and classified using Cipolle, and adverse drug reaction was assessed using Naranjo algorithm of adverse drug reaction probability scale, and Medscape was used for drug-drug interaction. Data were analyzed by using STATA software version 14.1. Logistic regression was used, and results were reported as odds ratios (ORs) with 95% Confidence intervals with P   value < 0.05 statistically significant. Result: A total of 389 study participants were included in the study. About 266 (68.4%) of the participants had at least a single drug-related problem. About 503 drug-related problems were identified with a mean of 1.32 (CI: 1.27-1.36) drug-related problem per patient. The three-leading categories of drug-related problems were dose too high 108 (21.5%), nonadherence 105 (20.9%), and adverse drug reaction 96 (19.1%). Alcohol use ( AOR = 2.2 , 95CI%: 1.23-3.94), source of the drug ( AOR = 2.85 , 95CI%: 1.63-4.98), length of hospitalization ( AOR = 2.32 , 95CI%: 1.37-3.95), number of comorbidities ( AOR = 1.48 , 95CI%: 1.09-1.99), and polypharmacy ( AOR = 3.06 , 95CI%: 1.72-5.46) were important risk factors for drug-related problems. From the intervention provided, 84.7% were accepted by prescribers. Among the total drug-related problems 67.4% of the problem was totally solved. Conclusion: This study revealed that DRPs were high among elderly patients admitted to medical ward of Northwest Ethiopia. Comorbidity, length of hospitalization, ploy-pharmacy, payer, and alcohol drinker were more likely to developed drug-related problems. Treatment optimizations were also done by clinical pharmacists and interventions were well accepted by prescribers.

Objective: Drug–drug interactions are of major concern due to links to untoward drug effects, hospitalizations, and serious health impacts. Elderly patients are more predisposed to drug interactions than younger patients. The present study aimed to find out the prevalence of drug–drug interactions at North West Ethiopian compressive specialized hospitals’ Internal Medicine wards. Methods: From 30 April to 30 July 2021 GC, a multicenter prospective observational study was conducted at north Ethiopian specialized hospitals. Data was collected by using a structured questionnaire adapted from different literature and medical records at the North West Ethiopian Comprehensive Specialized Hospitals’ Internal Medicine wards during the study period. Thereafter checked the completeness of the collected data was checked drug–drug interactions by using Medscape. Epi data version 4.6.2 software was used as data clearance and STATA version 14.1 was used for further data analysis. Result: A total of 389 subjects participated in the study of which more than half (55.53%) of them were female with a mean (SD) age of 68.9 ± 7.46 years. A total of 641 drug–drug interactions were detected in this investigation of which, 225(35.1%) were major, 299(46.6%) were significant interactions, and 117(18.3%) were minor interactions. Hospital stay (AOR = 5.95 CI: 3.49–10.12), retire (AOR = 6.71 CI: 1.26–35.78), 5–9 drugs (AOR = 5.30 CI: 2.91–9.67) and more than 10 drugs (AOR = 8.03 CI: 2.47–26.07) were important risk factors for drug–drug interactions. Conclusion: The findings of this study suggest that drug–drug interactions were high among hospitalized elderly patients. The presence of polypharmacy, to be retired, and hospital stayed were all found to be strongly linked with drug–drug interactions.

Background Prescribing medications without potential drug-drug interactions (pDDIs) is one of the components of the rational use of medications. However, taking combined medications has resulted in life-threatening pDDIs, which are causing severe clinical outcomes for patients. This study was aimed at assessing the prevalence of pDDIs and associated factors in admitted patients with psychiatric disorders. Methods An institution-based multicenter cross-sectional study was conducted among patients with psychiatric disorders admitted to a selected hospital in Northwest Ethiopia. Samples were approached through a systematic sampling method. The Statistical Package for the Social Sciences (SPSS) version 26 was used to analyze the data. Logistic regression was applied to determine the association of variables with pDDIs. A p-value of < 0.05 was statistically significant. Results Out of 325 study participants, more than half (52.9%) were females, with a median age of 61 years. Overall, more than two-thirds (68.9%) were exposed to at least one clinically significant, either significant or serious level of pDDIs. Nearly one-fourth (23.2%) of participants had at least one serious level of pDDIs. Older patients were found more likely to have pDDIs compared to younger patients (p = 0.043). Similarly, patients with a higher number of prescribed medications (p = 0.035) and patients with longer hospital admissions (p = 0.004) were found more likely to be exposed to pDDIs than their counterparts. Conclusion In this study, a significant number of admitted patients with psychiatric problems encountered clinically significant pDDIs. As a result, healthcare providers could assess and follow patients with a combination of medications that potentially have a drug-drug interaction outcome.

Background Misunderstanding dosage instructions in terms of dose, frequency, duration, or any other instruction with patients on polypharmacy is a common problem that leads to the irrational use of medications. This study aimed to assess the level of misunderstanding of dosing instructions among patients with chronic diseases receiving polypharmacy at the chronic outpatient pharmacy of the University of Gondar Compressive Specialized Hospital (UoGCSH). Methods An institutional-based cross-sectional survey was conducted from September to November 2021 at the UoGCSH chronic outpatient pharmacy in Northwest Ethiopia. Study subjects were selected by a systematic random sampling method. Drug-drug and drug-food interactions were also checked by Medscape and drug.com to evaluate the significance of interactions. Frequency, percentage, and mean standard deviation (SD) were used to describe the distributions of variables. With a statistical significance level of p < 0.05, the Chi-square test was used to assess the association of variables with the primary outcome. Results From a total of 400 participants, more than half (59%) were females, with a mean (SD) age of 57 (±16.3) years old. The study revealed that almost half (50.8%) of the participants misunderstood at least one dosage instruction, and around two-fifths (38.5%) misunderstood the frequency of drug administration. More than 90% of patients had no understanding of drug-drug interactions (DDIs). Sex (X2 = 16.837; P<0.0001), educational level (X2 = 50.251; P < 0.0001), residence (X2 = 5.164; P < 0.023) and duration of stay on medication (X2 = 13.806; P < 0.0003) were significantly associated with misunderstanding of dosage regimen instructions. Conclusion The study showed that a significant number of patients did not understand their medication dosage regimen instructions. To address these significant drug-related issues, healthcare providers could effectively engage in interventions such as written instructions accompanying patients and additional counseling.

Background chemotherapy-induced neutropenia is the most well-known oncologic emergencies and the most common hematologic toxicity of chemotherapy. A few studies have been carried out to assess the incidence and management practice of chemotherapy-induced neutropenia in Ethiopia. Objective the study was conducted to assess incidence, management, and predictors of chemotherapy-induced neutropenia among adult solid cancer patients at the University of Gondar Comprehensive and Specialized Hospital (UOGCSH) Methods A hospital-based retrospective follow-up study was conducted among adult solid cancer patients attending between January 1, 2017, to February 30, 2021, at the oncology ward of UOGCSH. A structured data abstraction format was used to collect data from patients' medical charts. Data were analyzed using STATA version 14.2. Bivariate and multivariable logistic regression analysis was used to identify independent predictors of chemotherapy-induced neutropenia and P-value, < 0.05 was considered statistically significant. Analysis of variance was used to compare the difference in recovery time of neutropenia between different treatment regimens Results A total of 416 patients were included in the study with a mean age of the patient 50.56 ± 14.4 years. The cumulative incidence of neutropenia was 62.3% (95% CI 57.9–67.1) and 13% of them developed infections. Advanced stage of cancer, poor performance status, patients taking triple treatment modality, lower baseline white blood cell count, elevated lactated dehydrogenase, cisplatin-paclitaxel, doxorubicin-cyclophosphamide, doxorubicin-cyclophosphamide followed by four cycles of paclitaxel and patients with two or more comorbidities were found to be predictors for chemotherapy-induced neutropenia (P < 0.05). The use of filgrastim has significantly reduced the duration of neutropenia recovery time by 33.28 days (P = 0.0001) as compared to chemotherapy delay. Conclusion The incidence of neutropenia was common in solid cancer and it is multifactorial. Health care professionals should be aware of these risk factors and greater effort is needed to reduce the risk of neutropenia. Filgrastim was the main management for chemotherapy-induced of neutropenia and it was significantly reduced the duration of neutrophil recovery time.