Aim: Non adherence to self-care behaviour is common in patients with heart failure leading to reduced quality of life, increased morbidity, mortality and health care costs. We assessed adherence to self-care behaviours and knowledge among adult patients with heart failure on active follow up. Method and results: Hospital based cross-sectional study was employed and patient reported adherence to self-care behaviours and knowledge on heart failure was assessed among 328 adult heart failure patients. The mean (± standard deviation (SD)) age was 52 (± 17) years; 55.5% were men. Among 26 self-care behaviours studied, four of the top eight most frequently performed were related to taking prescribed medications, and the seven least frequently performed ones were concerned with symptom monitoring or management. Adherence to individual self-care behaviours ranged from 9.7% to 99.7% however, cumulative good adherence was low at 62.7%, and only 17.4% of patients reported good adherence with all 26 self-care recommendations, indicating high rates of selective adherence. The mean (± SD) total knowledge score was 7.38 ± 2.2 out of a maximum score of 14. Multivariate analysis showed that age, co-morbidity, NYHA functional class and heart failure knowledge score were independent predictors of poor adherence to self-care behaviours (P<0.01). Conclusion: Overall adherence to heart failure self-care behaviours is low and selective. Majority of patients had a sever knowledge deficit related to heart failure and self-care behaviours. Age, co-morbidity, NYHA class and heart failure knowledge score were independent predictors for poor over all adherences.
BackgroundMedication error is common and preventable cause of medical errors and occurs as a result of either human error or a system flaw. The consequences of such errors are more harmful and frequent among pediatric patients.ObjectiveTo assess medication prescribing errors and associated factors in the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia.MethodsA cross-sectional study was carried out in the pediatric wards of Dessie Referral Hospital from February 17 to March 17, 2012. Data on the prescribed drugs were collected from patient charts and prescription papers among all patients who were admitted during the study period. Descriptive statistics was used to determine frequency, prevalence, means, and standard deviations. The relationship between dependent and independent variables were computed using logistic regression (with significance declared at p-value of 0.05 and 95% confidence interval).ResultsOut of the 384 Medication order s identified during the study, a total of 223 prescribing errors were identified. This corresponds to an overall medication prescribing error rate of 58.07%. Incomplete prescriptions and dosing errors were the two most common types of prescribing errors. Antibiotics (54.26%) were the most common classes of drugs subjected to prescribing error. Day of the week and route of administration were factors significantly associated with increased prescribing error.ConclusionsMedication prescribing errors are common in the pediatric wards of Dessie Referral Hospital. Improving quick access to up to date reference materials, providing regular refresher trainings and possibly including a clinical pharmacist in the healthcare team are recommended.
Introduction: Anti-epileptic drugs (AEDs) are the primary therapeutic modes for epileptic patients and have been demonstrated to control seizure, which decreases morbidity and mortality associated with epilepsy. There is a paucity of data on treatment outcome among epileptic patients in resource poor settings. The aim of this study was to assess AED utilization pattern and treatment outcome among epileptic patients on follow-up. Materials and Methods: A retrospective cross-sectional study was conducted among epileptic patients on follow-up at Epilepsy clinic of Jimma University specialized hospital. A total of 290 patient record cards which had 3 years of follow-up information was used to evaluate AED utilization pattern and treatment outcome through medical records review. Results: From a total 290 cards of epileptic patients on follow-up, 170 (58.6%) were males. The common type of seizure diagnosed was generalized tonic clonic seizure, 232 (80%). Monotherapy was commonly used in the management of seizure, 54.5%, among which phenobarbitone was the most commonly utilized single anticonvulsant drug. One hundred and sixty-five (56.7%) patients were seizure free during follow-up periods and 125 (43.3%) patients were not, of which 121 (73.3%) of patients had 1 up to 5 seizure attacks per 3 months during the 3 years follow-up period. Conclusion: All studied epileptic patients were put on traditional AEDs; phenobarbitone being the most frequently prescribed single drug. About one in every two epileptic patients evaluated were seizure free during the 3 years follow-up period.
Background: The life expectancy of people living with Human Immunodeficiency Virus (HIV) has dramatically improved with the much-increased access to antiretroviral therapy. Consequently, a larger number of people living with HIV are living longer and facing the increased burden of non-communicable diseases. This study assessed the effect of chronic non-communicable disease(s) and co-morbidities on the immunologic restoration of HIV infected patients on highly active antiretroviral therapy. Methods: A nested case-control study was conducted among people living with HIV at Jimma University Medical Center from February 20 to August 20, 2016. Cases were HIV infected patients living with chronic non-communicable diseases and controls were people living with HIV only. Patient-specific data were collected using a structured data collection tool to identify relevant information. Data were analyzed using the Statistical Package for Social Science version 20.0. Logistic regressions were used to identify factors associated with outcome. Statistical significance was considered at p-value <0.05. A patient's written informed consent was obtained after explaining the purpose of the study. Results: A total of 240 participants (120 cases and 120 controls) were included in the analysis. Prevalence of hypertension was 12.50%, and diabetes was 10.84%. About 10.42% of study participants were living with multi-morbidity. At baseline, the mean (±SD) age of cases was 42.32±10.69 years, whereas it was 38.41±8.23 years among controls. The median baseline CD4+ cell count was 184.50 cells/µL (IQR: 98.50 - 284.00 cells/µL) for cases and 177.0 cells/µL (IQR: 103.75 - 257.25 cells/µL) for controls. Post-6-months of highly active antiretroviral therapy initiation, about 29.17% of cases and 16.67% of controls had poor immunologic restoration. An average increase of CD4+ cell count was 6.4cells/µL per month among cases and 7.6 cells/µL per month among controls. Male sex [AOR, 3.51; 95% CI, 1.496 to 8.24; p=0.004], smoking history [AOR, 2.81; 95% CI, 1.072, to 7.342; p=0.036] and co-morbidity with chronic non-communicable disease(s) [AOR, 3.99; 95% CI, 1.604 to 9.916; p=0.003)] were independent predictors of poor immunologic restoration. Conclusions: Chronic non-communicable disease(s) have negative effects on the kinetics of CD4+ cell count among HIV-infected patients who initiated antiretroviral therapy. So the integration of chronic non-communicable disease-HIV collaborative activities will strengthen battle to control the double burden of chronic illnesses.
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