Home medication management practices and associated factors among patients with selected chronic diseases in a community pharmacy in Uganda

Abstract

BackgroundChronic diseases are rapidly increasing and are currently the major cause of death and disability worldwide. Patients with chronic diseases experience many challenges including medicine-related problems. However, there is limited information about the home management of medicines among these patients. This study therefore was to determine home medication management practices and associated factors among patients with chronic diseases seeking care in a community pharmacy in Uganda.MethodsA cross-sectional study was conducted in a community pharmacy in Kampala from June to July 2010. A total of 207 consenting chronic disease patients or caregivers of children with chronic disease were consecutively sampled. The patients were visited at home to evaluate their drug management practices and to check their medical forms for disease types and drugs prescribed. An interviewer-administered questionnaire and an observation checklist were used to collect the data.ResultsOverall home medication management was inappropriate for 70% (n = 145) of the participants (95% CI = 63.3-76.2) and was associated with perceived severity of disease (not severe OR =0.40, moderately severe OR = 0.35), duration of disease >5 years (OR = 2.15), and health worker not assessing for response to treatment (OR = 2.53). About 52% (n = 107) had inappropriate storage which was associated with inadequate information about the disease (OR = 2.39) and distance to the health facility >5 kilometres (OR = 2.82). Fifteen percent (n = 31) had no drug administration schedule and this was associated with increasing age (OR = 0.97), inadequate information about the disease (OR = 2.96), and missing last appointment for medical review (OR = 6.55). About 9% (n = 18) had actual medication duplication; 1.4% (n = 3) had expired medicines; while 18.4% (n = 38) had drug hoarding associated with increasing number of prescribers (OR = 1.34) and duration of disease (OR = 2.06). About 51% (n = 105) had multiple prescribers associated with perceiving the disease to be non severe (OR = 0.27), and having more than one chronic disease (OR = 2.37).ConclusionsPatients with chronic disease have poor home management of medicines. In order to limit the occurrence of poor outcomes of treatment or drug toxicity, health providers need to strengthen the education of patients with chronic disease on how to handle their medicines at home.

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda

“…The patients were informed about the study at the pharmacy and those that met the selection criteria were visited at home by a member of the research team in order to access their medical documents. An interviewer administered questionnaire translated into the main local language spoken in the area (Luganda) was used to collect data on participants’ socio-demographic characteristics; household characteristics; drug- and disease-related characteristics; health facility-related characteristics; knowledge and perception of the disease; drugs, and health care received; lifestyle characteristics; and home management of medicines [ 18 ]. The patients’ medical forms were reviewed to confirm information about the disease, prescribed drugs, the last date of review by health provider and the date for the next appointment.…”

Pattern and predictors of medicine use among households in Gondar Town, northwestern Ethiopia: a community-based medicine utilization study

“…Several studies on medicine utilization have been conducted globally as well as in Ethiopia, focusing mainly on health institutions [ 5 – 9 ]. A number of studies regarding utilization of medicines in the community have also been conducted in different countries [ 10 – 16 ].…”

Armazenamento Caseiro De Medicamentos Por Usuários Restritos Ao Domicílio Da Área De Abrangência Do Centro De Saúde Jaqueline I, Regional Norte, Município De Belo Horizonte, Brasil

“…Também existe a hipótese de haver acontecido troca de medicamentos e o usuário continuar com a guarda dos medicamentos anteriores (6); ou então, que o usuá-rio tenha sido atendido por vários profissionais médicos/ dentistas num mesmo período de tempo, somando as prescrições (31). Por isso é fundamental a implantação da estratégia de Conciliação Medicamentosa.…”

“…A quantidade encontrada de medicamentos não apropriados para o consumo é preocupante, sendo muito semelhante à encontrada por outros estudos no Brasil (7,10,11) e no exterior (6,31). Este é um problema que preocupa e que pode comprometer, ao longo dos anos, a política pública de distribuição de medicamentos e a economia familiar, quando da aquisição dos medicamentos pelo próprio paciente.…”

“…Problemas relacionados à forma de armazenamento dos medicamentos também estão de acordo com a literatura consultada (6,11,12,31) e mostram que este problema é de difícil solução. Comumente, o quarto foi o local preferido para a estocagem dos medicamentos (10,11), diferentemente da cozinha, local mais frequente encontrado em outros estudos (7,12).…”