<p>Drug-Related Problems and Their Predictors Among Patients with Diabetes Attending the Ambulatory Clinic of Gebre Tsadik Shawo General Hospital, Southwest Ethiopia</p>

Abstract

Background: Patients with diabetes are vulnerable to experiencing drug-related problems. Thus, this study aimed to assess drug-related problems and their predictors among patients with diabetes attending the ambulatory clinic of Gebre Tsadik Shawo General Hospital. Methods: A cross-sectional study was conducted from September 1, 2019 to November 30, 2019. Drug-related problems were identified using the Pharmaceutical Care Network Europe version 5.01. Patient's written informed consent was obtained after explaining the purpose of the study. The data were collected using structured questionnaires and entered into Epi data version 4.0.2. Then, it was exported to SPSS version 21.0 for analysis. To identify predictors of the occurrence of drug-related problems, multiple stepwise backward logistic regression analysis was done. For the accuracy of data analysis, a 95% confidence interval was used, and statistical significance was considered at p-values <0.05. Results: From a total of 141 patients with diabetes included in the study, 58.2% of them had at least one drug-related problem during the 3-month study period. A total of 156 drugrelated problems were identified in 141 patients. Drug interactions (30.76%) and drug choice problems (25%) were the most common type of drug-related problems identified. Presence of disease comorbidity (AOR=4.12, 95% CI=1.71-9.91), poly-pharmacy (AOR=6.27, 95% CI=1.67-23.52) and more than 5 years diabetes duration (AOR=3.89, 95% CI=1.52-9.95) were independent predictors of drug-related problems. Conclusion: Drug-related problems were high among patients with diabetes in the study setting. Early detection of drug-related problems ensures the appropriateness of drug therapy. Therefore, a sustainable pharmaceutical care service is needed for early identification, prevention and resolution of drug-related problems.

Prevalence and factors associated with inappropriate anti- diabetic medication therapy among type 2 diabetes mellitus patients at the medical and surgical wards of Mbarara Regional Referral Hospital, Uganda

“…Additionally, participants who had a T2DM duration of less than 1 year were 63% less likely to have IADT compared to patients with a T2DM duration of more than 10 years (AOR, 0.37; 95% CI, 0.11–0.35; P-value = 0.019). This finding is similar to a study in Ethiopia [ 31 ], India [ 62 ], and Pakistan [ 34 ]. This might be because those patients with a longer duration of diabetes had a higher chance of developing diabetes complications which contribute to drug-drug interactions and multiple drug therapy.…”

“…This might be because those patients with a longer duration of diabetes had a higher chance of developing diabetes complications which contribute to drug-drug interactions and multiple drug therapy. In addition, these patients are likely to have comorbid conditions which influence the desired outcome of other diseases by increasing the number of drugs, causing drug-drug, drug-disease, and disease-disease interactions which collectively resulted in increased likelihood of experiencing DRP in the study patients [ 31 – 34 ]. It was also found that patients with HbA1c of less than 7% during the current admission had 9.97 times higher (AOR, 9.97; 95% CI, 2.34–13.57; P-value = 0.002) odds of experiencing IADTs compared to patients with HbA1c of greater or equal to 7%.…”

“…Many associated factors have been identified to contribute to the development of DRPs in T2DM patients [ 25 ]. These factors include; the presence of comorbidity, poly-pharmacy, age, duration of diabetes, and gender [ 25 , 31 – 34 ]. Identifying contributing factors of IADT makes it possible for better control of diabetes and associated complications and can lead to a significant reduction in morbidity, mortality, and health care costs [ 35 , 36 ].…”

Prescribing Pattern and Medication Related Problems in Hospitalized Diabetic Patients: A Hospital-Based Study

“…The study findings revealed that drug interaction (53; 45.3%) was the most commonly identified drug-related problem in diabetic patients. These results are parallel with the findings of the study conducted in Southern Ethiopia [15]. The reason might be due to diabetic patients having a high rate of cardiovascular, neurological, ophthalmic, renal, and thyroid complications than non-diabetic patients.…”

“…Continuous and timely assessment of ADRs is very important to provide appropriate interventions in diabetic patients. These findings are nearly similar to the study conducted in Addis Ababa, and Ethiopia [15,17]. Other DRPs include untreated indication (17.9%), failure to receive drugs (5.1%), improper drug selection (4.3%), overdose (3.4%), underdose (2.6%), and drug use without indication (0.8%).…”