Misunderstanding of dosing regimen instructions among patients with chronic diseases receiving polypharmacy at the University of Gondar comprehensive specialized hospital

Abstract

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.

Medication regimen complexity and its impact on medication adherence in patients with multimorbidity at a comprehensive specialized hospital in Ethiopia

“…This could be attributed to the increasing complexity of medication regimens, which in turn impacts patients’ medication adherence. The burden could be significant particularly in the Ethiopian population with most of the patients having a lower level of health literacy ( 40 , 41 ) and a higher level of misunderstanding of dosage regimen instructions ( 42 ). A part of this study also demonstrated that patients with higher regimen complexity scores had a lower quality of life ( 43 ).…”