Pharmacy Practice

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Browsing Pharmacy Practice by Author "Alebachew, Minyahil (Assistant Professor of Clinical Pharmacy)"

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    Assessment of Medication Therapy Management Service outcome among Epilepsy Patients on Follow-up care at Ambulatory Clinic of Tikur Anbessa Specialized Hospital
    (Addis Abeba University, 2020-05) Bulbula, Meaza; Engidawork, Ephrem (PhD, Professor of Pharmacology); Alebachew, Minyahil (Assistant Professor of Clinical Pharmacy); Mamushet, Yared (MD, Associate Professor of Neurology)
    Background: The provision of medication therapy management services aims to prevent, identify and resolve drug-related problems (DTPs), thereby reducing morbidity and mortality as well as helping patients achieve improved clinical outcomes. Epilepsy is one of the most common neurological diseases affecting about 45.9 million people globally. However, about 90% of them are not receiving appropriate treatment due to lack of prioritization, poor health care system, and inadequate supply of antiepileptic drugs. Objective: This study aimed to assess the outcome of medication therapy management service among epileptic patients on follow up care at Tikur Anbessa Specialized Hospital. Methods: A pre/post study design and systematic random sampling technique were utilized. Data was collected through patient interview, medical charts and electronic data record review. Cipolle’s DTP classification, Treatment Satisfaction with Medicine Questionnaire, and Morisky Medication Adherence Scale were used as data collection tools. Data were entered and analyzed using statistical package for social science version 21. Descriptive statistics were used to summarize patients’ characteristics and paired sample t –test and McNamara’s was performed to examine the effect of intervention in the pre- and post-intervention phases. Inferential statistics (independent t-tests and logistic regression analysis) were used to examine the influences of different variables on outcome. P<0.05 was set as a level of significance. Results: From the total of 336 epileptic patients, generalized tonic-clonic seizure was the most common diagnosis (53.9%) followed by focal to bilateral (14.9%) and unclassified (14%). Majority of the study patients (57.7%) were on mono-therapy and phenobarbital (22.6%) was the most frequently prescribed antiepileptic drug. A total of 451 DTPs had been identified during the study and a significant reduction in the number of DTPs was noted in the post-intervention compared to the pre-intervention phase (t (335) =10.79, p< 0.005). Non-adherence, adverse drug reaction and dose too low showed significant reduction (p< 0.05) from pre to post study. Duration of seizure, number of comorbidities, total number of medications and seizure control status were significantly associated with DTPs (p<0.05). In the post-intervention phase 61% of the patients were adherent to their medication and the general treatment satisfaction was 72.1(SD ± 12.3). Conclusion: Implementation of medication therapy management service in the neurology clinic is associated with better patient outcomes, as revealed by reduction in the total number of DTPs and the number of patients with DTPs. Moreover, majority of the study patients were adherent to their medication and the general treatment satisfaction was good in the post-intervention phase.