Assessment of medication therapy management service among adult diabetes mellitus patients on follow up clinic at Tikur Anbessa Specialized Hospital
| dc.contributor.advisor | Shibeshi, Workineh(PhD) | |
| dc.contributor.advisor | Beyene, Alemseged | |
| dc.contributor.advisor | Ahmed, Abdurazak | |
| dc.contributor.author | Negash, Zenebe | |
| dc.date.accessioned | 2020-03-13T02:43:12Z | |
| dc.date.accessioned | 2023-11-29T04:30:30Z | |
| dc.date.available | 2020-03-13T02:43:12Z | |
| dc.date.available | 2023-11-29T04:30:30Z | |
| dc.date.issued | 2019-11 | |
| dc.description.abstract | Diabetes mellitus (DM) patients are at increased risk of developing drug therapy problems (DTPs) since they often receive multiple pharmacotherapeutic agents due to coexistence of multiple co-morbidities and complications associate with the disease. Medication therapy management (MTM) is a distinct service or group of services that optimize therapeutic outcomes for individual patients. Thus, the aim of this study was to assess impact of introduction of MTM service at DM clinic of Tikur Anbessa Specialized Hospital (TASH). A prospective hospital based interventional study was carried out at DM clinic between July 2018 and April 2019. The intervention package includes patient counseling, education, identification and resolving of DTPs for the given six months followed by four-months post- interventional assessment of DTPs, medication adherence and treatment satisfaction. Data were collected, entered and analyzed using Statistical Package for the Social Sciences (SPSS). Descriptive statistics and logistic regressions were performed for data analyses. Of 423 participants, 409 fulfilled the inclusion criteria and included in the final analysis of the study. The mean age of the patients was 52.3(SD, 15.6) years. Most of the study participants were type-II DM (78.2%). About 73.1% had comorbidity. They had mean disease duration of 13.86(SD, 8.64) years. There were decreases in hemoglobin A1c (HbA1c), fasting blood sugar (FBS) and systolic blood pressure (SBP) by 0.92%, 25.04 mg/dl and 6.62 mm Hg respectively as compared with the pre-intervention phase (P< 0.05). The prevalence of DTPs in the pre- and post-intervention of MTM services were found to be 72.9 %( n=298) and 26.2 %( n=107) respectively. Primary education level (AOR=2.94, 95% CI: 1.25-6.91), charging for medication from pocket (AOR= 2.27, 95%CI: 1.08-4.77), male gender (AOR=3.06, 95% CI: 1.54-6.07) were significant predictors of DTPs. About 80.4% of participants were adherent to their medications at the end of MTM intervention. Poorly controlled glycemic control (AOR=2.33, 95% CI: 1.17-4.68) and presence of three and above co-morbidities (AOR=4.76; 95% CI: 1.4-15.8) were associated with poor adherence. Theoverall mean score of treatment satisfaction was 75.6(±9.7). Diabetes patients of age below 40years (77.66(SD, 8.18)), type-I DM (77.79(SD, 8.46)), treated with one medication (77.89(SD, 7.19)) and good adherence to their medication (76.17(SD, 8.89)) had higher satisfaction score (P<0.05). In conclusion, provision of MTM service showed a significant improvement in DTPs reduction, medication adherence, treatment satisfaction and clinical parameter relative to the pre-intervention MTM services. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/21155 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Ababa University | en_US |
| dc.subject | Medication therapy management; Diabetes mellitus; Drugs therapy problems, Medication adherence, Treatment satisfaction | en_US |
| dc.title | Assessment of medication therapy management service among adult diabetes mellitus patients on follow up clinic at Tikur Anbessa Specialized Hospital | en_US |
| dc.type | Thesis | en_US |