Assessment of Drug Therapy Problems among Ambulatory Heart failure Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2018-07
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Addis Ababa Universty
Abstract
Assessment of Drug Therapy Problems among Ambulatory Heart failure patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Elham Seid
Addis Ababa University, 2018
Drug therapy problems (DTPs) are a major concern in health care and have been identified as contributing to negative clinical outcomes. The Care of heart failure patients is commonly complicated by the presence of comorbidity and poly-pharmacy, which inturn intensify the risk of occurrence of DTP. The occurrence of DTPs in heart failure patients is associated with worsening of disease, frequent hospitalization, adverse drug event, drug-drug interaction, and poor patient compliance. There is limited evidence regarding DTPs in heart failure patients. Thus, this study aimed at assessing DTPs and medication adherence among ambulatory heart failure patients at Tikur Anbessa Specialized Hospital (TASH).A hospital based cross sectional study was conducted on 423 heart failure patients who had follow up at TASH. Data collection was done through patient interview and chart review. Majority of the patients were in New York Heart Association class III (55.6%) and 66% of patients had preserved systolic function. About half of the etiology of heart failure was chronic rheumatic valvular heart disease (50.8%). Of the 423 participants, 277(65.4%) had DTPs with average number of 2+0.86 per patient. The most common DTPs identified were Drug interaction (40.5%) followed by not the most effective drug (17.5%), ADR (14.7%), inappropriate dosage (9.7%) and the need for preventive drug therapy (9.6%). β blockers were the most frequent drug class involved in DTPs followed by ACEIs, mineralocorticoid receptor antagonist, and antiplatelets. Metoprolol tartrate and Nifedipine were drugs with the highest drug risk ratio. Age, gender, presence of comorbidity, average number of drugs per day and left ventricular ejection fraction were an important risk factor for DTPs. The rate of medication non-adherence was 45.2%. Duration of treatment, average number of medication per day and ADR were found to have significant association with medication non-adherence. Prevalence of DTPs among heart failure patients was high and about 45.2% of the patients were non-adherent to their medication. Detection and prevention of DTPs along with identifying patients at risk can save lives, help to adopt efficient strategies to closely monitor patients at risk, enhance patient’s quality of life and optimize healthcare costs.
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Drug therapy problem, adherence, Heart failure, Tikur Anbessa Specializes Hospital