Assessment of Medication Therapy Management Service outcome among Hypertensive Patients on Follow up at Ambulatory Clinic of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2021-02
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Addis Abeba University
Abstract
The high prevalence of hypertension with multiple comorbidities and use of multiple
medications predisposes this group of patients to drug therapy problems (DTPs). This justifies
the need for the implementation of medication therapy management (MTM) service. The aim of
this study was to evaluate the impact of introducing MTM Services among patients with
hypertension attending follow-up at ambulatory clinic of Tikur Ambessa Specialized Hospital
(TASH).
A quasi-experimental study was performed with patients followed-up for six months at renal
clinic of TASH between July 2019 and April 2020. Data was analyzed using Statistical Package
for the Social Sciences (SPSS). Descriptive statistics, linear regression and logistic regressions
were also performed for the purpose of data analyses.
Out of 304 enrolled patients, 279 entered in to the final analysis, with attrition rate of 7.8%.
Mean age of the patients was 56.38(SD, 11.81) years and 50.5% of them were females. Data
showed a decline in the prevalence of DTPs from 63.1% at baseline to 31.1% during the post-
interventions phase. Using ≥ 5 drugs (AOR = 2.46; 95%CI: 1.27-4.77) and presence of
complication (AOR = 0.52; 95% CI: 0.27-0.99) were significantly associated with occurrence of
DTP at baseline. Intervention also brought about a decrease in mean systolic blood pressure
(SBP) (5.31 95% CI of difference 3.50-7.11: p < 0.001) and a significant increase (p < 0.001) in
the number of study patients whose blood pressure (BP) reached to a goal BP. About (69.5%) of
participants were adherent to their medications at the end of MTM intervention. Experiencing
DTP (AOR= 2.40; 95% CI: 1.33-4.334) and living outside Addis Ababa (AOR= 1.73; 95% CI:
1.38-1.88) were significantly associated with non-adherence at the end of follow-up. The overall
mean score (SD) of treatment satisfaction was 86.55 ± 10.34 at the end of MTM visit. Adherent
patients were found to be significantly more satisfied (p < 0.001) than non-adherent patients.
MTM service contributed to the resolution of DTPs and improvement of clinical outcomes.
Majority of the patients were found to be adherent and high treatment satisfaction score was
observed at the end of the MTM interventions.
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Keywords
Medication Therapy Management, Hypertension, Drug Therapy Problems, Medication Adherence, Treatment Satisfaction