ABSTRACT
Hypertension is an overwhelming global challenge. Despite the development of many effective anti hypertensive drugs, target to reduce morbidity and mortality due to high blood pressures are reached in only a minor of patients in clinical practice. Poor adherence is one of the biggest obstacles in therapeutic control of blood pressures. There are complaints from patients and physicians that the poor result of actual antihypertensive drug therapies. Many people with age indifference are attacked by this “silent killer” or which results in target organ damage as a complication. The aim of this study was to assess the magnitude of adherence and the factors associated with non-adherence to anti-hypertensive medication. Cross sectional exclusively convenient study was conducted by using structured questionnaires consisting of open and closed-ended questions on patients diagnosed for hypertension and have already been on anti hypertensive medications at least for three months at Dessie Referral hospital from 20/01/2012 to 29/01/2012. A total of hundred hypertensive patients were screened from hundred six cases by the exclusive criteria and the overall incidence of anti-hypertensive medication non adherence was 26%. The study identifies reasons why patients don’t adherent with the drug regiments. Among Factors associated with non adherence were health system and health care provider poor interaction with patient and therapy factors like frustration and unwanted effect of the medication in the long run. There was indication of non adherence from the study area. Great emphasis should be placed on intervention strategies such as patient counseling and increasing awareness of the physicians, all other prescribers and health care providers at large about the non adherence of anti hypertensive drugs as well as the complication what comes due to this medication non adherence.
ABSTRACT
Background: Much progress has been made in treating HIV infection in the last several years and currently antiretroviral therapy regimens are capable of reducing viral load of undetectable level with a consequent increase in T-lymphocyte, CD4+ counts and reduction in development of opportunistic infections. Hence, a substantial reduction in HIV associated morbidity and mortality can be attained. In spite of antiretroviral therapy benefits, adverse reaction to these drugs has been pointed to as one of the main reason for discontinuation, switch and non adherence to antiretroviral therapy. Methods: A cross-sectional retrospective review of patient record from December 2009-Novomber 2012 was performed to determine the common adverse drug reactions in patients taking ART medications. A sample of 154 who were taking ART medications at Ambo Zonal Hospital was studied and SPSS for windows software versions-16.0 was used for data analysis. Results: A total of patients with average age of 32.5 years who are taking ART drugs for more than 6 months were studied for the prevalence of adverse reactions. The frequency of GI tract adverse reactions were found to be 75 (48.7%) followed by CNS adverse effects, 55 (35.7%) skin reactions accounted for 29 (18.8%). The least frequently occurred adverse reactions were hematologic reaction (anemia). Patients with low BMI (OR =4.09, p=0.000), having comorbidities (OR=4.566, p=0.000), low CD4+, p=0.002) and treated by TDF/3-TC/EFV (OR=2.087, p=0.001) had high risk of developing adverse drug recreations. Conclusions: BMI, the presence of other diseases, types of regimen used, duration of therapy and CD4+ lymphocyte less than 400cell/mm3 were strongly associated with the occurrence of adverse drug effects in this study.
ABSTRACT
Background: The quality of pharmacotherapy is highly dependent on the process of choosing a drug in relation to nature of the disease. Several factors should be considered in choosing optimal pharmacotherapeutics strategy including efficacy, safety, availability and cost of the drugs. The objective of this study was to assess potential drug-drug interactions and risk factors in outpatients taking cardiovascular drugs at Jimma University specialized hospital. Methods: A cross-sectional study was conducted from Feb. to April, 2011on patients visiting the cardiac clinic of Jimma University Specialized hospital. A sample of 332 outpatients who were taking cardiovascular medications at study clinic was studied. MicroMedex software was used to screen drug-drug interactions and SPSS for windows software versions-16.0 was used for data analysis. Results: A total of 1249 drugs with average of 3.76 drugs per prescription were prescribed for the 332 patients. The frequency of potential DDIs was found to be 241 (72.6%). Among these 200 (67.3%) were of "moderate" severity and 164 (55.2%) were delayed in onset. The most common potential DDI observed was between Enalapril and Furosemide (20%). Patients who prescribed many drugs (AOR=4.09; P=0.00) by medical intern had a higher risk of developing potential DDIs (AOR=4.6; P=0.00). Conclusions: Patients with cardiovascular disorders are subjected to high risk of potential drug-drug interactions and the number of drugs prescribed and educational level of the prescribers has a high significantly associated with the occurrence of potential drug-drug interactions. Therefore, it is imperative that further studies need to be conducted to identify reasons for and tackle the problem and provide appropriate mechanisms for management.