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入住希沃特·法纳专科医院内科病房并在门诊接受随访的心血管疾病患者的药物治疗问题:埃塞俄比亚东部一家三级医院的案例

Drug therapy problems among patients with cardiovascular disease admitted to the medical ward and had a follow-up at the ambulatory clinic of Hiwot Fana Specialized University Hospital: The case of a tertiary hospital in eastern Ethiopia.

作者信息

Gelchu Tamene, Abdela Jemal

机构信息

School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

出版信息

SAGE Open Med. 2019 Jul 18;7:2050312119860401. doi: 10.1177/2050312119860401. eCollection 2019.

Abstract

BACKGROUND

Pharmacotherapy is important in reducing morbidity and mortality related to cardiovascular diseases. However, these advantages are limited by drug therapy problems that can impact on a patient's quality of life, prolong hospital stays, and increase the overall burden of healthcare expenditures. Therefore, this study was aimed to assess drug therapy problems among patients with cardiovascular diseases who were hospitalized and received follow-up at the ambulatory clinic of Hiwot Fana Specialized University Hospital.

METHODS

An institution-based cross-sectional study design was used to collect data from patients with cardiovascular diseases who were admitted to the medical ward and those who had received follow-up at the ambulatory clinic of Hiwot Fana Specialized University Hospital. The collected data were coded, entered, and analyzed using SPSS version 16. The associations of selected categorical variables were done using binary logistic and multivariate logistic regression analyses.

RESULTS

Out of 216 study participants, females accounted for 123 (57%), whereas 93 (43%) of them were males. Among cardiovascular diseases identified in the medical ward and ambulatory clinics of Hiwot Fana Specialized University Hospital, congestive heart failure 96 (44.4%) and hypertension 93 (43.1%) were the two most commonly diagnosed disorders. Of the total participants involved in the study, 131 (60.65%) had drug therapy problems. Among the seven classes of drug therapy problems assessed, the most commonly observed was the need for additional drug therapy 76 (58%); followed by cases related to unnecessary drug therapy and noncompliance both of which were estimated to be 16 (12.2%). In addition, of independent variables, only the use of more than three drugs was significantly associated in both binary logistic (crude odds ratio = 0.41, 95% confidence interval = 0.234-0.719, p = 0.002) and multivariate logistic regressions (adjusted odds ratio = 4.86, 95% confidence interval = 1.625-14.536, p = 0.005) as compared with those patients who were using less than three drugs.

CONCLUSION

The findings of the study indicated that more than half of the study participants experienced drug therapy problems, for which 58% required additional drug therapy. The risk of drug therapy problem is found to increase with the use of more than three drugs. Since these problems are adversely affecting the treatment outcome of patients, this is an area which requires special attention and the cooperation of healthcare professionals to tackle it.

摘要

背景

药物治疗对于降低心血管疾病相关的发病率和死亡率至关重要。然而,这些优势受到药物治疗问题的限制,这些问题可能会影响患者的生活质量、延长住院时间并增加医疗保健支出的总体负担。因此,本研究旨在评估在希沃特·法纳专科医院门诊部住院并接受随访的心血管疾病患者中的药物治疗问题。

方法

采用基于机构的横断面研究设计,从入住内科病房的心血管疾病患者以及在希沃特·法纳专科医院门诊部接受随访的患者中收集数据。收集到的数据进行编码、录入,并使用SPSS 16版进行分析。选定分类变量之间的关联通过二元逻辑回归和多元逻辑回归分析进行。

结果

在216名研究参与者中,女性占123名(57%),而男性为93名(43%)。在希沃特·法纳专科医院的内科病房和门诊部确诊的心血管疾病中,充血性心力衰竭96例(44.4%)和高血压93例(43.1%)是最常见的两种疾病。参与研究的所有参与者中,131名(60.65%)存在药物治疗问题。在评估的七类药物治疗问题中,最常观察到的是需要额外的药物治疗76例(58%);其次是与不必要的药物治疗和不依从相关的病例,两者均估计为16例(12.2%)。此外,在自变量中,与使用少于三种药物的患者相比,仅使用三种以上药物在二元逻辑回归(粗比值比=0.41,95%置信区间=0.234-0.719,p=0.002)和多元逻辑回归(调整比值比=4.86,95%置信区间=1.625-14.536,p=0.005)中均有显著关联。

结论

研究结果表明,超过一半的研究参与者存在药物治疗问题,其中58%需要额外的药物治疗。发现使用三种以上药物会增加药物治疗问题的风险。由于这些问题对患者的治疗结果产生不利影响,这是一个需要特别关注且需要医疗保健专业人员合作来解决的领域。

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