Department of Pharmaceutical Chemistry and Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia.
PLoS One. 2023 Aug 4;18(8):e0288093. doi: 10.1371/journal.pone.0288093. eCollection 2023.
Over the past few decades, drug therapy problems (DTPs) have become a significant public health concern worldwide. DTPs in patients with diabetes are responsible for uncontrolled glycemia, disease worsening, early development of complications, high healthcare expenses, prolonged and recurrent hospitalizations, and mortality.
This study aimed to identify the prevalence of drug therapy problems and determine the associated factors among patients with type II Diabetes Mellitus at a University Teaching Hospital in Southwest Ethiopia.
Hospital-based cross-sectional study was conducted between September and October 2022. Data were collected through medical record reviews and interviewer-administered structured questionnaires, which were then analyzed using SPSS version 26. Cipolle's method was adapted for classification of DTPs. Bivariate followed by multivariate logistic regression analysis was used to assess the association between predictor variables and the outcome variable. P-value ≤ 0.05 was employed as a cut-off point to determine statistical significance.
Among 117 participants, 172 drug therapy problems (DTPs) were identified, with an average of 1.47 DTPs per patient, and83 (70.9%) participants had at least one type of drug therapy problem. Of the seven DTPs identified, need additional drug therapy was the most common, 50 (42.7%), followed by non-compliance with medication, 45 (38.5%) and ineffective drug therapy, 25 (21.4%). Occupational status and comorbidity were factors that associated with the occurrence of DTPs. Farmers were approximately four times more likely to develop DTPs than housewives were (adjusted odds ratio (AOR) = 3.56, 95% CI: 1.12-11.38, P = 0.03). The odds of drug therapy problems were twice as high in those with four comorbid conditions than in those without comorbidities (AOR = 1.95, 95% CI: 0.90-3.76, p = 0.02).
In the current study, the proportion of type 2 diabetes patients with drug therapy problems was high. This potentially lead to uncontrolled glycemia and early development of comorbid conditions, increasing morbidity and mortality rates. This could be attributed to the failure to effectively integrate clinical pharmacy services in different hospital wards, which is the case in virtually all hospitals in Ethiopia.
在过去几十年中,药物治疗问题(DTP)已成为全球关注的重大公共卫生问题。糖尿病患者的 DTP 可导致血糖控制不佳、病情恶化、并发症早期发生、医疗费用高、住院时间延长和反复发作,以及死亡率升高。
本研究旨在确定埃塞俄比亚西南部一所大学教学医院 2 型糖尿病患者药物治疗问题的发生率,并确定其相关因素。
这是一项 2022 年 9 月至 10 月间在医院进行的横断面研究。通过病历回顾和访谈者管理的结构化问卷收集数据,然后使用 SPSS 版本 26 进行分析。采用 Cipolle 方法对药物治疗问题进行分类。采用二变量和多变量逻辑回归分析评估预测变量与结局变量之间的关联。采用 P 值≤0.05 作为判断统计学显著性的界限。
在 117 名参与者中,发现 172 种药物治疗问题(DTP),平均每位患者有 1.47 种 DTP,83 名(70.9%)参与者至少有一种类型的药物治疗问题。在确定的七种 DTP 中,需要额外的药物治疗是最常见的,有 50 种(42.7%),其次是不遵守用药规定,有 45 种(38.5%)和药物治疗无效,有 25 种(21.4%)。职业状况和合并症是与 DTP 发生相关的因素。农民发生 DTP 的可能性是家庭主妇的四倍(调整后的优势比(AOR)=3.56,95%置信区间:1.12-11.38,P=0.03)。有四种合并症的患者发生药物治疗问题的可能性是没有合并症的患者的两倍(AOR=1.95,95%置信区间:0.90-3.76,P=0.02)。
在本研究中,有药物治疗问题的 2 型糖尿病患者比例较高。这可能导致血糖控制不佳和合并症的早期发生,增加发病率和死亡率。这可能归因于未能在不同的医院病房有效整合临床药学服务,而这在埃塞俄比亚几乎所有的医院都是如此。