Pattern of anti-epileptic medications nonadherence and associated factors at ambulatory clinic of Jimma Medical Center, Southwestern Ethiopia: A prospective observational study

Objective: This study is designed to assess the pattern of nonadherence, and associated factors among ambulatory patients with epilepsy at Jimma Medical Center, Southwestern Ethiopia, from November 2020 to April 2021. Methods: A hospital-based prospective observational study was employed. A consecutive sampling method was used to recruit study participants. Nonadherence was assessed by the Hill–Bone compliance to the high blood pressure therapy scale. A threshold of 18 scores was used to classify adherence status. Epi-Data manager version 4.6 was used for data entry and all statistical analysis was performed by Statistical Package for Social Science 25.0. Multivariable logistic regression was performed to explore associated factors. Results: A survey included 334 patients with epilepsy. One hundred twenty-two (36.52%) of the study participants were found to be non-adherent. The factors associated with nonadherence were poor involvement of the patient in the therapeutic decision (adjusted odds ratio = 1.74; 95% confidence interval: 1.04–2.90; p  = 0.034), per month income of lesser than1000 Ethiopian birr (adjusted odds ratio = 2.66; 95% confidence interval: 1.03–6.84; p  = 0.042), recent seizure episodes (adjusted odds ratio = 1.97; 95% confidence interval: 1.20–3.23; p  = 0.007), adverse drug reaction (AOR = 2.13; 95% confidence interval: 1.31–3.47; p  = 0.002), and negative medication belief (adjusted odds ratio = 1.28; 95% confidence interval: 1.53–2.25; p  = 0.043). Conclusions: In our setting, the magnitude of nonadherence was substantially high. Hence, providing regular health-related information about the disease and treatment, supplying free antiepileptic drugs, routine assessment of adverse drug reactions, and a multidisciplinary approach involving patients may improve adherence

Drug therapy problems and predicting factors among ambulatory epileptic patients in Jimma Medical Center, Southwest Ethiopia.

BackgroundThe care of epileptic patients is complicated by the cognitive adverse effect of the drug, disease, pharmacokinetics, and pharmacodynamics properties of antiepileptic drugs which in turn intensify the risk of drug therapy problems among epileptic patients.ObjectiveTo assess drug therapy problems and predicting factors among ambulatory epileptic patients at Jimma University Medical Center, Southwest Ethiopia, from September 2020 to May 2021.MethodologyA hospital-based prospective observational study was conducted. A semi-structured questionnaire was used to collect data from patients as well as from charts. Drug therapy problems were identified using Cipolle's, Morley, and Strand drug therapy problem identification and classification method. Data were entered into Epi data manager version 4.6 and exported to statistical software package for social science version 23.0 for analysis. Multiplestepwise backward logistic regression analysis was carried out to identify predictors of drug therapy problems. The 95% CI was used to show an association between the dependent and independent variables. P-value ResultsOf the total 320 epileptic patients 224(70.0%) patients had at least one drug therapy problem. A total of 395 drug therapy problems were identified among two hundred twenty-four patients with an average of 1.2 drug therapy problems per patient. The frequently identified drug therapy problems were non-compliance 115(29.11), adverse drug reaction 110(27.84%), and dose too low 103(26%). Getting of a drug by purchasing [AOR = 4.6,95%CI:(2.05-10.7)], poorly involvement of the patients in therapeutic decision making [AOR = 3.02,95%CI:(1.5-6.06)], the number of medications ≥ two [AOR = 5.3,95%CI:(1.2-22.9)] and having had uncontrolled seizure [AOR = 10.9,95%CI:(4.9-24.2)] were independent predictors of drug therapy problems.ConclusionsDrug therapy problems were common among epileptic patients in the study area. Patients who were getting their drugs by purchasing, poorly involved in therapeutic decision making, having had an uncontrolled seizure, and taking two and above drugs were more likely to experience drug therapy problems. Therefore, due attention should be given to patients with the aforementioned problems to decrease the occurrence of drug therapy problems and improve overall outcomes among epileptic patients

Adverse clinical outcomes of warfarin therapy and predictors among adult outpatients at public hospitals in Nekemte town, western Ethiopia: A retrospective cross-sectional study

Abstracts: Background: Management with warfarin therapy becomes challenging globally due to the increased risk of adverse clinical outcomes from its use. In Africa, warfarin-related bleeding events and thromboembolic complications range from 0.006 % to 59 % and 1.6 %–7.5 %, respectively. Objectives: This study aimed to determine adverse clinical outcomes of warfarin therapy and predictors among adult outpatients at Wallaga University Referral and Nekemte Comprehensive Specialized Hospitals from April 1, 2021 to March 31, 2023. Methods: An institutional-based retrospective cross-sectional study was conducted from June 1 to July 31, 2023, by reviewing the patient's medical charts with warfarin indications. Descriptive statistics such as frequencies, percentages, means, and standard deviations were computed. Bivariable and multivariable logistic regression analyses were performed to check the association between dependent and independent variables. In multivariable logistic regression analysis, an adjusted odds ratio (AOR) with 95 % CI was determined and statistical significance was declared at a p-value <0.05. Results: A total of 402 patients' medical charts with warfarin indications were reviewed. The mean age of the study participants was 38.9 ± 17.9 years and 271(67.4 %) were female patients. Bleeding events 19(4.7 %) and thromboembolic complications 32(8 %) were adverse clinical outcomes of warfarin therapy observed in this study. Warfarin therapy used for 4–6 months (AOR = 3.270; [CI: 1.043–10.252]; p-value = 0.042), hypertension comorbidity (AOR = 3.582; [CI: 1.015–12.642]; p-value = 0.047) and aspirin use (AOR = 5.043; [CI: 1.964–12.948]; p-value = 0.001) were the independent predictors of warfarin related bleeding events. Patients aged 41–64 years were 67.4 % less likely to develop warfarin-related thromboembolic complications than those patients aged 18–40 years (AOR = 0.326; [CI: 0.108–0.983]; p-value = 0.046). Conclusions: Adverse clinical outcomes were found to be observed in less than one-fourth of the study participants in our study. Warfarin use for 4–6 months, hypertension comorbidity, and concomitant use of aspirin were identified as the independent predictors of warfarin-related bleeding events. The age range of 41–64 years was less likely predictive of warfarin-related thromboembolic complications. Institutional-based guidelines and clinical pharmacist involvement in anticoagulation management play a vital role in preventing adverse clinical outcomes

COVID-19-related dysfunctional anxiety and associated factors among adolescents in Southwest Ethiopia: a cross-sectional study

Abstract Background COVID-19 pandemic causes serious threats to people’s mental health, particularly it has huge negative mental health outcomes for adolescents. However, there is lack of studies examining COVID-19-related anxiety among adolescents in Ethiopia. Hence, this study was aimed to examine COVID-19-related dysfunctional anxiety and its associated factors among adolescents in Mettu town. Methods Community-based cross-sectional study was conducted from September 1 to 30, 2020 among 847 adolescents selected by stratified sampling technique. IBM SPSS Statistics Version 26.0 was used for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were computed. Bivariate and multivariate binary logistic regression analyses were done to identify factors associated with COVID-19-related dysfunctional anxiety. The statistical significance was declared at p ≤ 0.05; and the strength of association was described in terms of adjusted odds ratio. Results Out of the total sample, 819 adolescents participated in this study. The mean age of the participants was 14.9 (SD = 2.798) years. The magnitude of COVID-19-related dysfunctional anxiety was found to be 20.9% (95% CI (18.1, 23.9)). The finding indicates that sex [(AOR (95% CI)); (0.724 (0.502, 1.043))], having both parents deceased [(AOR (95% CI)); (2.981 (1.138, 7.814))], living alone [(AOR (95% CI)); (2.363 (1.050, 5.321))], having unemployed mothers [(AOR (95% CI)); (1.943 (1.194, 3.163))], absence of close friend [(AOR (95% CI)); (0.377 (0.225, 0.630))], and medical problem [(AOR (95% CI)); (0.408 (0.278, 0.597))] were significantly associated with COVID-19-related anxiety. Conclusion The magnitude of COVID-19-related dysfunctional anxiety was found to be high in the study area. The findings have shown that the likelihood of developing COVID-19-related dysfunctional anxiety was linked to several factors. Provision of continued psychological support for adolescents is extremely encouraged