Level of medication adherence and its determinants of cardiovascular disease patients attending at specialized teaching hospitals of Amhara regional state, Ethiopia: a multicenter cross-sectional study

BackgroundNon-adherence to medication in patients with cardiovascular disease continues to be a main cause of suboptimal management, increased morbidity and mortality, and increased healthcare expenses. The present study assessed the level of medication adherence and its determinants of cardiovascular disease patients.MethodsAn institutional-based multicenter cross-sectional study was conducted with patients with cardiovascular disease in Northwest Ethiopian teaching hospitals. The level of medication adherence was evaluated using a standardized questionnaire of the Adherence in Chronic Disease Scale (ACDS). To find determinants of the level of medication adherence, an ordinal logistic regression model was employed. Statistics were significant when P ≤ 0.05 at a 95% confidence interval (CI).ResultsIn the end, 336 participants were included in the research. According to this study, one-third of patients had low medication adherence, half had medium adherence, and one-fifth had high medication adherence. Elderly patients [adjusted odds ratio (AOR) = 2.691; 95% confidence interval (CI), 1.704–4.251; P < 0.000], marital status (AOR = 1.921; 95% CI, 1.214–3.039; P = 0.005), alcoholic patients (AOR = 2.782; 95% CI, 1.745–4.435; P < 0.000), Patients without physical activity (AOR = 1.987; 95% CI 1.251–3.156; P = 0.004), non health insurances (AOR = 1.593; 95% CI 1.003–2.529; P = 0.049), sever Charles comorbidity index (AOR = 2.486; 95% CI 1.103–5.604; P = 0.028), patients with polypharmacy (AOR = 2.998 (1.817–4.947) P < 0.000) and, manypolypharmacy (AOR = 3.031 (1.331–6.898) P = 0.008) were more likely to have low medication adherence.ConclusionThe current study concluded that one-third of study participants had low medication adherence. Older age, marital status, drinker, physical inactivity, drug source, comorbidity, and polypharmacy all contributed to the low level of medication adherence. To improve patients with cardiovascular disease’s adherence to their medications, intervention is necessary

Prescribing pattern of anti-hypertensive medications among hypertensive outpatients at selected hospitals of South Gondar Zone, Amhara, Ethiopia: a hospital based cross sectional study

Abstract Background Irrational prescription has a lion share for uncontrolled blood pressure. There is no study assessing prescription pattern among hypertensive patients at the study sites. Therefore, the objective of the current study was to evaluate prescription patterns for hypertension and blood pressure (BP) control at randomly selected hospitals of South Gondar Zone. Methods A hospital based cross sectional study was conducted from December 1, 2020 to February 30, 2021. Hypertensive patients were selected by systematic random sampling proportionally from study hospitals. Structured questionnaires were used to collect socio-demographic chacteristics and adherence. Data abstraction form was used to collect prescription patterns, BP level and other necessary information. The association of prescription patterns and other variables with blood pressure control was determined by using binary logistic regression. Results All recruited 423 patients were included in data analysis. Among prescriptions for hypertension, on average 93.5% were found to be in line with WHO guideline. About 53% of prescriptions for hypertension were monotherapies. Patient level low medication regimen complexity, and monotherapy were associated with blood pressure control (Ajusted Odds Ratio [AOR] = 2.04, [1.07–3.91]; AOR = 3.83 [1.42–10.35], respectively). Patients with inappropriate drug selection, and non-adherence were less likely to have controlled BP (AOR = 0.47 [0.26–0.85]; AOR = 0.52 [0.34–0.85], respectively). Moreover, patients who didn’t have health insurance and follow regular aerobic exercise were less likely to have controlled BP (AOR = 0.42 [0.26–0.68]; AOR = 0.53 [0.32–0.88], respectively). Conclusion Diuretics were the most frequently prescribed drug in monotherapy and in combination with calcium channel blockers (CCBs) as dual therapy. On average, more than 90% of prescription was in accordance with WHO guideline and around one-third of participants experienced at least one moderate or major drug-drug interaction. Patient level low medication regimen complexity and monotherapy were positively associated with BP control whereas, non-adherence, inappropriate drug selection, having no health insurance, and didn’t follow regular aerobic exercise were negatively associated with BP control. Clinicians should be adherent to treatment guidelines and focus on modifiable factors to improve BP control

Medication regimen complexity and its association with adherence and blood pressure control among hypertensive patients at selected hospitals of South Gondar Zone: A hospital based cross sectional study.

IntroductionDespite the availability of effective antihypertensive medications, blood pressure (BP) control is suboptimal. High medication regimen complexity index (MRCI) is known to reduce adherence and may be the reason for poor BP control. However, there is no data in the present study areas. Hence, the aim of this study was to assess MRCI and its association with adherence and BP control among hypertensive patients at selected hospitals of South Gondar Zone.MethodsA hospital based cross sectional study was conducted from December 1, 2020 to February 30, 2021 at selected hospitals of South Gondar Zone. Medication regimen complexity and adherence was evaluated using 65-item validated tool called MRCI (Text removed at time of retraction. See retraction notice for more information.). Multivariable logistic regression analysis was done to determine the association between predictive and outcome variables.ResultsAbout 3.3% of participants were classified as having high HTN specific MRCI whereas 34.75% of participants were classified as having high patient level MRCI. (Text removed at time of retraction. See retraction notice for more information.) Being illiterate, and having low HTN MRCI were more likely to have controlled BP in adjusted analyses. On the contrary, (Text removed at time of retraction. See retraction notice for more information.) not having health insurance, and having lower monthly income were less likely to have controlled BP.ConclusionA considerable proportion of patients had high MRCI. Having low HTN MRCI was more likely to have controlled BP. Simplification of a complex medication regimen for patients with HTN should be sought by physicians and pharmacists to improve BP control

Evaluation of In Vivo Wound-Healing and Anti-Inflammatory Activities of Solvent Fractions of Fruits of Argemone mexicana L. (Papaveraceae)

Introduction. The solvent fractions of the fruits of Argemone mexicana L. (Papaveraceae) have not yet been explored scientifically for in vivo wound healing and anti-inflammatory activities. The objective of this study was, therefore, to evaluate in vivo wound healing and anti-inflammatory activities of the solvent fractions of the fruit of Argemone mexicana L. (Papaveraceae) in rats. Method. The crude extract of Argemone mexicana was fractionated with n-hexane, ethyl acetate, and distilled water. Wound healing activity was evaluated using excision and incision wound models while anti-inflammatory activity was evaluated using carrageenan-induced rat paw and cotton pellet-induced granuloma models. The fractions were evaluated at 5 and 10% ointments using moist-exposed burn ointment as the standard drug, and 100, 200, and 400 mg/kg test doses using aspirin, and dexamethasone as standard drugs for wound healing and anti-inflammatory activities, respectively. All treatment administrations were made orally for anti-inflammatory activity and applied topically for wound healing activity. Result. The 10% w/w ethyl acetate fraction ointment showed a significant percentage of wound contraction, reduced period of epithelialization, increased amount of fibrosis, neovascularization, and collagen tissue formation (p<0.01). The ethyl acetate fraction also showed a significant increase in tensile strength (55%; p<0.01) and (81.10%; p<0.01) at the tested doses of 5 and 10% w/w ointments, which was comparable to moist-exposed burn ointment. The ethyl acetate fraction also revealed a significant percent edema inhibition (61.41%; p<0.01), suppression of the exudate (38.09% p<0.01), and granuloma mass formations (53.47% p<0.01) at the tested dose of 400 mg/kg. Conclusion. The results of this study showed that the Ethyl acetate fraction of Argemone mexicana fruit has significant wound healing and anti-inflammatory activities which support the traditional claims of the experimental plant