Figure - available from: SAGE Open Medicine
This content is subject to copyright.
Level of drug–drug interactions identified from elder patients admitted at North West Ethiopia Comprehensive Specialized Hospitals.
Source publication
Abstract
Objective: Drug–drug interactions are of major concern due to links to untoward drug effects, hospitalizations, and serious
health impacts. Elderly patients are more predisposed to drug interactions than younger patients. The present study aimed
to find out the prevalence of drug–drug interactions at North West Ethiopian compressive specia...
Similar publications
Introduction
Hospitals across the country are experiencing a rise in the length of hospital stays, ranging from 2% to 14%. As a result, patients who remain hospitalized for a prolonged period are three times more likely to suffer in-hospital deaths. Therefore, identifying contributing factors for prolonged hospital stays enhances the ability to imp...
Citations
... The adult ICU has 6 beds. DMCSH is located in East Gojam, which is located 300 km and 265 km from Addis Ababa and Bahir Dar, the capitals of Ethiopia and the Amhara regional state, respectively (43). The adult ICU has 4 beds, 3 functional mechanical ventilators, and 3 functional monitors. ...
Background
Worldwide, nearly half of the patients admitted to intensive care units require ventilatory support. Despite advances in intensive care unit patient management and mechanical ventilator utilization, the odds of mortality among mechanically ventilated patients are higher in resource-limited settings. Little is known about the mortality of patients on mechanical ventilation outside the capital of Ethiopia. This study aimed to assess mortality and its associated factors among mechanically ventilated adult patients in intensive care units.
Method
An institutional-based cross-sectional study was conducted on mechanically ventilated patients in intensive care units from 1 February 2020 to 1 March 2023. A simple random sampling technique was used to select 434 patients’ charts. A data extraction tool designed on the Kobo toolbox, a smartphone data collection platform, was used to collect the data. The data were exported into Microsoft Excel 2019 and then into Stata 17 for data management and analysis. Descriptive statistics were used to summarize the characteristics of the study participants. A bivariable logistic regression was conducted, and variables with p ≤ 0.20 were recruited for multivariable analysis. Statistical significance was declared at p < 0.05, and the strength of associations was summarized using an adjusted odds ratio with 95% confidence intervals.
Result
A total of 404 charts of mechanically ventilated patients were included, with a completeness rate of 93.1%. The overall proportion of mortality was 62.87%, with a 95% CI of (58.16–67.58). In the multivariable logistic regression, age 41–70 years (AOR: 4.28, 95% CI: 1.89–9.62), sepsis (AOR: 2.43, 95% CI: 1.08–5.46), reintubation (AOR: 2.76, 95% CI: 1.06–7.21), and sedation use (AOR: 0.41, 95% CI: 0.18–0.98) were found to be significant factors associated with the mortality of mechanically ventilated patients in the intensive care unit.
Conclusion
The magnitude of mortality among mechanically ventilated patients was high. Factors associated with increased odds of death were advanced age, sepsis, and reintubation. However, sedation use was a factor associated with decreased mortality. Healthcare professionals in intensive care units should pay special attention to patients with sepsis, those requiring reintubation, those undergoing sedation, and those who are of advanced age.
... Many classification systems have been developed to categorize DRPs, including the Helper-Strand classification [7], Cipolle's classification [8] and the Pharmaceutical Care Network Europe (PCNE) [8]. Three common types of DRPs mentioned in clinical practice represent potentially inappropriate medications (PIMs), drugdrug interactions (DDIs), and adverse drug events (ADEs) [6,[9][10][11][12][13]. Additionally, older populations are susceptible to DRPs, owing to age-related changes in pharmacokinetics and pharmacodynamics, cognitive decline and functional impairment [10,14,15]. ...
... DRPs increase the chance of unfavorable outcomes, such as poor quality of life, hospitalization, health care expenditure, morbidity and mortality [16][17][18][19][20]. As reported in previous studies, approximately 30% to 70% of hospitalized older patients developed DRPs [12,[21][22][23]. Many studies have shown more than one DRP per person [24,25]. ...
... Many studies have shown more than one DRP per person [24,25]. Furthermore, recent studies reported the prevalence of PIMs ranging from 28% to 73% [11,[26][27][28], DDIs from 8% to 58% [12,29,30] and ADEs from 15% to 58% in the older population [13,31,32]. However, appropriate medicine management could prevent 15% to 70% of DRPs [33,34]. ...
Background: Older persons are more likely to have multiple chronic diseases, leading to the simultaneous use of many medications. This situation results in increased drug-related problems (DRPs), which are the causes of adverse health outcomes. Therefore, we aimed to evaluate the prevalence of and associated risk factors for exposure to >1 criterion of DRPs among older adults admitted to a tertiary care hospital. Methods: We conducted a cross-sectional study involving 357 participants aged ≥60 years admitted to Ramathibodi Hospital from 1 February 2022 to 30 November 2022. The participants were evaluated for baseline characteristics, medications and DRPs and were classified into two groups, according to their exposure to DRPs: patients with exposure to ≤1 criteria and patients with exposure to >1 criterion of DRPs. Multivariate logistic regression analysis was performed to determine the independent risk factors for exposure to >1 criterion of DRPs. Results: Overall, 205 (57.4%) patients experienced >1 criterion of DRPs. Approximately 67.8%, 71.7% and 7.6% of the participants were exposed to at least one potentially inappropriate medication (PIM), drug–drug interaction (DDI) and adverse drug events (ADE), respectively. The most frequently prescribed PIMs were proton pump inhibitors (PPIs) (17.3%). Antineoplastics (48.1%) were the most frequently drug class related to ADEs. Overall, 37% of the ADEs in the current study were considered preventable ADEs. After adjustment for potential confounders, polypharmacy and the use of proton pump inhibitors, hypoglycemics, diuretics, psycholeptics, psychoanaleptics and cardiac therapy medications were correlated with a higher risk of exposure to > 1 criterion of PIMs, DDIs or ADEs. Conclusions: Therefore, comprehensive medication reviews and careful medication prescriptions are recommended in the geriatric population.
