Abstract:
Abstract
Background: Inappropriate dosageadjustment is one of the poor practices that affect the
effectiveness of treatments in patients with renal impairment. However, there is a paucity of
evidences in our country concerning the magnitude and factors of inappropriate
dosageadjustment among those patients.
Objective: This study aimed to assess medication dosage adjustment practice and associated
factors among adult patients with renal impairment admitted to medical wards at Amhara region
referral hospitals.
Method: An institutional based mixed approach, cross-sectional study and key informant
interview was conducted from March 28/2020 to August 30/2020.Asingle stage cluster sampling
technique was employed. The quantitative data was collected by using a pretested interviewer
administered structured questionnaire and the qualitative data was collected thorough key
informant interview by using an interview guide. Data were entered into Epi-Data version 4.6
and transferred into SPSS version 25 for further data processing and analysis.Descriptive
statistics such as frequencies and percentages were computed. Both bivariable and multivariable
binary logistic regression analysis was fitted to identify factors associated with dosage
adjustment practice. A 95% confidence interval and a p-value less than 0.05 were used to declare
statistical significance. Moreover, thematic analysis was done for the qualitative data to identify
key themes.
Result: Among 815 medications which need dosage adjustment 398(48.8%) of them were
adjusted appropriately, and the remaining 417 (51.2%) with 95% CI (44.7%,54.3%) were
adjusted inappropriately. Number of medications, number of comorbidities and being
unemployed were significantly associated with inappropriate dosageadjustment. Furthermore,
four themes were identified in the qualitative data analysis.
Conclusion: Our study revealed that there was a considerable rate of inappropriate dosage
adjustment in patients with renal impairment. Trainings for health care providers, use of
guidelines and communication with clinical pharmacist should be encouraged for good treatment
outcome.
Key words: Dosage Adjustment Practice, Renal Impairment, Amhara Referral Hospital,
Ethiopia
