Identification and Resolution of Drug Related Problems among Elderly Patients Admitted to Medical Wards of Northwest Ethiopia Comprehensive Specialized Hospitals: A Multicenter Prospective, Observational Study

Abstract

Abstract Introduction: Elderly patients are at risk of more than one disease and polypharmacy. When the use of drugs increases drug related problems well increase due to drug interaction, poor adherence, these lead to poor treatment outcome. These patients often excluded from premarketing trials that can further increase the occurrence of drug related problems. Objective: To identified and resolution of drug related problems and contributing factors among elderly patients admitted to medical ward of northwest Ethiopia comprehensive specialized hospitals from April 30, 2021, to July 30, 2021 Methods: A multicenter prospective observational study was conducted. A systematic sampling technique was used. The identified drug related problem was recorded and classified using Cipolle, and adverse drug reaction was assessed using Naranjo algorithm of adverse drug reaction probability scale, and Medscape was used for drug-drug interaction. Data were cleaned, coded, and entered into Epi data version 4.6.2 software and exported to STATA version 14.1 for further analysis. Logistic regression was used and results were reported as odds ratios (ORs) with 95% Confidence intervals with P-value <0.05 statistically significant. Result: A total of 389 study participants were included in the study. About 266 (68.4%) of the participants had at least a single drug related problem. A total of 503 drug related problems were identified with a mean of 1.32 (CI: 1.27 - 1.36) drug related problems per patient. The threeleading categories of drug related problems were dose too high 108 (21.5%), non-adherence 105

(20.9%),

and adverse drug reaction 96 (19.1%). Alcohol use (AOR= 2.2, 95CI%: 1.23 - 3.94), source of the drug (AOR = 2.85, 95CI%: 1.63 - 4.98), length of hospitalization (AOR = 2.32, 95CI%: 1.37 - 3.95), number of comorbidities (AOR =1.48, 95CI%: 1.09 - 1.99), and polypharmacy (AOR = 3.06, 95CI%: 1.72 - 5.46) were important risk factors for drug related problems. From the intervention provided 84.7% were accepted by prescribers. Among the total drug related problems 67.4 % of the problem was totally solved. Conclusion: This study revealed that, DRPs were high among elderly patients admitted to medical ward of northwest Ethiopia and the most prevalent were dose too high, non-adherence, and adverse drug reaction. Comorbidity, length of hospitalization, ploy-pharmacy, payer, and patients who drink alcohol were more likely to developed drug related problems. Special preference ought to be given to elder patients who are at a higher risk of developing drug related problems. Treatment optimizations were also done by clinical pharmacists and interventions were well accepted by prescribers. Key Words: Drug related problem, Elderly, Medical ward, Northwest, Ethiopia