Drug Related Problems and Glycaemic Control among Adult Type 2 Diabetic Patients at Wolaita Soddo University Teaching Hospital, Southern Ethiopia

Abstract

Background: A drug-related problem is an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes of patients. Type 2 diabetic patients generally use multiple medications for comorbidities increasing the risk of drug related problems and resultant poor glycemic control in this population. Objective: To assess epidemiology and predictors of drug related problems and glycaemic control among adult type 2 diabetic patients at Wolaita Soddo University teaching hospital, Southern Ethiopia. Method: A facility based cross-sectional study design was employed and data was collected from medical record reviews and using structured questionnaire. Drug related problems were identified by using Cipolle‟s drug related problems identification method which was adapted to diabetes patients and was further evaluated by experts. To examine the influences of different variables on drug related problems and on glycaemic level, both binary and multiple logistic analyses were performed. The 95% CI was used to show the accuracy of data analysis and P value <0.05 was considered as statistically significant. Results: A total of 243 adult type 2 diabetic patients were included, of these, two hundred twenty two patients with a total of 378 drug related problems were identified. Among these, 83.1% had at least one drug related problem, averaging 1.8 ± 0.751 problems per patient. Need additional drug, 137(56.37%) and non-compliance 126(51.9%) were the most common types while age≥ 65 [AOR=9.079, 95%CI= (2.213-37.241)], comorbidity [AOR=7.004, 95% CI= (1.285-18.194)], polypharmacy [AOR =3.311, 95% CI= (1.366- 30.329)], and history of hospitalization [AOR=0.403, 95%CI= (0.176-0.925)] were independent predictors of the problems. Non–compliance [AOR=2.860, 95% CI= (2.947- 5.715)], dose too low [AOR=2.277, 95%CI= (1.091-4.753)] and too high [AOR=0.105, 95%CI= (0.025-0.435)] independently predicted poor glycemic control among the patients. Conclusion: The large number of drug related problems identified showed that optimal medication management in type 2 diabetes remains a major challenge in clinical practice. Hence, the hospital should optimize utilization of statins, antiplatelet, metformin and, also make efforts to increase medication adherence of the diabetic patients. Key words: drug related problems, type 2 diabetes, Wolaita Soddo University teaching hospital, glycaemic control.