Drug related problems and associated factors among patients admitted with chronic kidney disease at jimma university medical center, jimma zone, jimma, south west Ethiopia

Abstract

Background: Chronic kidney disease patients are at risk of drug related problems that are associated with increased morbidity, mortality, impaired quality of life and increased healthcare costs. Objective: To determine prevalence of drug related problems and associated factors among chronic kidney disease patients admitted to Jimma university medical center from April to September 2018. Methods: Prospective general cohort study study was conducted among 103 CKD patients admitted to Jimma university medical center from April to September 2018. Data regarding patient characteristics, medications, diagnosis, length of hospitalization and laboratory results were collected through review of patients’ medical charts. Data were analyzed by using Statistical package for Social Science (SPSS) version 21.0. Univariate and multivariate logistic regression was utilized to assess the associations between dependent and independent variables. Statistical significance was considered at p-value <0.05. Results: Out of 103 study participants, 81(78.6%) of patients had DRPs, on average 1.94 ± 0.873 DRPs per patient. The rate of overall DRPs was 30.95 DRPs per 100 medication orders. The most common DRPs among CKD patients were: need additional drug therapy 62 (31%), nonadherence 40(20%) and dose too low 36(18%). The most common causes of need additional drug therapy 52(26%) were because of untreated medical conditions, non-adherence 19(9.5%) the patient/caregiver forgets to take/give the medication and dose too low 29(14.5%) were because of the dose is too low to produce the desired response. Poly-pharmacy (AOR= 4.695, 95% CI: 1.370.-16.091), number of co morbidities (AOR=3.616, 95% CI: 1.015-1.8741), and stage of CKD (AOR= 3.941, 95% CI: 1.221-12.715) were independent predictors for DRPs. Conclusions: Drug related problems were high among chronic kidney disease patients. The most common DRPs were need additional drug therapy and non-adherence. Poly-pharmacy and co morbidities were independent predictors for DRPs. Interdisciplinary health professionals should work to decrease the high prevalence of DRPs among chronic kidney disease patients.