Effect of Medication Therapy Management on Drug Therapy Problem and Low Density Lipo-Protein Goal Attainment Among Ambulatory Atherosclerotic Cardiovascular Disease Patients at Jimma Medical Center, Jimma South West Ethiopia, 2025

Abstract

Background: Uncontrolled low-density lipoprotein is a major contributing factor for the occurrence of atherosclerotic cardiovascular diseases, including ischemic stroke and ischemic heart disease. Drug therapy problems are common among these patients, yet their resolution and low-density lipoprotein cholesterol goal attainment remains suboptimal which necessitates implementation of medication therapy management. Objective: To determine the effect of medication therapy management on drug therapy problem resolution and low-density lipoprotein cholesterol goal attainment among ambulatory atherosclerotic cardiovascular disease patients at Jimma University Medical Center, South west Ethiopia from January, 2025 to April 2025. Methods and Participants: A one-group pre-post quasi-experimental study was conducted from January to April 2025 among atherosclerotic cardiovascular patients at Jimma medical center ambulatory clinic. Data was collected at baseline, one month, and two months post-intervention. Data was entered using Epidata 4.6.0.1 and analyzed using SPSS v26. Cochran’s Q and McNemar’s post-hoc tests assessed changes over time, while multivariate logistic regression identified factors associated with drug therapy problems and cholesterol goal attainment. Results: A total of 115 patients were enrolled, with a mean age of 57.5 years and 59.1% being male. At baseline 134 drug therapy problems were identified, while prevalence was 60.0% and later dropped to 28.7% after medication therapy management. Before intervention, drug therapy problems were significantly associated with non-prescription drug use (AOR=4.1, 95% CI:1.26 13.46), number of non-statin drugs (AOR=2.6, 95% CI:1.55–4.39), longer disease duration (AOR=1.3, CI:1.03–1.64), and patients who are able to use both insurance and pocket money reduced odd by 75% when compared to those who uses single payment method (AOR=0.25, CI:0.08–0.76). After intervention, number of non-statin drugs (AOR=2.1, CI:1.32–3.25) payment methods (AOR=0.22, CI:0.09–0.54) remained significant. Low-density lipoprotein cholesterol goal attainment improved from 53.9% at baseline to 65.2% at second follow-up. High statin adherence increased goal attainment over 20-fold at baseline (AOR=20.2, CI:5.15–79.39). Also, urban residency increased attainment (AOR=5.0, 95% CI:1.42–17.36), while irregular follow-up to clinic reduced it by 35% (AOR=0.65, CI:0.45–0.93). Post-intervention, baseline goal achievers were 4 times more likely to meet goals at second follow-up (AOR=4.24, CI:1.53 11.73), and statin adherence increased likelihood over 6-fold (AOR=6.28, 95% CI:1.50–26.19). Conclusion and Recommendation: Medication therapy management reduces drug therapy problems and improves low density lipoprotein-cholesterol goal achievement in atherosclerotic cardiovascular disease patients. Strengthening it through institutional support, policy changes, training and adoption of practices in follow-up clinics is recommended to enhance these benefits