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Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia.

ABSTRACT: Background:Drug use evaluation is a system of continuous, systematic, criteria-based drug evaluation that ensures the appropriate use of drugs. Rationalization of drug therapy in emergency medicine would be useful in managing the broad array of conditions that present for emergency care. High-quality drug utilization is associated with the use of a relatively limited number of essential medicines. The World Health Organization developed core drug use indicators for conducting drug utilization studies in healthcare setting. WHO core drug use indicators including prescribing indicators, patient care indicators, and health facility indicators are used nowadays. Objective:The aim of this study was to evaluate the drug use pattern in the Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia, 2018. Methods:A retrospective cross-sectional descriptive study was conducted in the emergency department (ED) of Dilchora Referral Hospital from July 20 to August 19, 2018, using structured data collection format. Result:Out of 344 prescriptions analyzed, a total of 753 medications were prescribed. The average number of drugs per prescription was 2.19. Of drugs prescribed, 685 (90.97%) were in their generic names. Antibiotics were prescribed in 95 (27.62%) of encounters, and injections were prescribed in 154 (44.77%) of encounters. Among 753 medications prescribed, the name and strength of drugs are indicated in 100% and 95.22%, respectively. 679 (90.17%) of drugs were prescribed from the essential drug list of Ethiopia. Conclusion:The findings of this study revealed that the drug utilization pattern was not optimal in accordance with the standard values of WHO prescribing indicators. Some of the prescribing indicators like overprescribing of antibiotics and injections were a problem. Therefore, it is very imperative for the concerned stakeholders and healthcare providers to work toward ensuring drug use according to the standard.

SUBMITTER: Mishore KM

PROVIDER: S-EPMC7060873 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia.

Mishore Kirubel M KM Bekele Nigatu A NA Yirba Tsegaab Y TY Abone Tsion F TF

Emergency medicine international 20200225

<h4>Background</h4>Drug use evaluation is a system of continuous, systematic, criteria-based drug evaluation that ensures the appropriate use of drugs. Rationalization of drug therapy in emergency medicine would be useful in managing the broad array of conditions that present for emergency care. High-quality drug utilization is associated with the use of a relatively limited number of essential medicines. The World Health Organization developed core drug use indicators for conducting drug utiliz ...[more]

PMID: 32185081

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Project description:BACKGROUND: Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC) are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average. OBJECTIVES: To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia. METHODS: A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant's knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression. RESULT: Out of 390 women interviewed, 162 women (41.5%) heard about EC, only 133 (34.1%) had good knowledge, and 200 (51.3%) of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%). Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR = 0.027, 95% CI (0.007, 0.105)]. CONCLUSION: The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low. RECOMMENDATIONS: Health professions should give attention in increasing knowledge and uptake of Emergency Contraception.

Project description:IntroductionMore than two-thirds of the pregnant women in Africa have at least one antenatal care contact with a health care provider. However, to achieve the full life-saving potential that antenatal care promises for women and babies, four visits providing essential evidence-based interventions - a package often called focused antenatal care are required. Hence, identifying the factors associated with dropout of maternal health care utilization would have meaningful implications. The study aimed to assess antenatal care dropout and associated factors among mothers delivering in the public health facilities of Dire Dawa town, Ethiopia.MethodsFacility-based cross-sectional study was conducted from January 1 to 30, 2020. Proportionate sampling and simple random sampling techniques were used to select 230 women. Data were collected using a structured and pretested interview administered questionnaire during delivery. The data were entered into Epidata version 3.1 and analyzed using SPSS version 20. A binary logistic regression model with a 95 % confidence interval was used to analyze the results. Bivariable analysis (COR [crude odds ratio]) and multivariable analysis (AOR [adjusted odds ratio]) was used to analyze the results. From the bivariable analysis, variables with a p-value < 0.25 were entered into the multivariable logistic regression analysis. From the multivariable logistic regression analysis, variables with a significance level of p-value < 0.05 were taken as factors independently associated with ANC dropout.ResultThe proportion of antenatal care dropouts was 86 (37.4 %) (95 % CI: 31.3-43.9). In logistic regression analyses, those who had no past antenatal care follow up were more likely to have ANC dropout (AOR = 7.89; 95 % CI: 2.109-29.498) and those who had no professional advice were more likely to have antenatal care dropout (AOR = 4.64 95 % CI: 1.246-17.254).ConclusionsThis study indicates that a high number of women had antenatal care dropout. Having no past ANC follow-up and professional advice were the major factors of ANC service utilization dropout. Hence, giving more information during the ANC visit is important to reduce the dropout rate from the maternity continuum of care.

Project description:IntroductionPost cesarean section surgical site infection increases both the duration of a patient's hospital stay and unplanned hospital costs. It can delays recovery, prolongs hospitalization, necessitates readmission, and adds to hospital bills and other morbidities as well as mortalities.MethodFacility-based case-control study was conducted from 1st March to 20th April, 2019 among all the mother records enrolled from 1st January to 31st December, 2018 at Public hospitals in Dire Dawa administration. The records of the mothers' who had post-cesarean section surgical site infection (119) was extracted by a census and every three consecutive controls (357) for each case were collected by trained data collectors using a structured data extraction tool. Variables which had p-value <0.25 in bivariate analysis were considered as candidates for multivariable analysis. Statistical significance was declared at P-value ≤0.05 with adjusted odd ratio and 95% confidence interval in the multivariable logistic regression model.ResultAge 20-34 years (AOR:5.4; 95%CI:2.35,12.7), age >35 years (AOR:8.9; 95%CI:1.8,43.9), ≥4 per vaginal examinations (AOR: 4.2; 95%CI:2.16,8.22), current history of Chorioamnionitis (AOR:5; 95%CI:1.05,23.9), previous history of cesarean section (AOR:6.2; 95%CI: 2.72,14.36), provision of antibiotics prophylaxis (AOR:3.2; 95%CI:1.81,5.62), perioperative HCT level <30% (AOR:6.9; 95%CI:3.45,14.1) and duration of rupture of membrane >12 hours (AOR:5.4; 95%CI:1.84,15.87) were the independent determinants of post-cesarean section surgical site infection.ConclusionIncreased in age of the mother, higher number of per vaginal examination, having a history of chorioamnionitis, having previous history of cesarean section, not receiving antibiotics prophylaxis, lower perioperative hematocrit level and longer duration of rupture of membrane were statistically significant in multivariable analysis. Therefore; emphasis should be given for mothers who have higher age category, previous cesarean scar and history of choriamnionitis. In addition; provision of antibiotics should be comprehensive for all mothers undergoing cesarean section.

Project description:ObjectiveGlobally, 8.8% of adults were estimated to have diabetes mellitus, with the low-and middle-income countries sharing the largest burden. However, the research evidence for targeted interventions is lacking in sub-Saharan Africa, particularly in Ethiopia. Therefore, this study aimed to assess the prevalence of diabetes mellitus, disaggregated by the epidemiology of diabetes mellitus morbidity and associated factors among adults in Dire Dawa town, Eastern Ethiopia.MethodsData from a total of 872 randomly sampled adults aged 25-64 years were obtained for analysis using the World Health Organization STEPwise approach to non-communicable disease risk factors surveillance instruments. We estimated the prevalence of diabetes mellitus disaggregated by the previous diabetes mellitus diagnosis status and by the current blood sugar level control status. The bivariable and multivariable binary logistic regression model was used to identify correlates of diabetes mellitus, along with STATA version 14.2 for data management and analysis. All statistical tests were declared significant at p-value < 0.05.Results14.9% (95% confidence interval: 12.1, 17.4) of adults aged 25-64 years had diabetes mellitus in the study sample with 58.5% (95% confidence interval: 49.7, 66.7) on diabetes mellitus medication. Among adults currently taking diabetes mellitus medications, 30.3% (95% confidence interval: 19.8, 45.6) had uncontrolled diabetes mellitus. The magnitude of previously undiagnosed diabetes mellitus was 6.2% (95% confidence interval: 4.8, 8.0) in the study sample and 41.5% (95% confidence interval: 33.3, 50.3) among the diabetics. The odds of diabetes mellitus were higher among adults over the age of 55 years (adjusted odds ratio = 2.1, 95% confidence interval: 1.2, 3.6), currently married adults (adjusted odds ratio = 2.3, 95% confidence interval: 1.2, 4.4), and overweight adults (adjusted odds ratio = 1.6, 95% confidence interval: 1.1, 2.1). Adults with primary education (adjusted odds ratio = 0.4, 95% confidence interval: 0.2, 0.8) and no formal education (adjusted odds ratio = 0.5, 95% confidence interval: 0.2, 0.9) had lower odds of diabetes mellitus.ConclusionThe prevalence of diabetes mellitus among adults was high in Dire Dawa, with a third of the diabetics having poor control of their blood sugar levels and, nearly four in ten were previously undiagnosed. Adults who were overweight, currently married, and those over 55 years need to be targeted for regular diabetes health checkups and community-based screening. Also, a mechanism should be instituted to track a patient's adherence to medications and promote diabetes self-care management.

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Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia.

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Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia.

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