scholarly journals Drug-Therapy Problems and Predictors among Hospitalized Heart-Failure Patients: A Prospective Observational Study

2020 ◽  
Vol Volume 12 ◽  
pp. 281-291
Author(s):  
Teklehaimanot Fentie Wendie ◽  
Mulugeta Tarekegn Angamo
Keyword(s):  
Heart Failure ◽  
Drug Therapy ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Heart Failure Patients ◽  
Drug Therapy Problems

scholarly journals Heart failure care and outcomes in a Tanzanian emergency department: A prospective observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254609
Author(s):  
Sainikitha Prattipati ◽  
Francis M. Sakita ◽  
Godfrey L. Kweka ◽  
Tumsifu G. Tarimo ◽  
Timothy Peterson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Observational Study ◽  
Clinical Diagnosis ◽  
Prospective Observational Study ◽  
Medication Use ◽  
Sub Saharan Africa ◽  
Prior History ◽  
Heart Failure Patients ◽  
History Of

Background The burden of heart failure is growing in sub-Saharan Africa, but there is a dearth of data characterizing care and outcomes of heart failure patients in the region, particularly in emergency department settings. Methods In a prospective observational study, adult patients presenting with shortness of breath or chest pain to an emergency department in northern Tanzania were consecutively enrolled. Participants with a physician-documented clinical diagnosis of heart failure were included in the present analysis. Standardized questionnaires regarding medical history and medication use were administered at enrollment, and treatments given in the emergency department were recorded. Thirty days after enrollment, a follow-up questionnaire was administered to assess mortality and medication use. Multivariate logistic regression was performed to identify baseline predictors of thirty-day mortality. Results Of 1020 enrolled participants enrolled from August 2018 through October 2019, 267 patients (26.2%) were diagnosed with heart failure. Of these, 139 (52.1%) reported a prior history of heart failure, 168 (62.9%) had self-reported history of hypertension, and 186 (69.7%) had NYHA Class III or IV heart failure. At baseline, 40 (15.0%) reported taking a diuretic and 67 (25.1%) reported taking any antihypertensive. Thirty days following presentation, 63 (25.4%) participants diagnosed with heart failure had died. Of 185 surviving participants, 16 (8.6%) reported taking a diuretic, 24 (13.0%) reported taking an antihypertensive, and 26 (14.1%) were rehospitalized. Multivariate predictors of thirty-day mortality included self-reported hypertension (OR = 0.42, 95% CI: 0.21–0.86], p = 0.017) and symptomatic leg swelling at presentation (OR = 2.69, 95% CI: 1.35–5.56, p = 0.006). Conclusion In a northern Tanzanian emergency department, heart failure is a common clinical diagnosis, but uptake of evidence-based outpatient therapies is poor and thirty-day mortality is high. Interventions are needed to improve care and outcomes for heart failure patients in the emergency department setting.

scholarly journals A Prospective Observational Study of Drug Therapy Problems in Pediatric Ward of a Referral Hospital, Northeastern Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Gizachew Kassahun Bizuneh ◽  
Betelhem Anteneh Adamu ◽  
Getenet Tadege Bizuayehu ◽  
Solomon Debebe Adane
Keyword(s):  
Risk Factors ◽  
Drug Therapy ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Dose Calculation ◽  
Referral Hospital ◽  
Pediatric Ward ◽  
Drug Therapy Problem ◽  
Drug Therapy Problems ◽  
Dessie Referral Hospital

Background. A drug therapy problem is any undesirable event experienced by a patient during drug therapy that interferes with achieving the desired goals of therapy. It has been pointed out that hospitalized pediatric patients are particularly prone to drug-related problems. Identifying drug therapy problems enables risk quantification and determination of the potential impact of prevention strategies. The purpose of this study was to assess the drug therapy problems in a pediatric ward of Dessie Referral Hospital, northeast of Ethiopia, and to identify associated factors for drug therapy problems. Methods. A prospective observational study design was carried out to assess drug therapy problems in a pediatric ward of Dessie Referral Hospital from February 1, 2018, to May 30, 2018. Ethical approval was obtained, and informed consent was signed by each study participant’s parent before the commencement of the study. All patients admitted to the ward during the study period were included in the study. Data was collected by trained pharmacy staffs through medical record reviews of patients using a prepared standard checklist and semistructured questionnaire. The collected data were cleared and checked every day for completeness and consistency before processing. Data were entered, and descriptive statistical analysis was done using SPSS Version 20 Software. A P value of less than 0.05 was considered significant. Results. The participants’ mean age was 2.32 years with the standard deviation (SD) of 0.76 years. Among 81 patients, 71 (87.7%) of them had at least one drug therapy problem per patient which indicates that the prevalence of the drug therapy problem was substantially high. Needs additional drug was the most predominantly encountered drug therapy problem accounted (30 (25.2%)). On the other hand, ineffective drug was the least (3 (2.5%)) drug therapy problem. Antibiotics (47 (39.5%)) followed by fluid and electrolyte (25 (21%)) were classes of drugs mostly involved in the drug therapy problem. The main risk factors reported to the occurrence of the drug therapy problems were prescribing and dose calculation errors. Conclusion. The present study revealed that majority of the patients had at least one DTP per patient; this indicates that prevalence of DTP was very high in the study area. Needs additional drug therapy followed by noncompliance was the major cause of the occurrence of DTP. Antibiotics were the main class of drugs involved in the drug therapy problem, and among the risk factors assessed, prescribing and dose calculation errors showed statistical significance.

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