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Background: Application of different value sets to health-related quality of life (HRQoL) measure... more Background: Application of different value sets to health-related quality of life (HRQoL) measured with the EQ-5D-3L may lead to different results due to differences in methods, perspectives, and countries used. Focusing on concordance, this study aimed at understanding the implications of applying EQ-5D-3L value sets from Sweden, Germany, Denmark, and the UK to evaluate HRQoL of patients undergoing total hip replacement (THR) in Sweden before and after surgery. Methods: We performed a longitudinal study of patients in the Swedish Hip Arthroplasty Register from preoperative stage to 1-year follow-up (n = 73,523) using data collected from 2008 to 2016. Eight EQ-5D-3L value sets from the four countries were compared based on a valuation method (visual analogue scale (VAS) or time trade-off (TTO)), perspective (experience-based or hypothetical), and country. Concordance among the value sets with patient-reported EQ VAS score was also assessed. Longitudinal changes in EQ-5D-3L index ove...
Background: The headache disorders, namely, migraine and tension type headache and the associated... more Background: The headache disorders, namely, migraine and tension type headache and the associated analgesic consumption is badly underestimated and thus makes a major current public health problem. The objective of this study was to determine the prevalence of migraine and tension type headaches and the associated management options used among undergraduate students
Southern African Journal of Infectious Diseases, 2019
Background: Pneumonia is one of the commonest diseases among children in Ethiopia resulting in de... more Background: Pneumonia is one of the commonest diseases among children in Ethiopia resulting in deaths and hospitalisations. The objective of the current study was to determine the cost incurred by caregivers of under-five children with community-acquired pneumonia admitted to the paediatric ward of Jimma University Specialized Hospital, south-western Ethiopia. Methods: An institution-based cross-sectional study was conducted from 01 January to 28 February 2017, through interviews with caregivers. Data on costs incurred before hospital visit, direct medical and non-medical costs, and indirect costs incurred by caregivers of the children were collected. The collected data were analysed using Statistical Package for Social Sciences version 23. Results: Among the 120 caregivers in the study, a median total cost of 304.5 Ethiopian birr (13.22 USD) was reported. This was mostly contributed by indirect costs associated with earnings lost by caregivers related to travel and stay at hospital with the children. Factors, including permanent residence, family size, hospital stay, wealth index, education and major occupation, were found to have statistically significant association with the level of cost incurred by caregivers. Conclusion: This study identified that a significant level of cost is incurred by caregivers of the children in the hospital, a majority of which was contributed by the lost earnings because of the time spent at the hospital with the children.
Background: A significant amount of potentially effective and lifesaving medications were wasted ... more Background: A significant amount of potentially effective and lifesaving medications were wasted at the health facilities due to lack of a system for checking their effectiveness and returning them to the system. Objectives: To assess the prevalence of unused medications and related consequences in selected health facilities of Awi zone, Amhara regional state, Ethiopia. Methods: A facility-based cross-sectional study design supplemented by a qualitative approach was employed. Descriptive data were collected using checklists while interviews were conducted with respective personnel at the health facilities. Results: A total of 4 health facilities were included in the study. During the 1 month of study period, 56 types of medications were found unused at the health facilities. Anti-infective medications were the most commonly unused medications 36.4%. At the in-patient departments of the 4 hospitals, a total of 173 medications were found unused. Similarly, 605 medications were found wasted at the pharmacy stores of those hospitals in the 2009 fiscal year. Conclusion: A significant amount of unused medications were present at the health facilities. Health facilities need to monitor health professionals strictly follow national and international treatment guidelines and monitor the rational use of medications.
Background: Out-of-pocket expenditure constitutes high proportion of healthcare spending in low-i... more Background: Out-of-pocket expenditure constitutes high proportion of healthcare spending in low-income countries. It can affect patients' adherence to treatments leading to serious health consequences. The objective of this study was to document costs incurred by patients visiting Gondar University Referral Hospital, in Gondar, northwestern Ethiopia.
Background: Hypertension is an important public health problem worldwide. There is lac... more Background: Hypertension is an important public health problem worldwide. There is lack of data on uncontrolled blood pressure in developing countries. Objectives: To determine the magnitude and predicting factors of uncontrolled blood pressure in hypertensive patients attending Gondar university hospital, Ethiopia.Methods: A hospital-based cross-sectional survey wasconducted from July 2015 to March 2016. All hypertensive patients were followed and the blood pressure levels were measured. Binary logistic regression analysis was doneto determine the predictors of uncontrolled blood pressure. A p-value of <0.05 was set at priori with 95% confidence interval to test the level of significance.Results: Of the total 578 hypertension patients, 543 (93.9%) fulfilledthe study criteria and were included in the final analysis. The mean age of the participants was 55.96±14.6 years. Nearly two-third (58.2%) of the participants were females. More than one-tenth (11.4%) of the respondents haduncontrolled blood pressure. High salt intake carried six times more risk of uncontrolled blood pressure. Elderly individuals had lower risk as compared to young age group. However, comorbidities were not related with uncontrolled blood pressure. Conclusions: Blood pressure control was relatively high in the hospital studied. High salt intake was strongly linked with uncontrolled blood pressure. Individuals with high salt intake should be followed for their medication experience and disease knowledge.
The study assessed the pattern and appropriateness of medicines prescribed to outpatients at Gond... more The study assessed the pattern and appropriateness of medicines prescribed to outpatients at Gondar University Referral Hospital in northwestern Ethiopia. An institution-based cross-sectional study was employed, through interviews and prescription reviews, among 346 patients at the outpatient pharmacy, from 2nd to 20th of May 2016. Data on sociodemographic profile of patients and medicines prescribed to them were collected. A mean of 1.72 medicines per encounter was prescribed, over a third of the total being anti-infectives. Patients were able to get about 85% of these medicines. An unskilled government employee would be required to work more than one and a half day to be able to afford the average priced medicine. Among prescriptions with two or more medicines, more than a third had at least one potential drug-drug interaction (PDDI), the commonest pair containing amoxicillin and doxycycline. Being male, being older (50–59 years), and increased number of medicines were associated with higher likelihood of PDDIs. In conclusion, the number of medicines prescribed per encounter was up to accepted standard. However, their availability fell short, together with considerable cost. Regarding appropriateness, a significant proportion of potential drug-drug interactions is identified and associated with patient's sex, age, and number of medicines prescribed.
Background: Highly active antiretroviral therapy improves the longevity of patients living with H... more Background: Highly active antiretroviral therapy improves the longevity of patients living with HIV/AIDS. We conducted the study in order to assess health related quality of life of HIV/AIDS patients and the association of socio-demographic and disease related variables with health related quality of life.
Background: Medicine use can be influenced by several factors. Health managers need specific info... more Background: Medicine use can be influenced by several factors. Health managers need specific information about irrational use of medicines, in order to identify opportunities to enhance rational use of medicines in their communities. This study aimed to assess the pattern and factors associated with household medicine use in Gondar town, northwestern Ethiopia. Methods: An interviewer-administered cross-sectional survey was conducted on 771 households, carried out between 5 April and 6 May 2015. The questionnaire contained items focusing on different aspects of medicine use in the households. The analysis involved descriptive summary and binary logistic regression test, which assessed association of independent variables with medicine use. Results: Of the households interviewed, 22.4% (173/771) disclosed the presence of at least one chronic disease in the family; while 49.2% reported the use of medicine in the one month prior to the study. Almost all of the households (92.6%) reported a habit of discontinuing medicines, and 17.8% disclosed a practice of sharing medicines with household members and others. Level of education, presence of health professionals, and individuals with chronic illness in the households were linked to increased likelihood of reporting medicine use. Discarding leftover medicines with garbage (56.7%) was the principal means of disposal reported by the households. Conclusions: A high proportion of reported medicine use, together with problems such as sharing with other people and leaving medicines unfinished were found among the households in the study.
The objective of this study was to assess traditional, complementary, and alternative medicine (T... more The objective of this study was to assess traditional, complementary, and alternative medicine (TCAM) utilization pattern among HIV/AIDS patients on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital. Materials and Methods. Data on sociodemographic profile and clinical and TCAM utilization were collected using a structured, pretested questionnaire from April 01 to May 28, 2014, through interviews with patients. Data on CD4 count, HIV stage, and ART regimen were collected from patient records. Analysis was conducted descriptively using SPSS version 20. Results. Of the 300 participants, 43.7% reported using TCAM, with the largest proportion of them from religious institutions (churches/mosques) (41.22%), followed by home prepared (32.82%) and traditional healers (16.03%). The leading forms of TCAM used were spiritual and herbal therapies constituting 56.49% and 36.64% of the patients, respectively. The most frequently used herbal products included Nigella sativa (22.92%) and Moringa oleifera (20.83%). Most of the patients (73.30%) using TCAM reported improvement in their conditions. Conclusions. TCAM utilization among HIV/AIDS patients on ART was common and different sources and types were used alongside ART, with improvement reported by most. Further research is needed to identify CAM therapies which may be used as adjunct treatments among these patients.
Background: Household surveys are crucial to get accurate information on how medicines are acquir... more Background: Household surveys are crucial to get accurate information on how medicines are acquired, and used by consumers, as they provide the best evidence in the area. The objective of this study was to document household medicine storage practices in Gondar town, northwestern Ethiopia. Methods: A cross-sectional household survey was conducted from April 5 to May 6, 2015. In the study, 809 households were surveyed from four sub-cities in the town selected through multistage sampling with 771 included in the final analysis. Data on the extent of storage, storage conditions, sources of medicines and their current status among others were collected through structured interviews and observations. The data were entered in to Epidata version 3.1, exported to and analyzed using Statistical Packages for Social Sciences (SPSS) version 21. Results: Of the 771 households in the study, 44.2% stored medicines. Presence of family members with chronic illness(es) and higher levels of household incomes predicted higher likelihood of medicine storage. In the households which allowed observation of stored medicines (n = 299), a mean of 1.85 [SD = 1.09] medicines per household were found. By category, anti-infectives for systemic use (23.9%), medicines for alimentary tract and metabolism (19.2%) and those for cardiovascular system (17.7%) ranked top. Among individual medicines stored, diclofenac (10.7%), paracetamol (9.9%) and amoxicillin (8.0%) were on top of the list. Dispensaries (97.8%) and physicians (83.5%) were almost exclusive sources of medicines and advices/orders for medicines respectively. Nearly two-thirds of the medicines found were on use and a vast majority (76.5%) were stored in chests of drawers. Proportion of expired medicines was very low (3.14%).
Background: The headache disorders, namely, migraine and tension type headache and the associated... more Background: The headache disorders, namely, migraine and tension type headache and the associated analgesic consumption is badly underestimated and thus makes a major current public health problem. The objective of this study was to determine the prevalence of migraine and tension type headaches and the associated management options used among undergraduate students
Background: Acute diarrhea is the major cause of child morbidity and mortality in low-income nati... more Background: Acute diarrhea is the major cause of child morbidity and mortality in low-income nations. It is the second most common cause of death among children <5 years of age globally. The indispensable role of community pharmacists is clearly observed in the prevention and treatment of diarrhea. However, there is a paucity of data on how community pharmacies manage acute childhood diarrhea cases in Ethiopia. This study aimed to evaluate the experience of community pharmacies in the management of acute diarrhea in northern Ethiopia. Methods: A simulated case-based cross-sectional study was conducted in community pharmacies from five towns of northern Ethiopia between April 2015 and September 2015. Convenience sampling technique was used to select sample towns. A structured questionnaire was organized to collect the information. Descriptive statistics, chi-squared test, one-way analysis of variance, and binary logistic regression were performed to describe, infer, and test for association between the variables. SPSS for Windows Version 21 was used to enter and analyze the data. A 95% confidence interval and P-value of 0.05 were set to test the level of significance. Results: Approximately 113 community pharmacies were visited to collect the required data from five towns. Majority (78, 69%) of them were located away from hospitals and health care areas. Nine components of history taking were presented for dispensers. Regarding the patient history, “age” was frequently taken, (90.3%), whereas “chief complaint” was the least to be taken (23%), for patients presenting with diarrhea. Approximately 96 (85.0%) cases were provided with one or more medications. The remaining 17 (15%) cases did not receive any medication. A total of six pharmacologic groups of medications were given to alleviate acute diarrheal symptoms. Majority (66, 29.6%) of the medications were oral rehydration salts with zinc. The mean number of medications was 1.99 per visit. Components of advice, such as dose, frequency, duration, drug action, and adverse drug reactions, were found to vary among the five towns at a statistically significant level. Conclusion: Community pharmacies provided inadequate treatment for acute childhood diarrhea. Inappropriate history taking and incorrect drug and food instructions have been frequently encountered during acute diarrhea management. Practitioners working in northern Ethiopia should receive proper training on the management of acute childhood diarrhea.
Abstract
Background: The estimate of the number of people chewing Khat globally ranges from 5 to ... more Abstract Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro‐intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution‐based cross‐sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two‐thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.
A cross-sectional study was conducted at Gondar university referral hospital from 10th of Februar... more A cross-sectional study was conducted at Gondar university referral hospital from 10th of February to 5th of March 2012 using retrospective data on the diseases and medications from medical records of 392 elderly outpatients aged 60 years or older. Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer’s criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, respectively. Statistical analyses done included binary logistic regression using SPSS version 16. The results indicated that anti-infectives were the most commonly prescribed medications. Average number of medications per patient was 1.63 and antibiotics were prescribed during 35.5% of patient encounters. Among the 255 patients aged 65 years or older, 25 (9.8%) were prescribed potentially inappropriate medications based on 2002 Beers...
Abstract
Background: Evaluation of patient/client satisfaction with pharmacy services as a crucia... more Abstract Background: Evaluation of patient/client satisfaction with pharmacy services as a crucial part of the health services through appropriate studies is important. This will help identify specific areas of the service which need improvement in realizing high quality pharmacy services in general and enhance the positive changes in the current pharmaceutical services provision in Ethiopia. The current study aimed at assessing the level of client satisfaction with the services of the outpatient pharmacy of Gondar University Referral Hospital (GURH) in northwestern Ethiopia. Methods: An institution-based cross-sectional study was conducted involving 400 clients who had prescriptions/orders filled at the outpatient pharmacy of the hospital during the period of 5th to 25th of November 2013. The data on the level of satisfaction of clients with the services of the outpatient pharmacy in the hospital was collected using a structured interview guide adopted from an instrument translated into Amharic and validated. The data collected was entered into and analyzed using Statistical Packages for Social Sciences (SPSS) version 16. Results: The overall mean score the respondents gave to satisfaction with the pharmaceutical services was 2.48 out of a maximum of 5.00 score. The mean scores for all the individual parameters rated were less than 3.00. Maximum mean scores were given for parameters asking about the promptness of prescription medication service (2.99), and professionalism of the pharmacy staff (2.96) with the lowest being scored for information given to clients about the storage of medication (1.25), and explanations of possible side effects (1.27). Clients who were served free of fee recorded significantly higher level of satisfaction than those who paid. Higher levels of satisfaction were also reported among illiterates, older adults and those with no job compared to those with higher education, merchants and government employees. Conclusions: This study showed that the overall mean satisfaction level of clients of the outpatient pharmacy was low and it differed among different socio-demographic characteristics. Further research in to the reasons behind the low satisfaction should be done to provide appropriate solutions to improve the service. Keywords: Satisfaction, Pharmacy, Clients, Services, Ethiopia, Gondar University Referral Hospital
Objective: To assess the structural and process components of the pharmaceutical care at Gondar U... more Objective: To assess the structural and process components of the pharmaceutical care at Gondar University Referral Hospital (GURH). Materials and Methods: An institution‑based cross‑sectional study was conducted on all the four pharmacies at GURH from October 1 to December 31, 2013. By adopting data collection instruments from a previously done study, the structural aspects of the pharmacies were assessed using an observation checklist and the process of pharmaceutical care delivery using a self‑administered questionnaire. The data collected was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 16.0. Results: none of the pharmacies had a private counseling room, fire extinguisher and meeting area. None of the pharmacy stores were equipped with fan and air ventilation system and had no cross aisles. The mean values for documentation, patient assessment and implementation of therapeutic objective were 12.14, 14.03 and 5.64 respectively. Many pharmacists (64.29%) did not participate in ward rotation with physicians. The overall pharmacy professionals' level of job satisfaction was found to be 2.77. Conclusion: There were gaps in the structure and the process of the provision of pharmaceutical care in GURH.
Purpose: The aim of this study was to assess clients’ level of expectation from and satisfaction ... more Purpose: The aim of this study was to assess clients’ level of expectation from and satisfaction with medicine retail outlets (MROs) in Gondar town, northwestern Ethiopia. Patients and methods: An institutions-based cross-sectional study was conducted from April 20 to May 5, 2014, by sampling five pharmacies and eight drug stores through simple random sampling. Clients, 424, who came to the MROs during the study period were included in the study. Data were collected using structured questionnaires measuring expectations and satisfaction of clients using a Likert scale of 1–5 through face-to-face interviews. Results: Out of the total 424 interview encounters, 422 (99.5% response rate) questionnaires were included in the analysis, of which 61.1% were of males. The overall mean expectation of respondents toward MRO setting and services was 3.82 and that of satisfaction of the respondents was 3.02. More than three-quarters (76.8%) of the respondents expected medicines in affordable prices from MROs, but nearly half (44.8%) were not satisfied with it. Much more than half (58.5%) of the respondents were dissatisfied with the comfort and convenience of private counseling area. Also, nearly half (47.6%) of the respondents claimed that pharmacy professionals did not provide information regarding the storage condition of medications. There was statistically significant difference in overall expectation (t=2.707, P=0.007) and satisfaction (t=2.260, P=0.024) with the setting and services of MROs between respondents who claimed to know the difference between a pharmacy and a drug store and those who claimed they did not. Conclusion: Clients’ expectation from MRO services was high, with average satisfaction. The overall expectation and satisfaction of the respondents toward MROs were lower in those who reported they did not know the difference between a pharmacy and a drug store than in those who claimed to know the difference. Supportive supervision by the town’s health bureau on the MROs is recommended to help improve clients’ satisfaction.
Objective: to assess the knowledge, attitude and practice of diabetic patients who were self-admi... more Objective: to assess the knowledge, attitude and practice of diabetic patients who were self-administering
insulin towards their management of disease and medication.
Materials and Methods: a cross-sectional study was done in the hospital from 1st of April to 16th of May 2013
through a structured interview with 150 diabetes mellitus patients who were self administering insulin as part of
their therapy. Data collected was analyzed descriptively using SPSS version 19.0.
Results: majority (61.3%) were men and those in the age group of 14-29 years (47.3%). Among those who
experienced hypoglycemia, 135 (90%) knew the home management of hypoglycemic effect of insulin. More
than three quarters (78%) reported they were comfortable with their insulin therapy. More than half (54.7%) of
the participants had their blood sugar level monitored every month. Forty six (30.7%) of the patients reported
they had missed their insulin due to different reasons at different times. Insulin storage appropriateness was
significantly associated to educational level.
Conclusions: this study showed that there was poor practice among the patients regarding diabetes and self
insulin therapy which calls for education on self-care management and insulin self-therapy for diabetes mellitus
patients by skilled health care providers.
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will app... more Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:
Background: Application of different value sets to health-related quality of life (HRQoL) measure... more Background: Application of different value sets to health-related quality of life (HRQoL) measured with the EQ-5D-3L may lead to different results due to differences in methods, perspectives, and countries used. Focusing on concordance, this study aimed at understanding the implications of applying EQ-5D-3L value sets from Sweden, Germany, Denmark, and the UK to evaluate HRQoL of patients undergoing total hip replacement (THR) in Sweden before and after surgery. Methods: We performed a longitudinal study of patients in the Swedish Hip Arthroplasty Register from preoperative stage to 1-year follow-up (n = 73,523) using data collected from 2008 to 2016. Eight EQ-5D-3L value sets from the four countries were compared based on a valuation method (visual analogue scale (VAS) or time trade-off (TTO)), perspective (experience-based or hypothetical), and country. Concordance among the value sets with patient-reported EQ VAS score was also assessed. Longitudinal changes in EQ-5D-3L index ove...
Background: The headache disorders, namely, migraine and tension type headache and the associated... more Background: The headache disorders, namely, migraine and tension type headache and the associated analgesic consumption is badly underestimated and thus makes a major current public health problem. The objective of this study was to determine the prevalence of migraine and tension type headaches and the associated management options used among undergraduate students
Southern African Journal of Infectious Diseases, 2019
Background: Pneumonia is one of the commonest diseases among children in Ethiopia resulting in de... more Background: Pneumonia is one of the commonest diseases among children in Ethiopia resulting in deaths and hospitalisations. The objective of the current study was to determine the cost incurred by caregivers of under-five children with community-acquired pneumonia admitted to the paediatric ward of Jimma University Specialized Hospital, south-western Ethiopia. Methods: An institution-based cross-sectional study was conducted from 01 January to 28 February 2017, through interviews with caregivers. Data on costs incurred before hospital visit, direct medical and non-medical costs, and indirect costs incurred by caregivers of the children were collected. The collected data were analysed using Statistical Package for Social Sciences version 23. Results: Among the 120 caregivers in the study, a median total cost of 304.5 Ethiopian birr (13.22 USD) was reported. This was mostly contributed by indirect costs associated with earnings lost by caregivers related to travel and stay at hospital with the children. Factors, including permanent residence, family size, hospital stay, wealth index, education and major occupation, were found to have statistically significant association with the level of cost incurred by caregivers. Conclusion: This study identified that a significant level of cost is incurred by caregivers of the children in the hospital, a majority of which was contributed by the lost earnings because of the time spent at the hospital with the children.
Background: A significant amount of potentially effective and lifesaving medications were wasted ... more Background: A significant amount of potentially effective and lifesaving medications were wasted at the health facilities due to lack of a system for checking their effectiveness and returning them to the system. Objectives: To assess the prevalence of unused medications and related consequences in selected health facilities of Awi zone, Amhara regional state, Ethiopia. Methods: A facility-based cross-sectional study design supplemented by a qualitative approach was employed. Descriptive data were collected using checklists while interviews were conducted with respective personnel at the health facilities. Results: A total of 4 health facilities were included in the study. During the 1 month of study period, 56 types of medications were found unused at the health facilities. Anti-infective medications were the most commonly unused medications 36.4%. At the in-patient departments of the 4 hospitals, a total of 173 medications were found unused. Similarly, 605 medications were found wasted at the pharmacy stores of those hospitals in the 2009 fiscal year. Conclusion: A significant amount of unused medications were present at the health facilities. Health facilities need to monitor health professionals strictly follow national and international treatment guidelines and monitor the rational use of medications.
Background: Out-of-pocket expenditure constitutes high proportion of healthcare spending in low-i... more Background: Out-of-pocket expenditure constitutes high proportion of healthcare spending in low-income countries. It can affect patients' adherence to treatments leading to serious health consequences. The objective of this study was to document costs incurred by patients visiting Gondar University Referral Hospital, in Gondar, northwestern Ethiopia.
Background: Hypertension is an important public health problem worldwide. There is lac... more Background: Hypertension is an important public health problem worldwide. There is lack of data on uncontrolled blood pressure in developing countries. Objectives: To determine the magnitude and predicting factors of uncontrolled blood pressure in hypertensive patients attending Gondar university hospital, Ethiopia.Methods: A hospital-based cross-sectional survey wasconducted from July 2015 to March 2016. All hypertensive patients were followed and the blood pressure levels were measured. Binary logistic regression analysis was doneto determine the predictors of uncontrolled blood pressure. A p-value of <0.05 was set at priori with 95% confidence interval to test the level of significance.Results: Of the total 578 hypertension patients, 543 (93.9%) fulfilledthe study criteria and were included in the final analysis. The mean age of the participants was 55.96±14.6 years. Nearly two-third (58.2%) of the participants were females. More than one-tenth (11.4%) of the respondents haduncontrolled blood pressure. High salt intake carried six times more risk of uncontrolled blood pressure. Elderly individuals had lower risk as compared to young age group. However, comorbidities were not related with uncontrolled blood pressure. Conclusions: Blood pressure control was relatively high in the hospital studied. High salt intake was strongly linked with uncontrolled blood pressure. Individuals with high salt intake should be followed for their medication experience and disease knowledge.
The study assessed the pattern and appropriateness of medicines prescribed to outpatients at Gond... more The study assessed the pattern and appropriateness of medicines prescribed to outpatients at Gondar University Referral Hospital in northwestern Ethiopia. An institution-based cross-sectional study was employed, through interviews and prescription reviews, among 346 patients at the outpatient pharmacy, from 2nd to 20th of May 2016. Data on sociodemographic profile of patients and medicines prescribed to them were collected. A mean of 1.72 medicines per encounter was prescribed, over a third of the total being anti-infectives. Patients were able to get about 85% of these medicines. An unskilled government employee would be required to work more than one and a half day to be able to afford the average priced medicine. Among prescriptions with two or more medicines, more than a third had at least one potential drug-drug interaction (PDDI), the commonest pair containing amoxicillin and doxycycline. Being male, being older (50–59 years), and increased number of medicines were associated with higher likelihood of PDDIs. In conclusion, the number of medicines prescribed per encounter was up to accepted standard. However, their availability fell short, together with considerable cost. Regarding appropriateness, a significant proportion of potential drug-drug interactions is identified and associated with patient's sex, age, and number of medicines prescribed.
Background: Highly active antiretroviral therapy improves the longevity of patients living with H... more Background: Highly active antiretroviral therapy improves the longevity of patients living with HIV/AIDS. We conducted the study in order to assess health related quality of life of HIV/AIDS patients and the association of socio-demographic and disease related variables with health related quality of life.
Background: Medicine use can be influenced by several factors. Health managers need specific info... more Background: Medicine use can be influenced by several factors. Health managers need specific information about irrational use of medicines, in order to identify opportunities to enhance rational use of medicines in their communities. This study aimed to assess the pattern and factors associated with household medicine use in Gondar town, northwestern Ethiopia. Methods: An interviewer-administered cross-sectional survey was conducted on 771 households, carried out between 5 April and 6 May 2015. The questionnaire contained items focusing on different aspects of medicine use in the households. The analysis involved descriptive summary and binary logistic regression test, which assessed association of independent variables with medicine use. Results: Of the households interviewed, 22.4% (173/771) disclosed the presence of at least one chronic disease in the family; while 49.2% reported the use of medicine in the one month prior to the study. Almost all of the households (92.6%) reported a habit of discontinuing medicines, and 17.8% disclosed a practice of sharing medicines with household members and others. Level of education, presence of health professionals, and individuals with chronic illness in the households were linked to increased likelihood of reporting medicine use. Discarding leftover medicines with garbage (56.7%) was the principal means of disposal reported by the households. Conclusions: A high proportion of reported medicine use, together with problems such as sharing with other people and leaving medicines unfinished were found among the households in the study.
The objective of this study was to assess traditional, complementary, and alternative medicine (T... more The objective of this study was to assess traditional, complementary, and alternative medicine (TCAM) utilization pattern among HIV/AIDS patients on antiretroviral therapy at University of Gondar Comprehensive Specialized Hospital. Materials and Methods. Data on sociodemographic profile and clinical and TCAM utilization were collected using a structured, pretested questionnaire from April 01 to May 28, 2014, through interviews with patients. Data on CD4 count, HIV stage, and ART regimen were collected from patient records. Analysis was conducted descriptively using SPSS version 20. Results. Of the 300 participants, 43.7% reported using TCAM, with the largest proportion of them from religious institutions (churches/mosques) (41.22%), followed by home prepared (32.82%) and traditional healers (16.03%). The leading forms of TCAM used were spiritual and herbal therapies constituting 56.49% and 36.64% of the patients, respectively. The most frequently used herbal products included Nigella sativa (22.92%) and Moringa oleifera (20.83%). Most of the patients (73.30%) using TCAM reported improvement in their conditions. Conclusions. TCAM utilization among HIV/AIDS patients on ART was common and different sources and types were used alongside ART, with improvement reported by most. Further research is needed to identify CAM therapies which may be used as adjunct treatments among these patients.
Background: Household surveys are crucial to get accurate information on how medicines are acquir... more Background: Household surveys are crucial to get accurate information on how medicines are acquired, and used by consumers, as they provide the best evidence in the area. The objective of this study was to document household medicine storage practices in Gondar town, northwestern Ethiopia. Methods: A cross-sectional household survey was conducted from April 5 to May 6, 2015. In the study, 809 households were surveyed from four sub-cities in the town selected through multistage sampling with 771 included in the final analysis. Data on the extent of storage, storage conditions, sources of medicines and their current status among others were collected through structured interviews and observations. The data were entered in to Epidata version 3.1, exported to and analyzed using Statistical Packages for Social Sciences (SPSS) version 21. Results: Of the 771 households in the study, 44.2% stored medicines. Presence of family members with chronic illness(es) and higher levels of household incomes predicted higher likelihood of medicine storage. In the households which allowed observation of stored medicines (n = 299), a mean of 1.85 [SD = 1.09] medicines per household were found. By category, anti-infectives for systemic use (23.9%), medicines for alimentary tract and metabolism (19.2%) and those for cardiovascular system (17.7%) ranked top. Among individual medicines stored, diclofenac (10.7%), paracetamol (9.9%) and amoxicillin (8.0%) were on top of the list. Dispensaries (97.8%) and physicians (83.5%) were almost exclusive sources of medicines and advices/orders for medicines respectively. Nearly two-thirds of the medicines found were on use and a vast majority (76.5%) were stored in chests of drawers. Proportion of expired medicines was very low (3.14%).
Background: The headache disorders, namely, migraine and tension type headache and the associated... more Background: The headache disorders, namely, migraine and tension type headache and the associated analgesic consumption is badly underestimated and thus makes a major current public health problem. The objective of this study was to determine the prevalence of migraine and tension type headaches and the associated management options used among undergraduate students
Background: Acute diarrhea is the major cause of child morbidity and mortality in low-income nati... more Background: Acute diarrhea is the major cause of child morbidity and mortality in low-income nations. It is the second most common cause of death among children <5 years of age globally. The indispensable role of community pharmacists is clearly observed in the prevention and treatment of diarrhea. However, there is a paucity of data on how community pharmacies manage acute childhood diarrhea cases in Ethiopia. This study aimed to evaluate the experience of community pharmacies in the management of acute diarrhea in northern Ethiopia. Methods: A simulated case-based cross-sectional study was conducted in community pharmacies from five towns of northern Ethiopia between April 2015 and September 2015. Convenience sampling technique was used to select sample towns. A structured questionnaire was organized to collect the information. Descriptive statistics, chi-squared test, one-way analysis of variance, and binary logistic regression were performed to describe, infer, and test for association between the variables. SPSS for Windows Version 21 was used to enter and analyze the data. A 95% confidence interval and P-value of 0.05 were set to test the level of significance. Results: Approximately 113 community pharmacies were visited to collect the required data from five towns. Majority (78, 69%) of them were located away from hospitals and health care areas. Nine components of history taking were presented for dispensers. Regarding the patient history, “age” was frequently taken, (90.3%), whereas “chief complaint” was the least to be taken (23%), for patients presenting with diarrhea. Approximately 96 (85.0%) cases were provided with one or more medications. The remaining 17 (15%) cases did not receive any medication. A total of six pharmacologic groups of medications were given to alleviate acute diarrheal symptoms. Majority (66, 29.6%) of the medications were oral rehydration salts with zinc. The mean number of medications was 1.99 per visit. Components of advice, such as dose, frequency, duration, drug action, and adverse drug reactions, were found to vary among the five towns at a statistically significant level. Conclusion: Community pharmacies provided inadequate treatment for acute childhood diarrhea. Inappropriate history taking and incorrect drug and food instructions have been frequently encountered during acute diarrhea management. Practitioners working in northern Ethiopia should receive proper training on the management of acute childhood diarrhea.
Abstract
Background: The estimate of the number of people chewing Khat globally ranges from 5 to ... more Abstract Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro‐intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution‐based cross‐sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two‐thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.
A cross-sectional study was conducted at Gondar university referral hospital from 10th of Februar... more A cross-sectional study was conducted at Gondar university referral hospital from 10th of February to 5th of March 2012 using retrospective data on the diseases and medications from medical records of 392 elderly outpatients aged 60 years or older. Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer’s criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, respectively. Statistical analyses done included binary logistic regression using SPSS version 16. The results indicated that anti-infectives were the most commonly prescribed medications. Average number of medications per patient was 1.63 and antibiotics were prescribed during 35.5% of patient encounters. Among the 255 patients aged 65 years or older, 25 (9.8%) were prescribed potentially inappropriate medications based on 2002 Beers...
Abstract
Background: Evaluation of patient/client satisfaction with pharmacy services as a crucia... more Abstract Background: Evaluation of patient/client satisfaction with pharmacy services as a crucial part of the health services through appropriate studies is important. This will help identify specific areas of the service which need improvement in realizing high quality pharmacy services in general and enhance the positive changes in the current pharmaceutical services provision in Ethiopia. The current study aimed at assessing the level of client satisfaction with the services of the outpatient pharmacy of Gondar University Referral Hospital (GURH) in northwestern Ethiopia. Methods: An institution-based cross-sectional study was conducted involving 400 clients who had prescriptions/orders filled at the outpatient pharmacy of the hospital during the period of 5th to 25th of November 2013. The data on the level of satisfaction of clients with the services of the outpatient pharmacy in the hospital was collected using a structured interview guide adopted from an instrument translated into Amharic and validated. The data collected was entered into and analyzed using Statistical Packages for Social Sciences (SPSS) version 16. Results: The overall mean score the respondents gave to satisfaction with the pharmaceutical services was 2.48 out of a maximum of 5.00 score. The mean scores for all the individual parameters rated were less than 3.00. Maximum mean scores were given for parameters asking about the promptness of prescription medication service (2.99), and professionalism of the pharmacy staff (2.96) with the lowest being scored for information given to clients about the storage of medication (1.25), and explanations of possible side effects (1.27). Clients who were served free of fee recorded significantly higher level of satisfaction than those who paid. Higher levels of satisfaction were also reported among illiterates, older adults and those with no job compared to those with higher education, merchants and government employees. Conclusions: This study showed that the overall mean satisfaction level of clients of the outpatient pharmacy was low and it differed among different socio-demographic characteristics. Further research in to the reasons behind the low satisfaction should be done to provide appropriate solutions to improve the service. Keywords: Satisfaction, Pharmacy, Clients, Services, Ethiopia, Gondar University Referral Hospital
Objective: To assess the structural and process components of the pharmaceutical care at Gondar U... more Objective: To assess the structural and process components of the pharmaceutical care at Gondar University Referral Hospital (GURH). Materials and Methods: An institution‑based cross‑sectional study was conducted on all the four pharmacies at GURH from October 1 to December 31, 2013. By adopting data collection instruments from a previously done study, the structural aspects of the pharmacies were assessed using an observation checklist and the process of pharmaceutical care delivery using a self‑administered questionnaire. The data collected was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 16.0. Results: none of the pharmacies had a private counseling room, fire extinguisher and meeting area. None of the pharmacy stores were equipped with fan and air ventilation system and had no cross aisles. The mean values for documentation, patient assessment and implementation of therapeutic objective were 12.14, 14.03 and 5.64 respectively. Many pharmacists (64.29%) did not participate in ward rotation with physicians. The overall pharmacy professionals' level of job satisfaction was found to be 2.77. Conclusion: There were gaps in the structure and the process of the provision of pharmaceutical care in GURH.
Purpose: The aim of this study was to assess clients’ level of expectation from and satisfaction ... more Purpose: The aim of this study was to assess clients’ level of expectation from and satisfaction with medicine retail outlets (MROs) in Gondar town, northwestern Ethiopia. Patients and methods: An institutions-based cross-sectional study was conducted from April 20 to May 5, 2014, by sampling five pharmacies and eight drug stores through simple random sampling. Clients, 424, who came to the MROs during the study period were included in the study. Data were collected using structured questionnaires measuring expectations and satisfaction of clients using a Likert scale of 1–5 through face-to-face interviews. Results: Out of the total 424 interview encounters, 422 (99.5% response rate) questionnaires were included in the analysis, of which 61.1% were of males. The overall mean expectation of respondents toward MRO setting and services was 3.82 and that of satisfaction of the respondents was 3.02. More than three-quarters (76.8%) of the respondents expected medicines in affordable prices from MROs, but nearly half (44.8%) were not satisfied with it. Much more than half (58.5%) of the respondents were dissatisfied with the comfort and convenience of private counseling area. Also, nearly half (47.6%) of the respondents claimed that pharmacy professionals did not provide information regarding the storage condition of medications. There was statistically significant difference in overall expectation (t=2.707, P=0.007) and satisfaction (t=2.260, P=0.024) with the setting and services of MROs between respondents who claimed to know the difference between a pharmacy and a drug store and those who claimed they did not. Conclusion: Clients’ expectation from MRO services was high, with average satisfaction. The overall expectation and satisfaction of the respondents toward MROs were lower in those who reported they did not know the difference between a pharmacy and a drug store than in those who claimed to know the difference. Supportive supervision by the town’s health bureau on the MROs is recommended to help improve clients’ satisfaction.
Objective: to assess the knowledge, attitude and practice of diabetic patients who were self-admi... more Objective: to assess the knowledge, attitude and practice of diabetic patients who were self-administering
insulin towards their management of disease and medication.
Materials and Methods: a cross-sectional study was done in the hospital from 1st of April to 16th of May 2013
through a structured interview with 150 diabetes mellitus patients who were self administering insulin as part of
their therapy. Data collected was analyzed descriptively using SPSS version 19.0.
Results: majority (61.3%) were men and those in the age group of 14-29 years (47.3%). Among those who
experienced hypoglycemia, 135 (90%) knew the home management of hypoglycemic effect of insulin. More
than three quarters (78%) reported they were comfortable with their insulin therapy. More than half (54.7%) of
the participants had their blood sugar level monitored every month. Forty six (30.7%) of the patients reported
they had missed their insulin due to different reasons at different times. Insulin storage appropriateness was
significantly associated to educational level.
Conclusions: this study showed that there was poor practice among the patients regarding diabetes and self
insulin therapy which calls for education on self-care management and insulin self-therapy for diabetes mellitus
patients by skilled health care providers.
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Methods: An institution-based cross-sectional study was conducted from 01 January to 28 February 2017, through interviews with caregivers. Data on costs incurred before hospital visit, direct medical and non-medical costs, and indirect costs incurred by caregivers of the children were collected. The collected data were analysed using Statistical Package for Social Sciences version 23.
Results: Among the 120 caregivers in the study, a median total cost of 304.5 Ethiopian birr (13.22 USD) was reported. This was mostly contributed by indirect costs associated with earnings lost by caregivers related to travel and stay at hospital with the children. Factors, including permanent residence, family size, hospital stay, wealth index, education and major occupation, were found to have statistically significant association with the level of cost incurred by caregivers.
Conclusion: This study identified that a significant level of cost is incurred by caregivers of the children in the hospital, a majority of which was contributed by the lost earnings because of the time spent at the hospital with the children.
Descriptive data were collected using checklists while interviews were conducted with respective personnel at the health facilities. Results: A total of 4 health facilities were included in the study. During the 1 month of study period, 56 types of medications were found unused at the health facilities. Anti-infective medications were the most commonly unused medications 36.4%. At the in-patient departments of the 4 hospitals, a total of 173 medications were found unused. Similarly,
605 medications were found wasted at the pharmacy stores of those hospitals in the 2009 fiscal year. Conclusion: A significant amount of unused medications were present at the health facilities. Health facilities need to monitor health professionals strictly follow national and international treatment guidelines and monitor the rational use of medications.
Methods: A simulated case-based cross-sectional study was conducted in community pharmacies from five towns of northern Ethiopia between April 2015 and September 2015. Convenience sampling technique was used to select sample towns. A structured questionnaire was organized to collect the information. Descriptive statistics, chi-squared test, one-way analysis of variance, and binary logistic regression were performed to describe, infer, and test for association between the variables. SPSS for Windows Version 21 was used to enter and analyze the data. A 95% confidence interval and P-value of 0.05 were set to test the level of significance.
Results: Approximately 113 community pharmacies were visited to collect the required data from five towns. Majority (78, 69%) of them were located away from hospitals and health care areas. Nine components of history taking were presented for dispensers. Regarding the patient history, “age” was frequently taken, (90.3%), whereas “chief complaint” was the least to be taken (23%), for patients presenting with diarrhea. Approximately 96 (85.0%) cases were provided with one or more medications. The remaining 17 (15%) cases did not receive any medication. A total of six pharmacologic groups of medications were given to alleviate acute diarrheal symptoms. Majority (66, 29.6%) of the medications were oral rehydration salts with zinc. The mean number of medications was 1.99 per visit. Components of advice, such as dose, frequency, duration, drug action, and adverse drug reactions, were found to vary among the five towns at a statistically significant level.
Conclusion: Community pharmacies provided inadequate treatment for acute childhood diarrhea. Inappropriate history taking and incorrect drug and food instructions have been frequently encountered during acute diarrhea management. Practitioners working in northern Ethiopia should receive proper training on the management of acute childhood diarrhea.
Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro‐intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution‐based cross‐sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two‐thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.
Background: Evaluation of patient/client satisfaction with pharmacy services as a crucial part of the health services through appropriate studies is important. This will help identify specific areas of the service which need improvement in realizing high quality pharmacy services in general and enhance the positive changes in the current pharmaceutical services provision in Ethiopia. The current study aimed at assessing the level of client satisfaction with the services of the outpatient pharmacy of Gondar University Referral Hospital (GURH) in northwestern Ethiopia.
Methods: An institution-based cross-sectional study was conducted involving 400 clients who had prescriptions/orders filled at the outpatient pharmacy of the hospital during the period of 5th to 25th of November 2013. The data on the level of satisfaction of clients with the services of the outpatient pharmacy in the hospital was collected using a structured interview guide adopted from an instrument translated into Amharic and validated. The data collected was entered into and analyzed using Statistical Packages for Social Sciences (SPSS) version 16.
Results: The overall mean score the respondents gave to satisfaction with the pharmaceutical services was 2.48 out of a maximum of 5.00 score. The mean scores for all the individual parameters rated were less than 3.00. Maximum mean scores were given for parameters asking about the promptness of prescription medication service (2.99), and professionalism of the pharmacy staff (2.96) with the lowest being scored for information given to clients about the storage of medication (1.25), and explanations of possible side effects (1.27). Clients who were served free of fee recorded significantly higher level of satisfaction than those who paid. Higher levels of satisfaction were also reported among illiterates, older adults and those with no job compared to those with higher education, merchants and government employees.
Conclusions: This study showed that the overall mean satisfaction level of clients of the outpatient pharmacy was low and it differed among different socio-demographic characteristics. Further research in to the reasons behind the low satisfaction should be done to provide appropriate solutions to improve the service.
Keywords: Satisfaction, Pharmacy, Clients, Services, Ethiopia, Gondar University Referral Hospital
Referral Hospital (GURH). Materials and Methods: An institution‑based cross‑sectional study was conducted on
all the four pharmacies at GURH from October 1 to December 31, 2013. By adopting data collection instruments
from a previously done study, the structural aspects of the pharmacies were assessed using an observation
checklist and the process of pharmaceutical care delivery using a self‑administered questionnaire. The data
collected was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 16.0.
Results: none of the pharmacies had a private counseling room, fire extinguisher and meeting area. None of
the pharmacy stores were equipped with fan and air ventilation system and had no cross aisles. The mean
values for documentation, patient assessment and implementation of therapeutic objective were 12.14, 14.03
and 5.64 respectively. Many pharmacists (64.29%) did not participate in ward rotation with physicians. The
overall pharmacy professionals' level of job satisfaction was found to be 2.77. Conclusion: There were gaps
in the structure and the process of the provision of pharmaceutical care in GURH.
Patients and methods: An institutions-based cross-sectional study was conducted from April 20 to May 5, 2014, by sampling five pharmacies and eight drug stores through simple random sampling. Clients, 424, who came to the MROs during the study period were included in the study. Data were collected using structured questionnaires measuring expectations and satisfaction of clients using a Likert scale of 1–5 through face-to-face interviews.
Results: Out of the total 424 interview encounters, 422 (99.5% response rate) questionnaires were included in the analysis, of which 61.1% were of males. The overall mean expectation of respondents toward MRO setting and services was 3.82 and that of satisfaction of the respondents was 3.02. More than three-quarters (76.8%) of the respondents expected medicines in affordable prices from MROs, but nearly half (44.8%) were not satisfied with it. Much more than half (58.5%) of the respondents were dissatisfied with the comfort and convenience of private counseling area. Also, nearly half (47.6%) of the respondents claimed that pharmacy professionals did not provide information regarding the storage condition of medications. There was statistically significant difference in overall expectation (t=2.707, P=0.007) and satisfaction (t=2.260, P=0.024) with the setting and services of MROs between respondents who claimed to know the difference between a pharmacy and a drug store and those who claimed they did not.
Conclusion: Clients’ expectation from MRO services was high, with average satisfaction. The overall expectation and satisfaction of the respondents toward MROs were lower in those who reported they did not know the difference between a pharmacy and a drug store than in those who claimed to know the difference. Supportive supervision by the town’s health bureau on the MROs is recommended to help improve clients’ satisfaction.
insulin towards their management of disease and medication.
Materials and Methods: a cross-sectional study was done in the hospital from 1st of April to 16th of May 2013
through a structured interview with 150 diabetes mellitus patients who were self administering insulin as part of
their therapy. Data collected was analyzed descriptively using SPSS version 19.0.
Results: majority (61.3%) were men and those in the age group of 14-29 years (47.3%). Among those who
experienced hypoglycemia, 135 (90%) knew the home management of hypoglycemic effect of insulin. More
than three quarters (78%) reported they were comfortable with their insulin therapy. More than half (54.7%) of
the participants had their blood sugar level monitored every month. Forty six (30.7%) of the patients reported
they had missed their insulin due to different reasons at different times. Insulin storage appropriateness was
significantly associated to educational level.
Conclusions: this study showed that there was poor practice among the patients regarding diabetes and self
insulin therapy which calls for education on self-care management and insulin self-therapy for diabetes mellitus
patients by skilled health care providers.
Methods: An institution-based cross-sectional study was conducted from 01 January to 28 February 2017, through interviews with caregivers. Data on costs incurred before hospital visit, direct medical and non-medical costs, and indirect costs incurred by caregivers of the children were collected. The collected data were analysed using Statistical Package for Social Sciences version 23.
Results: Among the 120 caregivers in the study, a median total cost of 304.5 Ethiopian birr (13.22 USD) was reported. This was mostly contributed by indirect costs associated with earnings lost by caregivers related to travel and stay at hospital with the children. Factors, including permanent residence, family size, hospital stay, wealth index, education and major occupation, were found to have statistically significant association with the level of cost incurred by caregivers.
Conclusion: This study identified that a significant level of cost is incurred by caregivers of the children in the hospital, a majority of which was contributed by the lost earnings because of the time spent at the hospital with the children.
Descriptive data were collected using checklists while interviews were conducted with respective personnel at the health facilities. Results: A total of 4 health facilities were included in the study. During the 1 month of study period, 56 types of medications were found unused at the health facilities. Anti-infective medications were the most commonly unused medications 36.4%. At the in-patient departments of the 4 hospitals, a total of 173 medications were found unused. Similarly,
605 medications were found wasted at the pharmacy stores of those hospitals in the 2009 fiscal year. Conclusion: A significant amount of unused medications were present at the health facilities. Health facilities need to monitor health professionals strictly follow national and international treatment guidelines and monitor the rational use of medications.
Methods: A simulated case-based cross-sectional study was conducted in community pharmacies from five towns of northern Ethiopia between April 2015 and September 2015. Convenience sampling technique was used to select sample towns. A structured questionnaire was organized to collect the information. Descriptive statistics, chi-squared test, one-way analysis of variance, and binary logistic regression were performed to describe, infer, and test for association between the variables. SPSS for Windows Version 21 was used to enter and analyze the data. A 95% confidence interval and P-value of 0.05 were set to test the level of significance.
Results: Approximately 113 community pharmacies were visited to collect the required data from five towns. Majority (78, 69%) of them were located away from hospitals and health care areas. Nine components of history taking were presented for dispensers. Regarding the patient history, “age” was frequently taken, (90.3%), whereas “chief complaint” was the least to be taken (23%), for patients presenting with diarrhea. Approximately 96 (85.0%) cases were provided with one or more medications. The remaining 17 (15%) cases did not receive any medication. A total of six pharmacologic groups of medications were given to alleviate acute diarrheal symptoms. Majority (66, 29.6%) of the medications were oral rehydration salts with zinc. The mean number of medications was 1.99 per visit. Components of advice, such as dose, frequency, duration, drug action, and adverse drug reactions, were found to vary among the five towns at a statistically significant level.
Conclusion: Community pharmacies provided inadequate treatment for acute childhood diarrhea. Inappropriate history taking and incorrect drug and food instructions have been frequently encountered during acute diarrhea management. Practitioners working in northern Ethiopia should receive proper training on the management of acute childhood diarrhea.
Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro‐intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution‐based cross‐sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two‐thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.
Background: Evaluation of patient/client satisfaction with pharmacy services as a crucial part of the health services through appropriate studies is important. This will help identify specific areas of the service which need improvement in realizing high quality pharmacy services in general and enhance the positive changes in the current pharmaceutical services provision in Ethiopia. The current study aimed at assessing the level of client satisfaction with the services of the outpatient pharmacy of Gondar University Referral Hospital (GURH) in northwestern Ethiopia.
Methods: An institution-based cross-sectional study was conducted involving 400 clients who had prescriptions/orders filled at the outpatient pharmacy of the hospital during the period of 5th to 25th of November 2013. The data on the level of satisfaction of clients with the services of the outpatient pharmacy in the hospital was collected using a structured interview guide adopted from an instrument translated into Amharic and validated. The data collected was entered into and analyzed using Statistical Packages for Social Sciences (SPSS) version 16.
Results: The overall mean score the respondents gave to satisfaction with the pharmaceutical services was 2.48 out of a maximum of 5.00 score. The mean scores for all the individual parameters rated were less than 3.00. Maximum mean scores were given for parameters asking about the promptness of prescription medication service (2.99), and professionalism of the pharmacy staff (2.96) with the lowest being scored for information given to clients about the storage of medication (1.25), and explanations of possible side effects (1.27). Clients who were served free of fee recorded significantly higher level of satisfaction than those who paid. Higher levels of satisfaction were also reported among illiterates, older adults and those with no job compared to those with higher education, merchants and government employees.
Conclusions: This study showed that the overall mean satisfaction level of clients of the outpatient pharmacy was low and it differed among different socio-demographic characteristics. Further research in to the reasons behind the low satisfaction should be done to provide appropriate solutions to improve the service.
Keywords: Satisfaction, Pharmacy, Clients, Services, Ethiopia, Gondar University Referral Hospital
Referral Hospital (GURH). Materials and Methods: An institution‑based cross‑sectional study was conducted on
all the four pharmacies at GURH from October 1 to December 31, 2013. By adopting data collection instruments
from a previously done study, the structural aspects of the pharmacies were assessed using an observation
checklist and the process of pharmaceutical care delivery using a self‑administered questionnaire. The data
collected was entered to and analyzed using Statistical Packages for Social Sciences (SPSS) version 16.0.
Results: none of the pharmacies had a private counseling room, fire extinguisher and meeting area. None of
the pharmacy stores were equipped with fan and air ventilation system and had no cross aisles. The mean
values for documentation, patient assessment and implementation of therapeutic objective were 12.14, 14.03
and 5.64 respectively. Many pharmacists (64.29%) did not participate in ward rotation with physicians. The
overall pharmacy professionals' level of job satisfaction was found to be 2.77. Conclusion: There were gaps
in the structure and the process of the provision of pharmaceutical care in GURH.
Patients and methods: An institutions-based cross-sectional study was conducted from April 20 to May 5, 2014, by sampling five pharmacies and eight drug stores through simple random sampling. Clients, 424, who came to the MROs during the study period were included in the study. Data were collected using structured questionnaires measuring expectations and satisfaction of clients using a Likert scale of 1–5 through face-to-face interviews.
Results: Out of the total 424 interview encounters, 422 (99.5% response rate) questionnaires were included in the analysis, of which 61.1% were of males. The overall mean expectation of respondents toward MRO setting and services was 3.82 and that of satisfaction of the respondents was 3.02. More than three-quarters (76.8%) of the respondents expected medicines in affordable prices from MROs, but nearly half (44.8%) were not satisfied with it. Much more than half (58.5%) of the respondents were dissatisfied with the comfort and convenience of private counseling area. Also, nearly half (47.6%) of the respondents claimed that pharmacy professionals did not provide information regarding the storage condition of medications. There was statistically significant difference in overall expectation (t=2.707, P=0.007) and satisfaction (t=2.260, P=0.024) with the setting and services of MROs between respondents who claimed to know the difference between a pharmacy and a drug store and those who claimed they did not.
Conclusion: Clients’ expectation from MRO services was high, with average satisfaction. The overall expectation and satisfaction of the respondents toward MROs were lower in those who reported they did not know the difference between a pharmacy and a drug store than in those who claimed to know the difference. Supportive supervision by the town’s health bureau on the MROs is recommended to help improve clients’ satisfaction.
insulin towards their management of disease and medication.
Materials and Methods: a cross-sectional study was done in the hospital from 1st of April to 16th of May 2013
through a structured interview with 150 diabetes mellitus patients who were self administering insulin as part of
their therapy. Data collected was analyzed descriptively using SPSS version 19.0.
Results: majority (61.3%) were men and those in the age group of 14-29 years (47.3%). Among those who
experienced hypoglycemia, 135 (90%) knew the home management of hypoglycemic effect of insulin. More
than three quarters (78%) reported they were comfortable with their insulin therapy. More than half (54.7%) of
the participants had their blood sugar level monitored every month. Forty six (30.7%) of the patients reported
they had missed their insulin due to different reasons at different times. Insulin storage appropriateness was
significantly associated to educational level.
Conclusions: this study showed that there was poor practice among the patients regarding diabetes and self
insulin therapy which calls for education on self-care management and insulin self-therapy for diabetes mellitus
patients by skilled health care providers.