Frequency types and severity of medication usere

Authors: Kazeem B Yusuff Fola Tayo

Publish Date: 2011/04/28

Volume: 33, Issue: 3, Pages: 558-

PDF Link

Abstract

Objectives To determine the frequency types and severity of medications userelated problems among medical outpatients in a tertiary care setting in southwestern Nigeria Setting Medical outpatient clinics of a 900bed Teaching Hospital located in Ibadan Southwestern Nigeria Methods A prospective crosssectional medication use review was conducted by ten pharmacists for 400 randomly selected medical outpatients over a 4 week period at a 900bed premier teaching hospital located in Ibadan Nigeria Severity assessment of medication userelated problems was done by 3 independent assessors with a modified severity index Main outcome measure Frequency types and severity of medication userelated problems identified through pharmacistinitiated medication use review Results Of the 400 randomly selected patients 324 810 consented and were interviewed One hundred and sixtythree 503 of the cohort were males and 161 497 were females with mean ages 515 ± 176 and 521 ± 174 years respectively Median no of drugs prescribed per patient per day was 4 Minimum–Maximum 1–7 About 275 were self medicating with orthodox prescriptiononly and overthecounter and/or herbal medicines and only 146 claimed disclosure to their physicians The proportion of patients self medicating with orthodox medicines was significantly higher P  00001 Two hundred and twentysix medication userelated problems were identified from 586 of patients but the highest number 5 was identified among 26 of patients The frequency of medication userelated problems appear strongly related to the number of medicines prescribed r = 071 P = 0006 The majority of medication userelated problems were ranked as potentially harmful Interrater reliability coefficient Gwet AC1 07214 P ≤ 0001 Nonadherence 438 problems associated with self medication 393 and adverse drug reactions 156 were the most frequent Unauthorized drug holidays 465 and stoppage of prescribed prescriptiononly medications for local herbs 293 were the major consequences of nonadherence Potentially harmful drugdisease interactions were the most frequent medication userelated problems arising from self medication 404 Conclusion Potentially harmful medication userelated problems are frequently encountered among medical outpatients in Nigeria The institutionalization of medication use review and the devolution of this task to pharmacists may prove beneficial in optimizing outcomes of medication use in Nigeria

Keywords: