Medication-related Problems Among Adult Patients With Diabetes at Kenyatta National Hospital Outpatient Clinic

Abstract

Background: The IDF estimated that in 2017 there were 451 million people with diabetes worldwide and the figure was expected to rise to 693 million by 2045. WHO estimates the prevalence of diabetes in Kenya to be 3.3% and it is expected to rise to 4.5% by 2025. The prevalence of MRPs is on the rise and studies show that anti-diabetic drugs are associated with many MRPs. Study objective: The main objective of this study was to establish the prevalence, types and factors associated with MRPs among adult diabetic outpatients at KNH. Study Methods: The study was an analytical observational cross-sectional study carried out at Kenyatta National Hospital. The data was collected for three months. It involved 280 adult diabetic outpatients attending the clinic at KNH who were recruited using consecutive sampling. Patients who met the eligibility criteria were recruited and interviewed using a pretested data collection form. MRPs identified were classified according to Hepler-Strand Classification. Data was analyzed using STATA version 13(StataCorp Inc., USA). Descriptive statistics was conducted. Multivariable logistic regression was done to identify factors associated with MRPs. Results: The study showed that 235 (83.9%) of the respondents had at least one of the MRPs. Adherence was the most common with a prevalenceof 203(72%). Reasons for non-adherence were costly drugs (118, 42.1%) and 85 (30.4%) alluded to forgetting to take drugs, 61 (21.8%) of the respondents had drug safety problems,82 (29.3%) had drug effectiveness problems, and 27(9.6%) had conditions not treated as drug indication problems. Age and number of drugs were found to be statistically significant independent predictors. Patients 50 years and above were 2.4 times as likely as younger patients to have an MRP, (AOR =2.4, 95%CI, 1.1, 3.9, p = 0.023), while patients taking 5 or more different types of drugs were 1.3 times as likely as patients taking fewer than 5 drugs to have an MRP, (AOR =1.3, 95%CI, 1.15 2.5, p < 0.001). Conclusion: Prevalence of MRPs was high at 84%. The most common one was non-adherence to medication. Thus, it is essential to consider improving patient support through encouraging caregivers to remind them when to take drugs as well as initiate health education programs to improve knowledge on drugs and adherence.