Drug therapy problems among pediatric patients with infectious diseases admitted to Debre Birhan Hakim Gizaw teaching hospital in Ethiopia

Abstract

Drug therapy problem (DTP) is any event involving drug therapy that interferes with a patient's desired clinical outcome. It is associated with morbidity, mortality, increased hospital stays, and reduced quality of life. Moreover, pediatric patients are quite susceptible to DTP. To determine drug therapy problems and their contributing factors among pediatric patients with infectious diseases admitted at the pediatric ward of Debre Birhan Hakim Gizaw Teaching Hospital (DBHGTH), Ethiopia. A hospital-based prospective follow-up study was conducted at DBHGTH from March 1 to August 31, 2024. To ensure that the sample was representative, a systematic random sampling technique was employed to select participants. Data was collected from interviewing patients' parents/caregivers, older children, and reviews of patients' medical records using prepared standard data abstraction tools and structured questionnaires. Data was analysed by SPSS version 27.0. Binary logistic regression analysis was used. Statistical significance was determined at a 95% CI, with a p-value < 0.05 considered statistically significant. Of the total 163 participants, 70 (42.94%) [95% CI (35.52-50.90%)] of them had at least one DTP during their hospital stay. A total of 201 DTPs were identified among 70 patients. Antibiotics were the most frequently prescribed drug class, with a mean of 1.73 antibiotics per child. Needs additional drug therapy (27.86%) and patient noncompliance (18.90%) were the most predominant encountered DTPs. The most important interventions made were the addition of drugs (28.29%), followed by patient education/counseling/adherence (24.30%). Patients living in rural area [AOR: 4.58, 95%CI: 1.94-10.81, p < 0.001]; patients using traditional herbal [AOR: 4.66, 95%CI: 1.28-16.97, p = 0.020]; patients with the prolonged hospital stay (> 10 days) [AOR: 6.18, 95%CI: 1.95-19.56, p = 0.002]; patients with high number of medications (≥ 5) [AOR: 3.91, 95%CI: 1.33-11.48, p = 0.013]; and patients with high number of comorbidity (> 1) [AOR: 4.27, 95% CI: 1.60-11.37, p = 0,004] were the predictors of the occurrence of DTPs. The prevalence of DTPs in the pediatric ward was moderate. It implies a substantial burden requiring attention. It was found that the majority of the problems were related to indication, whereas the need for additional drugs was the predominant DTP. Antibiotics were the commonly prescribed classes of drugs involved in DTPs.