Department of Pharmacology and Toxicology

Permanent URI for this collectionhttps://repository.mu.edu.et/handle/123456789/410

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    Patients’ Beliefs about Medicines, Adherence and Potential Drug-Drug Interactions in Cancer Treatment: A Tripartite Study at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia
    (Mekelle University, 2025-08-28) Tsegay Lemma
    Background: Patients’ beliefs about medications, adherence to therapy, and of drug-drug interactions (DDIs) are critical in optimizing cancer treatment outcomes and ensuring safety. Understanding these factors can enhance adherence and reduce the risks associated with polypharmacy. Objective: This study assessed beliefs about medicines, medication adherence, and the prevalence of DDIs among cancer chemotherapy patients at Ayder Comprehensive Specialized Hospital in Mekelle, Ethiopia. It also explored factors influencing these outcomes and the relationships between them. Methods: A cross-sectional study was conducted from March 2024 to March 2025 involving 385 ambulatory cancer patients aged ≥18 years. Participants were randomly selected and evaluated using the Beliefs about Medicines Questionnaire (BMQ) and the 8-item Morisky Medication Adherence Scale (MMAS-8). Data analysis employed SPSS version 26 with descriptive statistics, logistic regression, and Pearson’s correlation. Significance was set at p ≤ 0.05. Results: The study analyzed data from 385 patients (mean age 45.6 years; 74.3% female). Most were married (60.8%), had no formal education (44.2%), and low monthly income (71.4% earned ≤1500 ETB). Among them, 94.3% had been diagnosed within five years, 90.1% had no comorbidities, and 60% had non-breast cancers. BMQ findings showed that 92.7% believed in the necessity of their medications, but 67.3% had concerns about harm. MMAS-8 results revealed 71.7% adherence, with 94.8% reporting they rarely forget doses. 88.3% of cases of major DDI were those between 5-fluorouracil and leucovorin. Adherence was correlated positively with necessity and negatively with concerns and harm. Conclusion: The study revealed a high level of perceived necessity and moderate adherence, higher than reported in comparable settings. However, concerns about medication and the high prevalence of DDIs highlight the need for improved patient counseling and medication safety practices.
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    The impact of patient characteristics on the pharmacokinetics of Rifampicin
    (Mekelle University, 2025-02-22) Haftamu Gebremariam
    Introduction: Rifampicin is a critical component of tuberculosis (TB) treatment, often dosed based on body weight. However, variability in pharmacokinetics (PK) can impact therapeutic outcomes. Understanding factors such as body weight, age, and sex is essential for optimizing dosing strategies and improving patient care in TB management. Objective: This study aims to evaluate the effects of covariates such as body weight, lean body mass, age, sex, and HIV status on the pharmacokinetics of rifampicin in TB treatment. Methods: Nineteen TB patients in the intensive phase were enrolled, receiving weight-based rifampicin dosing for at least 14 days. Blood samples (5 mL) were collected 4-6 times daily and analyzed using HPLC-UV. Data were analyzed using software MONOLIXSUITER12023 which contain MONOLIX for population pharmacokinetics estimation and PK-analix for average results of 19 patients to determine the relationship between covariates and PK parameters. Results: A one-compartment model with linear elimination and zero-order absorption described the data best. The volume of distribution decreased from 55 to 37.2 L due to effects of food and age. Clearance showed no significant covariate dependency, with a total objective function value decrease from 323.31 to 308.5. Clearance (Cl=9.1 L/h) was highly correlated with volume of distribution (Vd=37.2 L). Inter-individual variability (IIV) in clearance was 36.3% (CV=37.5). PKanalix analysis indicated higher clearance in patients taking 2 and 4 tablets (300 mg, 600 mg) and aged under 55. Volume of distribution was larger in males, HIV-negative patients, those older than 55, and those weighing less than 40 kg or over 55 kg. Conclusion: Rifampicin clearance was not significantly affected by covariates at the population PK level, warranting further investigation with larger data samples to confirm these findings.
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    Patients' Beliefs about Medications, Adherence to Treatment, and Drug-Drug Interactions in the Management of Heart Failure: A cross-sectional Study at Ayder Comprehensive Specialized Hospital, Northern Ethiopia
    (Mekelle University, 2025-06-12) Asmelash Araya Welecheal
    Background: Heart failure (HF) is the heart’s inability to pump blood effectively due to structural or functional impairments. Patients’ beliefs about medications, adherence, and drug-drug interactions are critical factors in heart failure managements and understanding these can enhance HF management and outcomes. Objective: To assess beliefs about medications, adherence levels, and the prevalence of drug-drug interactions in heart failure treatment. Method: A cross-sectional study was conducted from June 15 to August 30, 2024, with 314 HF patients selected via convenience sampling methods. Data was collected using the Beliefs about Medicines Questionnaire, Morisky Medication Adherence Scale-8, and DDInetr software. The analysis was performed in SPSS 27 using descriptive statistics, Mann-Whitney U, and Kruskal Wallis H tests (p < 0.05, 95% CI). Results: Among 314 participants, the median (IQR) age was 51.5 (32-65) years, 51.9% were female. The median treatment duration was four years. The mean score for specific necessity (20 ± 3.19), specific concern (15 ± 3.396), overuse (11.05 ± 2.297) and harm (9.03 ± 2.47) was scored. A majority of participants (79.3%) were classified as ambivalent, with a necessity-concern differential of +5.1. Non-adherence was observed in 41.4% of participants, with forgetfulness cited as the leading reason (37.6%). Significant correlations were found between adherence and both specific necessity (r = +0.27, p < 0.001) and harm beliefs (r = -0.27, p < 0.001). A total of 993 drug-drug interactions were identified, with moderate interactions being the most common and enalapril with Spironolactone was the drugs with sever interaction. These interactions were more prevalent among older patients and those experiencing polypharmacy. Conclusion: Overall heart failure patients have strong necessity belief than concern about their medication where 84.7% knows the benefit of their medication. Over half of the participants were adherent to their medication due to high necessity belief, low concern, and forgetfulness. Severe DDIs were less common (6.95%) but requires medical treatment. Collaborative healthcare efforts are key to improving positive beliefs, and adherence, and reducing DDIs for better HF outcomes.
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    CHALLENGES AND BARRIERS OF GLYCEMIC CONTROL AMONG ADULTS WITH DIABETES IN AYDER COMPREHENSIVE SPECIALIZED HOSPITAL
    (Mekelle University, 2025-04-25) Filmon Beyenne Demoz
    Diabetes mellitus is a public health concern in developed and developing countries. Currently, attaining the intended glycemic control in adult patients with diabetes is challenging more in lower income countries. This study aimed to evaluate the challenges and barriers of controlling glycated hemoglobin among adult patients with diabetes in diabetes clinic, Ayder Comprehensive Specialized Hospital, Mekelle University. The study also aimed to evaluate associated factors of knowledge, medication adherence, and self-care practice of the same patients. A cross-sectional study was conducted in diabetes clinic, Ayder comprehensive specialized hospital Mekelle University from May to June 2024. Structured tools were used to collect data about socio-demographics, knowledge, medication adherence, and self-care practices. The data was analyzed using the software Statistical Package for Social Science (SPSS) version 27.0. Binary logistic regression was performed to determine associated factors with poor glycemic control and poor self-care practice whereas ordinal logistic regression was applied to determine factors associated with knowledge and medication adherence. Statistical consideration was given for bivariate binary logistic regression at p-value<0.25 and a p-value <0.05 was considered statistically significant for mult-variate and ordinal logistic regression. Out of 338 study participants nearly three-fourth (73.4%) had poor glycemic control. Secondary educational level (AOR = 5.1, P<0.02), diabetes duration [(AOR = 3.1, p<0.002), AOR = 3, p<0.01), AOR = 5.1, p<0.02)], moderate adherence (AOR = 0.28, p<0.001), high knowledge levels (AOR = 3.3, p<0.007), and good self-care practice (0.26, p< 0.001) were found associated with poor glycemic control. Single (AOR = 3.3, p<0.018) and married (AOR = 2.4, p<0.03) marital status, levels of knowledge [(low, AOR = 0.3, p<0.001), (average, AOR = 0.4, p<0.03)] and presence of comorbidities (AOR = 0.56, p<0.03) and high knowledge level (AOR = 2.1, p<0.01) were associated with counterparts of knowledge, adherence, and self-care practice. Glycemic status was observed uncontrolled in participants with secondary educational level, long diabetes duration, poor adherence and self-care practice. Thus, the study recommends patients to overcome the problems discussed through strictly following the advice offered by physicians and stick to their prescribed medication.