Department of Pharmacology and Toxicology

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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.