Prevalence and Management of Potential Drug-drug Interactions Among Chronic Liver Disease Patients at Kenyatta National Hospital

Abstract

Background: Drug-drug interactions in patients receiving multi-drug therapies are of great concern. Such interactions are important causes of adverse drug reactions that may lead to increased morbidity and mortality. The prevalence of drug-drug interactions varies with geographical regions and patient characteristics Study Objectives: The main objective of the study was to assess the prevalence and management of potential drug-drug interactions among adult patients with chronic liver disease at Kenyatta National Hospital Study Design: A cross-sectional study. Study Area: Kenyatta National Hospital Liver Clinic. Study Population: One hundred and thirty-seven (137) participants aged 18 years and above, with diagnosed chronic liver disease who met the study inclusion criteria. Methods: Chronic liver disease patients were recruited while attending their liver clinic appointments. Participants were sampled through simple random sampling technique. Data was collected through interviews, using interviewer administered questionnaires. Some data on prescribed drugs was abstracted from patient files to compliment data obtained through the interviews. Once collected, data was entered into MS excel 2016. Bivariate and multivariate data analysis was carried out using STATA version 14. Results: Majority of the respondents were male (63.5%). The mean age in years of the participants was 39.2 years. The total number of prescriptions evaluated for pDDIs was 67, giving a prevalence rate of 48.9%. The prevalence of participants with major DDIs in their prescriptions was 58.2%, moderate 37.3% and minor was 4.5%. Almost a half of the prescriptions that had pDDIs, 49.3% had only one pair of interacting drugs whereas a small proportion (4.5%) had six and above interacting pairs with 29.9% having two interaction pairs. The most commonly prescribed drugs among chronic liver disease patients were antibiotics (60.6%), followed by proton pump inhibitors (48.2%) then laxatives (29.9%). Independent predictors of pDDIs were total number of drugs per patient and having secondary level of education. Conclusion: We were able to establish a moderate prevalence of pDDIs among chronic liver disease patients at KNH liver clinic which suggested average management of these patients. Recommendations: The findings of this study should be shared with the respective prescribers to reduce the incidences of concomitant prescription of majorly and moderately interacting drugs.