Drug Related Problems Among Patients With Rheumatic Diseases and Connective Tissue Disorders in Kenyatta National Hospital

Abstract

Background information: Patients with rheumatic diseases are often on multiple long term medications predisposing them to drug therapy problems which can occur at any point of therapy. DRPs hinder the achievement of the desired treatment outcomes and can prolong the hospital stay, allow disease progression and cause poor quality of life for these patients. There is inadequate available literature on DRPs amid these patients in Africa. Objective: The purpose of the study is to describe drug related problems and their associated factors among patients suffering from rheumatic diseases attending the rheumatology clinic at Kenyatta National Hospital. The significance of this study is that it will provide a basis for understanding the various drug therapy challenges patients with rheumatic disease undergo that impact negatively on the intended goals of treatment and the various factors linked to the problems and therefore provide grounds to minimize the therapy problems for both the patients and the care providers. Methodology: A cross-sectional survey was carried on patients with rheumatic conditions including psoriasis, rheumatoid arthritis, systemic lupus erythematosus, osteoarthritis and ankylosing spondylitis attending the rheumatology clinic at KNH. Universal sampling was employed to get participants for the study as patients with this condition are scarce. The patients were screened for eligibility using a predesigned form and the ones found eligible were taken through the consenting process and if they accepted to take part in the study willingly signed a consent declaration form. Participants data such as socio demographic data, laboratory findings and current treatment was collected using a predesigned data collection tool from the patients’ files. The participants were then taken through a structured questionnaire by the principal investigator to assess for drug related problems through systemic review and patient interviews. Relevance of therapy, effectiveness and safety was also assessed as per the treatment guidelines and interactions checked by use of Medscape and Epocrites drug interaction checker. The data collected was checked for completeness and then keyed into Microsoft excel and processed using STATA version 13.0. Binary, descriptive and multi-variable logistic analysis was utilized to define the population and establish the relationship between the independent and the dependent variables with a p value of 0.05 and below being statistically significant and therefore need to investigate the relationship between the independent and dependent variable. Drug related

problems were expected to have a high prevalence among patients ailing from rheumatic conditions with the prevalence considerably related to the number of drugs the patient is on, the number of comorbidities, socioeconomic status age and duration of disease..........................................................................................