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Inappropriate prescribing among Ethiopian cardiovascular patients using STOPP/START criteria.

Cardiovascular disorders are among the leading chronic illnesses. Medications play a pivotal role to control the signs, symptoms and progression of these disorders. However, the outcome of the management is depend on the delivery of the right regimen to the right patient. A recent prospective evaluation of prescriptions among Ethiopian cardiovascular patients have identified that approximately, two-thirds of elderly cardiovascular patients encountered potentially inappropriate prescription which is more significant.  The magnitude of inappropriate prescription is aggravated by long hospital stay and large number of medications. Therefore, it is essential to evaluate patients’ medications during hospital stay to reduce the burden of potentially inappropriate prescription. Members of the young professionals’ chronic diseases network-Gondar chapter have been engaged in the acquisition, analysis and interpretation of results on this project.

Readers are advised to visit the following link to access the full text of the article.

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195949

Inappropriate prescribing among Ethiopian cardiovascular patients using STOPP/START criteria.
Inappropriate prescribing among Ethiopian cardiovascular patients using STOPP/START criteria.

Older patients’ perception of deprescribing in resource-limited settings

As people get older, Chronic diseases become common causes of diseases, having multimorbidity. This will lead to have polypharmacy in older patients contributing to the regimen complexity which can affects patients medication adherence, prescribing quality, adverse drug reaction, health related quality of life and death. All these necessitates a clinical intervention such as deprescribing (reducing inappropriate poly-pharmacy). But such intervention should consider older patients decision/willingness in medication discontinuation process as it may affects the ultimate their clinical outcome. Though this has been extensively explored in developed countries, no attempt was made to explore willingness of older adults with chronic disease for discontinuation of inappropriate medications. 

Young Professionals Chronic Disease Network (YP-CDN) Ethiopia chapter, has worked with older patients living with chronic diseases and has identified their priorities for advocacy, and were used as an input for this research project.

Medication safety for older patients with chronic disease requires deprescription of the inappropriate prescriptions. 

Find the full article at http://bmjopen.bmj.com/content/8/4/e020590

 

Older patients’ perception of deprescribing in resource-limited settings
Older patients’ perception of deprescribing in resource-limited settings

Adherence to Novel Oral Anticoagulants in Atrial Fibrillation: Systematic Review and Meta-analysis

 

Novel Oral Anticoagulants (NOACs) are front line medications for the prevention of cerebrovascular accident secondary to cardio-embolism. Recently, NOACs are replacing coumarins since they do not require close monitoring. But, real world evidence was required to evaluate the extent of adherence to these agents. Accordingly, sub-optimal adherence to NOACs was noted based on evidence obtained from a meta-analysis of 1.6 million Atrial Fibrillation (AF) patients. Interventions should be promptly designed to improve the compliance of patients for NOACs. Further, the availability and affordability of these medications should be insured in developing countries to save the lives of individuals who are suffering from AF.

The finding of the study is available from the following link.  doi: 10.2174/1570161116666180123111949.

Adherence to Novel Oral Anticoagulants in Atrial Fibrillation: Systematic Review and Meta-analysis
Adherence to Novel Oral Anticoagulants in Atrial Fibrillation: Systematic Review and Meta-analysis

Short- and long-term outcomes in endocarditis patients: a systematic review and meta-analysis.

Infective Endocarditis (IE) affects the endothelial lining of the heart. its mortality after medical therapy has been poorly reported. only recently, a meta-analysis of more than 22, 000 subjects revealed the short- and long term mortality of IE. Accordingly, the 30-day mortality was found to be 20% whereas 2 out of 5 individuals die of IE after 30- day follow-up. In addition to its burden on mortality; it complicates to cardiac, renal and embolic events. Risk factors such as rheumatic heart diseases, congenital heart diseases, diabetes and substance use should be appropriately managed to reduce this morbidity and mortality.      

Readers are suggested to access the full text of the article from the following link. 

DOI: 10.1186/s12872-017-0729-5 

Short- and long-term outcomes in endocarditis patients: a systematic review and meta-analysis.
Short- and long-term outcomes in endocarditis patients: a systematic review and meta-analysis.

Pharmacist-led medication therapy management in Patients with T2DM: A randomized controlled study

The randomized controlled study done in Gondar University Hospital showed that pharmacist-led medication therapy management has turned out to improve medication adherence and reduce number of hospitalizations in patients with type 2 diabetes mellitus. This necessitates the role of clinical pharmacists in patients care to improve patient outcome particularly patients with chronic disease such as Diabetes Mellitus.  Read the full article at https://www.pharmacypractice.org/journal/index.php/pp/article/view/1026 

Pharmacist-led medication therapy management in Patients with T2DM: A randomized controlled study
Pharmacist-led medication therapy management in Patients with T2DM: A randomized controlled study

Non-adherence to clinical practice guidelines exposed patients for target organ damages

 Insight from Ethiopian hypertensive population

Hypertension damages major organs of the body which makes it deadly. A recent cohort study on Ethiopian hypertension patients reported that target organ damage was more prevalent (40.3%) in those groups of patients.  Non-adherence to clinical practice guidelines was found to be correlated with the incidence of target organ damages, especially in patients with long standing hypertension. Appropriate management of hypertension and modification of triggering factors are to be seriously addressed to prevent complications.

The authors recommend readers to visit the following link for the scholarly article

https://www.google.com/search?q=target+organ+damages+in+ethiopia&ie=utf-8&oe=utf-8

Non-adherence to clinical practice guidelines exposed patients for target organ damages
Non-adherence to clinical practice guidelines exposed patients for target organ damages

full text

The changing trend of cardiovascular disease in Ethiopia:

please visit the following link for full article.

https://www.dovepress.com/the-changing-trend-of-cardiovascular-disease-and-its-clinical-characte-peer-reviewed-article-VHRM. 

 

full text
full text

The changing trend of cardiovascular disease in Ethiopia:

 “From rheumatic heart disease to hypertensive heart disease.”

In recent decades, there has been significant epidemiological transition of NCDs, particularly CVDs in developing countries, due to factors related to diet, sedentary lifestyle and longevity of the general population. Despite the rise of NCDs, the full attention of these countries was in combating the communicable diseases. There is paucity of data on the changing trend and clinical characteristics of CVD in Africa, specially, in Ethiopia. In light of this, a recent study revealed the epidemiological shift of CVDs in last decades in Ethiopia. According to this study findings, Hypertension was found to be the most frequent CVD followed by HF, and hypertensive heart disease was the leading cause of cardiac diseases. However, the incidence of rheumatic heart disease has declined due in part to the accessibility of secondary prophylaxis. In addition, poor cardiovascular outcome was observed in rural regions and in patients with comorbid medical condition. Hence, a due attention should be given to improve outcomes in rural dwellers.

The changing trend of cardiovascular disease in Ethiopia:
The changing trend of cardiovascular disease in Ethiopia:

Adequate Cancer Pain Management for a better quality of life of cancer patients

In the next issue of pain research and management journal (In press), the YP-CDN members of Ethiopia (Gondar Chapter), Eyob Alemayehu and Henok Getachew have done a preliminary assessment of pain management adequacy and pain interference in the quality of life of patients living with cancer who visited Oncology Unit, Gondar University Hospital. We know that Cancer is one of the non communicable diseases (NCDs) becoming an increasing public health burden for Ethiopia. Pain is among the most common of symptoms in patients with cancer. Hence, we aimed to assess cancer pain prevalence, cancer pain interference, and adequacy of cancer pain treatment in the oncology ward of an Ethiopian teaching hospital. Of 83 patients, total of 76 (91.6%) cancer patients experienced pain with varying degree of severity, and 7(8.4%) patients experienced severe pain. Of the 76 cancer patients with pain, 68(89.2%) experienced pain interference with their daily activities. Fifty four (65%) patients were receiving inadequate cancer pain treatment with negative Pain Management Index. Therefore, availability of analgesics, pain assessment and management guideline and quality service should be assured to improve the quality of life of cancer patients.

For more information on this upcoming article, check the link below  

https://www.hindawi.com/journals/prm/aip/5698640/ 

Adequate Cancer Pain Management for a better quality of life of cancer patients
Adequate Cancer Pain Management for a better quality of life of cancer patients

Establishment of Africa CDC

We need more organizations that work for non-communicable diseases control in Africa. African nations are reunited again to establish Africa Centers for Disease Control and Prevention (Africa CDC) in Addis Ababa, Ethiopia as of January 31, 2017. Headquartered in Addis Ababa, Africa CDC functions in network with Regional Collaborating Centers in Egypt, Nigeria, Gabon, Zambia, and Kenya. Priorities will be given for emerging health threats of Africa. A ground work of YPCDN can act as a plat form for inauguration and incorporation of policies whenever new organizations are launched. Proactively, YPCDN calls the attention of African CDC towards neglected NCDs in the context of LMICs. 

for more reads, please visit 

http://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(17)30025-6.pdf

Establishment of Africa CDC
Establishment of Africa CDC

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