According to World health organization (WHO), Adherence is defined as ‘extent to which a person’s behavior—taking medication, following a diet and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider’. Hence, It may not be sufficient if a person’s behavior strongly corresponds with the agreed recommendation to the prescribed medications. In other words, patient's clinical outcome may not be achieved adequately with good medication adherence. There are other behavioral domains to be considered including following dietary recommendations and lifestyle modifications to improve health outcomes such as glycemic control in patients with diabetes mellitus (DM). 

In the current study, most type 2 DM patients (74%) have been found to poorly follow dietary recommendations. This was partly due to lack of knowledge, lack of diet education, inability to afford the cost of healthy diet and poor awareness about the benefit of dietary recommendations.

Find the full article below. 

https://doi.org/10.1186/s40842-018-0070-7 

Individual data revealed that depression remains a major psychiatry condition in perinatal period. However, its burden haven not yet been comprehensively assessed nationally. This review determined the magnitude of perinatal depression and major factors leading to the episode of depressive disorder among mothers in Ethiopia. The study indicated that, the pooled prevalence of   perinatal depression was 25.8% [95% CI, 24.6%-27.1%]. Predisposing factors such as, having obstetric complications in previous and/or this pregnancy [RR: 2.74 (95% CI, 1.48-5.06), I² = 67.7%], and having unplanned pregnancy [RR: 2.73 (95% CI, 2.11-3.53), I² = 0%] were the major factors associated with perinatal depression. To attenuate these factors and to realize the sustainable development goals (SDGs) outlined by united nation, much attention should be given to improve maternal mental health through reduction of identified modifiable factors.

The full text of the article can be accessed via the following link.  

https://doi.org/10.1155/2018/1813834

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

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

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.

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 

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 

 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

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. 

 “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.