Home medication management practices and associated factors among patients with selected chronic diseases in a community pharmacy in Uganda
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Date
2012
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Health Services Research
Abstract
Chronic diseases are rapidly increasing and are currently the major cause of death and disability
worldwide. Patients with chronic diseases experience many challenges including medicine-related problems.
However, there is limited information about the home management of medicines among these patients. This study
therefore was to determine home medication management practices and associated factors among patients with
chronic diseases seeking care in a community pharmacy in Uganda.
Methods: A cross-sectional study was conducted in a community pharmacy in Kampala from June to July 2010. A
total of 207 consenting chronic disease patients or caregivers of children with chronic disease were consecutively
sampled. The patients were visited at home to evaluate their drug management practices and to check their
medical forms for disease types and drugs prescribed. An interviewer-administered questionnaire and an
observation checklist were used to collect the data.
Results: Overall home medication management was inappropriate for 70% (n = 145) of the participants (95%
CI = 63.3-76.2) and was associated with perceived severity of disease (not severe OR =0.40, moderately severe
OR = 0.35), duration of disease >5 years (OR = 2.15), and health worker not assessing for response to treatment
(OR = 2.53). About 52% (n = 107) had inappropriate storage which was associated with inadequate information
about the disease (OR = 2.39) and distance to the health facility >5 kilometres (OR = 2.82). Fifteen percent (n = 31)
had no drug administration schedule and this was associated with increasing age (OR = 0.97), inadequate
information about the disease (OR = 2.96), and missing last appointment for medical review (OR = 6.55). About 9%
(n = 18) had actual medication duplication; 1.4% (n = 3) had expired medicines; while 18.4% (n = 38) had drug
hoarding associated with increasing number of prescribers (OR = 1.34) and duration of disease (OR = 2.06). About
51% (n = 105) had multiple prescribers associated with perceiving the disease to be non severe (OR = 0.27), and
having more than one chronic disease (OR = 2.37).
Conclusions: Patients with chronic disease have poor home management of medicines. In order to limit the
occurrence of poor outcomes of treatment or drug toxicity, health providers need to strengthen the education of
patients with chronic disease on how to handle their medicines at home.
Description
Keywords
Home management, Medicines management, Chronic disease
Citation
Kalyango et al.: Home medication management practices and associated factors among patients with selected chronic diseases in a community pharmacy in Uganda. BMC Health Services Research 2012 12:323. doi:10.1186/1472-6963-12-323