Lieke G Meulendijks1, Emmanuel A Adomako2, Emmanuel B Appiah3, Cornelis Kramers4. 1. Department of Pharmacology-Toxicology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. 2. Department of Medicine, Agogo Presbyterian Hospital, Agogo Asante-Akyem, Ghana. 3. Pharmacy Department, Agogo Presbyterian Hospital, Agogo Asante-Akyem, Ghana. 4. Department of Pharmacology-Toxicology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Department of Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Department of Clinical Pharmacy, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands.
Abstract
BACKGROUND: Preventable adverse events of medication are an important cause of hospital admissions in the developed world, in which non-steroidal anti-inflammatory drugs (NSAIDs) and renin-angiotensin system (RAS-) inhibitors are frequently involved. NSAIDs and RAS-inhibitors are also often used in Ghana. The purpose of this study is to assess whether biochemical monitoring in patients on RAS-inhibitors, and co-administration of gastro protective agents (GPAs) in patients on NSAIDs, is done properly in Ghana. MATERIAL AND METHODS: Two retrospective cross-sectional studies were carried out at the Agogo Presbyterian Hospital, Ghana, in 2013. In 114 out-and inpatients who are on NSAIDs, the risk for gastrointestinal side effects and the frequency of co-administration of GPAs were determined. In 301 outpatients who are on RAS-inhibitors, the risk for renal dysfunction and the frequency of biochemical monitoring were determined. Fisher's exact test was used to determine the statistical strength. RESULTS: Co-administration of GPAs was done in 1.8% of patients on NSAIDs. Serum creatinine and potassium monitoring within one month after initiation of treatment with RAS-inhibitors were performed in 6.3% and 3.7%, respectively. Risk factors were neither associated with prescription of a GPA in patients on NSAIDs (p=0.134), nor in performing biochemical monitoring in patients on RAS-inhibitors (p=0.219 for creatinine, p=0.062 for potassium). CONCLUSIONS: Biochemical monitoring in patients on RAS-inhibitors and use of GPAs in patients on NSAIDs is poorly performed at the Agogo Presbyterian Hospital in Ghana. Improving the already existing Ghanaian guidelines, especially those for RAS-inhibitors, and encouraging their widespread use among prescribers should be pursued.
BACKGROUND: Preventable adverse events of medication are an important cause of hospital admissions in the developed world, in which non-steroidal anti-inflammatory drugs (NSAIDs) and renin-angiotensin system (RAS-) inhibitors are frequently involved. NSAIDs and RAS-inhibitors are also often used in Ghana. The purpose of this study is to assess whether biochemical monitoring in patients on RAS-inhibitors, and co-administration of gastro protective agents (GPAs) in patients on NSAIDs, is done properly in Ghana. MATERIAL AND METHODS: Two retrospective cross-sectional studies were carried out at the Agogo Presbyterian Hospital, Ghana, in 2013. In 114 out-and inpatients who are on NSAIDs, the risk for gastrointestinal side effects and the frequency of co-administration of GPAs were determined. In 301 outpatients who are on RAS-inhibitors, the risk for renal dysfunction and the frequency of biochemical monitoring were determined. Fisher's exact test was used to determine the statistical strength. RESULTS: Co-administration of GPAs was done in 1.8% of patients on NSAIDs. Serum creatinine and potassium monitoring within one month after initiation of treatment with RAS-inhibitors were performed in 6.3% and 3.7%, respectively. Risk factors were neither associated with prescription of a GPA in patients on NSAIDs (p=0.134), nor in performing biochemical monitoring in patients on RAS-inhibitors (p=0.219 for creatinine, p=0.062 for potassium). CONCLUSIONS: Biochemical monitoring in patients on RAS-inhibitors and use of GPAs in patients on NSAIDs is poorly performed at the Agogo Presbyterian Hospital in Ghana. Improving the already existing Ghanaian guidelines, especially those for RAS-inhibitors, and encouraging their widespread use among prescribers should be pursued.
Authors: Janet E M Bootsma; Margreet F Warlé-van Herwaarden; André L M Verbeek; Peter Füssenich; Peter A G M De Smet; Marcel G Olde Rikkert; Cornelis Kramers Journal: Drug Saf Date: 2011-07-01 Impact factor: 5.606
Authors: R M Wilson; P Michel; S Olsen; R W Gibberd; C Vincent; R El-Assady; O Rasslan; S Qsous; W M Macharia; A Sahel; S Whittaker; M Abdo-Ali; M Letaief; N A Ahmed; A Abdellatif; I Larizgoitia Journal: BMJ Date: 2012-03-13