Study design and study setting
A facility based retrospective cross sectional study was conducted at HFSUH by reviewing the medical records of T2DM outpatients on chronic follow up from July-December 2018 G.C at HFSUH.
Study population
Patients diagnosed with T2DM aged 18 years or older of both gender and receiving at least one anti-diabetic medication and those who had been on treatment for at least three months at HFSUH during the data collection period were included in the study. Patients with missing or incomplete data were excluded.
Sample size determination and sampling technique
The sample size was 148 calculated using single population proportion formula, with prevalence of 45.9% based on previous study done in Addis Ababa, at Tikur Anbessa Specialized Hospital (TASH) [20] and the total number of T2DM on follow up at HFSUH was 211. The patient medical record (PMR) was selected using a simple random sampling technique.
Data collection method and procedure
The record of patients with T2DM patients on chronic follow up from July-December 2018 G.C at HFSUH were identified until the targeted sample size was achieved. Required information was collected by the principal investigator from the PMR using a structured data collection check list. The Cipolle’s method of DRP classification system was used together with Ethiopian treatment Guideline and standards of medical care for diabetes.
Data processing and analysis
Data was checked for completeness by principal investigator (PI) on daily basis during collection before actual analysis. Analysis was done using statistical software for social sciences (SPSS) 20
Operational definition
DRP: Refers to any unwanted incident related to medication therapy that actually or potentially affects the desired goals of treatment [12]
Cipolle’s method: It classifies DRPs in to seven major groups as follows: These include: including unnecessary drug therapy, needs additional drug therapy, ineffective drug therapy, dosage too low, adverse drug reaction, dosage too high and noncompliance [21].
The DRPs were defined as follows:-
Dosage too high: If the prescribed dose was too high than the recommended dose by standard treatment guideline of Ethiopia [22].
Dosage too low: If the prescribed dose was less than recommended dose by standard treatment guideline of Ethiopia [22].
Unnecessary drug therapy: If there is duplication of therapy or unwanted addition of a medication or if the patient doesn’t have indication for adding another medication.
Needs additional drug therapy: If a patient was inadequately medicated with his/her blood glucose not within the target range (80-130mg/dL), this was classified as needs additional drug therapy.
ADR: Adequate doses resulting in unpleasant or harmful reactions.
Ineffective drug therapy: Inappropriate drug use according to standard treatment guideline of Ethiopia [22].