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Background: Evidence-based beta-blockers are essential in managing heart failure with reduced ejection fraction (HFrEF) and are known to improve cardiovascular outcomes. Despite robust nascent guideline recommendations, studies indicate that beta-blockers are often underutilized or administered below target doses. This shivery issue is particularly relevant in Ethiopia, where comprehensive evaluations of beta-blocker utilization and dosing practices are limited. The Northeast region, specifically Dessie, remains underexplored in this context. Objective: This study aimed to evaluate the appropriate usage trend and dose optimization of beta-blockers among HFrEF patients attending ambulatory clinics of Dessie Comprehensive Specialized Hospital (DCSH) and Boru Meda General Hospital (BMH), Dessie, Ethiopia, 2024 G.C. Methods: A cross-sectional, multi-center study was conducted from February 1 to July 30, 2024, involving 200 randomly selected adult patients with confirmed HFrEF (120 from DCSH and 80 from BMH), who had at least 6-month regular follow-up visits at their respective ambulatory clinics. The study rigorously followed the latest (2022) American Heart Association (AHA) guideline recommendation. Patient's medical records was reviewed to gather the necessary data. A logistic regression analysis was performed to identify factors associated with beta-blocker use. Statistical significance was declared at p-value < 0.05. Results: Among the 200 patients, 88% were prescribed beta-blockers. About 15% of the patients were not receiving beta-blockers whereas they are indicated. Out of the total, 96.5% received guideline-recommended beta-blockers, with bisoprolol being the most common (65%), followed by metoprolol (29%) and carvedilol (3%). Only 13% of beta-blocker users were on optimal doses, with average daily doses of 27.9 mg for metoprolol succinate, 10.0 mg for carvedilol, and 4.8 mg for bisoprolol. Factors positively associated with beta-blocker use included Angiotensin Converting Enzyme Inhibitor use (AOR: 15.48, 95% CI: 2.11-113.54, p = 0.007), and taking multiple medications (AOR: 7.12, 95% CI: 1.54–33.02, p = 0.012), while ingestion of secondary prevention agents (AOR: 0.05, 95% CI: 0.01–0.98, p = 0.048) and male gender (AOR: 0.08, 95% CI: 0.01–0.47, p = 0.005) were negatively associated. Baseline ejection fraction of 25–40% (AOR: 5.44, 95% CI: 1.09–27.12, P = 0.039) was a sole predictor for sub-optimal beta-blocker use. Conclusion: Although most patients with HFrEF were prescribed evidence-based beta-blockers, only a limited number reached the optimal dosing levels. It is crucial to align clinical practice with the latest guidelines, prioritize ongoing research, and enhance educational efforts for both healthcare providers and patients. By doing so, it is possible to significantly improve the effective utilization of beta-blockers, ultimately leading to better patient outcomes in this region. [ABSTRACT FROM AUTHOR]

Background: Fraud in pharmaceutical tenders is a severe form of corruption that poses a significant threat to public health, patients, and the community. Due to the substantial financial volume in the pharmaceutical sector, vulnerable points in decision-making for market entry and purchase are at risk. As a result, the objective of this study was to measure the level of transparency and risk of corruption in pharmaceuticals' procurement practices in South Wollo, North-East Ethiopia. Methodology: From October 1 to December 15, 2023, a multi-facility, cross-sectional study was conducted. The participants were pharmaceutical procurement committee (PPC) members. The World Health Organization's (WHO's) standardised interviewer-administered questionnaire was used to collect the data. The collected data was entered, cleaned, processed, and analyzed using Statistical Package for Social Sciences (SPSS) version 27. Both descriptive and inferential statistics (univariate and linear regression analyses) were computed. The relationship between the independent (health facility level) and dependent (level of transparency) variables was determined using beta with a p-value of less than 0.05 and a 95% CI. Results: One hundred eighty-seven respondents, from 47 health centres (low, medium, and high volume) and 14 hospitals (primary, secondary, and tertiary), participated. The aggregate result showed that pharmaceutical procurement practice was very vulnerable to corruption, with a transparency level of only 33.0% (3.3 out of 10). The univariate analysis demonstrated a significant disparity in the mean transparency scores between health centres and hospitals. The linear regression also showed that for every one standard deviation increase in the facility level, there was an associated 0.39 increase in the transparency level of pharmaceutical procurement (β = 0.39, 95% CI: 0.02-0.04). Conclusion: The pharmaceutical procurement practice at the health facilities was generally found to be very vulnerable to corruption, which slightly increased with a decrease in facility levels and vice versa. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a major health concern globally and in Ethiopia. Ensuring optimal diabetes management through minimizing drug therapy problems is important for improving patient outcomes. However, data on the prevalence and factors associated with unmet drug-related needs in patients with diabetes in Ethiopia is limited. This systematic review and meta-analysis aims to provide a comprehensive analysis of the prevalence of unmet drug-related needs among patients with diabetes mellitus in Ethiopia. Methods: A thorough exploration of databases, including PubMed, Scopus, Hinari, and Embase and Google Scholar, was conducted to identify pertinent studies. Inclusion criteria involved observational studies that reported the prevalence of unmet drug-related needs in Ethiopian patients with diabetes. The quality of the studies was assessed using Joanna Briggs Institute (JBI) checklists. A random-effects meta-analysis was employed to amalgamate data on study characteristics and prevalence estimates, followed by subsequent subgroup and sensitivity analyses. Graphical and statistical assessments were employed to evaluate publication bias. Results: Analysis of twelve studies involving 4,017 patients revealed a pooled prevalence of unmet drug-related needs at 74% (95% CI 63-83%). On average, each patient had 1.45 unmet drug-related needs. The most prevalent type of unmet need was ineffective drug therapy, 35% (95% CI 20-50). Type 2 diabetes, retrospective study designs, and studies from the Harari Region were associated with a higher prevalence. Frequently reported factors associated with the unmet drug-related needs includesmultiple comorbidities, older age, and polypharmacy. Notably, the results indicated significant heterogeneity (I² = 99.0%; p value < 0.001), and Egger's regression test revealed publication bias with p<0.001. Conclusion: The prevalence of unmet drug-related needs among diabetes patients with diabetes in Ethiopia is high with the most prevalent issue being ineffective drug therapy. Targeted interventions are needed; especially patients on multiple medications, advanced age, with comorbidities, and prolonged illness duration to improve diabetes management and outcomes. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42024501096. [ABSTRACT FROM AUTHOR]

aimanot Fentie Wendie,1 Mulugeta Tarekegn Angamo21Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, EthiopiaCorrespondence: Teklehaimanot Fentie Wendie Email tklhmntfnt5@gmail.com Background: Heart-failure patients are at high risk of experiencing drug-therapy problems, owing to polypharmacy, comorbidities, and usually advanced age. Drug-therapy problems can lead to poor clinical outcomes, increased health-care costs and decreased quality of life, and thus strategies for identifying, resolving, and preventing them are urgently needed. Therefore, this study aimed at investigating the incidence and predictors of drug-therapy problems among hospitalized heart-failure patients. Methods: This hospital-based prospective observational study was conducted from February 1 to May 31, 2014 at Jimma University Specialized Hospital. Patients of either sex aged 18 years and above with chronic heart failure and complete medical records were enrolled. Patients with high-output heart failure, < 1 day of hospital stay, unwilling to give written informed consent, and unconscious without caregivers were excluded. Data were collected from medication charts, laboratory reports, patients/caregivers, morning multidisciplinary meetings, and ward rounds. Multivariate binary logistic regression analysis was done to identify independent predictors of drug-therapy problems. Results: A total of 104 heart-failure patients (mean age 51.20± 15.66 years, females 51.9%) were consecutively enrolled, and 95 (91.3%) had experienced at least one drug-therapy problem (total 268, mean 2.82± 1.39 encounters per patient). Of these problems, 45.5% were the need for additional drugs, followed by noncompliance (22.0%), inappropriate dosing (9.3%), unnecessary drugs (9.0%), ineffective drugs (8.2%), and adverse drug reactions (6.0%). None of the independent variables was found to be an independent predictor of having at least one drug-therapy problem. However, the number of clinical/pharmacological risk factors (AOR 7.93), female sex (AOR 3.24), and length of hospital stay (AOR 12.98) were predictors of noncompliance. Conclusion: Patients suffered from a large number of drug-therapy problems. Drugs with survival benefit were underused. Noncompliance and the need for additional drug therapy were the most frequently identified drug-therapy problems. Numbers of clinical/pharmacological risk factors, length of hospital stay, and female sex were identified as predictors for noncompliance. [ABSTRACT FROM AUTHOR]

aimanot Fentie Wendie, Birhanu Demeke Workneh Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Teklehaimanot Fentie Wendie Email tklhmntfnt5@gmail.com Background: Highly active antiretroviral therapy has dramatically altered progression of HIV infection and significantly improved patients' quality of life. However, drug resistance with consequent treatment failure raises the need for much more expensive and toxic second-line regimens. Thus, this study aimed at investigating the predictors of virologic failure among adults in Northeast Ethiopia. Methods: A retrospective cohort study was carried out among adults who started first-line antiretroviral treatment from September 2005 to January 2018. Data were collected from patients' medical records, entered and validated using EpiData version 3.1 and then exported to SPSS version 20 for analysis. Binary logistic regression was carried out; odds ratio with 95% CI was used to identify covariates associated with virologic failure. Statistical significance was considered at p-value < 0.05. Results: A total of 384 patients with mean age of 35.73± 9.44 years were consecutively enrolled; of which, 213 (55.5%) were females, 255 (66.4%) had WHO clinical stage III/IV, and 130 (33.9%) had baseline CD4 count < 100 cells/mm3. Mean baseline CD4 count was 179 cells/mm3 (range: 2– 853 cells), and 158 (41.1%) participants were on AZT/3TC/NVP. Virological failure was diagnosed among 61 (15.9%) patients. The mean time to virologic failure after initiation of ART was 63.80 months (range: 17– 150 months). After adjusting for other confounders, risk of experiencing virologic failure was significantly associated with being divorced (AOR 3.40, 95% CI 1.20– 9.59), being naïve to ART (AOR 2.55, 95% CI 1.23– 5.28), low (< 100) baseline CD4 count (AOR 2.39, 95% CI 1.03– 5.54) and nonadherence (AOR 6.73, 95% CI 3.29– 13.76). Conclusion: In this study, the prevalence of antiretroviral treatment failure was 15.9%. Being divorced, being naïve to antiretroviral therapy, low (< 100 cells/mm3) baseline CD4 count and nonadherence were found to be significant predictors of virologic failure. ART programs should focus on early HIV diagnosis and ART initiation as well as enhanced adherence support. [ABSTRACT FROM AUTHOR]