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Geriatric patients often face issues related to polypharmacy and adverse drug events. Re-evaluating prescribed medications and considering deprescribing is critical. Medication discrepancies (MDs) during care transitions can compromise patient safety, as over 60% of medication errors occur at these points. This study aimed to assess the magnitude of MDs and their contributing factors through the medication reconciliation (MedRec) process among geriatric patients in emergency departments of comprehensive specialised hospitals in northwest Ethiopia, as well as to determine the acceptance of pharmaceutical interventions.
In this multicentre prospective observational study, the best possible medication history (BPMH) was obtained within 24 hours of emergency department admission from at least two sources. A comparison of the BPMH list with medication orders from treating physicians revealed discrepancies. Data were analysed using STATA V.17.0, using multivariable logistic regression to assess variable associations.
Adult emergency departments of comprehensive specialised hospitals in northwest Ethiopia.
Overall, 384 geriatric patients with chronic conditions and current medication use who visited the adult emergency department of the hospital from 10 January 2025 to 30 March 2025 were involved in this study.
Magnitude and types of MDs, acceptance of pharmacist interventions, and factors associated with MDs.
In total, 384 patients with chronic diseases visiting the hospital emergency department were recruited in the present study. Out of 384 patients involved in the study, 218 (56.77%) had encountered at least one MD. Omission error 190 (45.24%) was the most common type of MD, followed by wrong dose 82 (19.50%). Among 420 interventions, 80.48% of the total cases were accepted. Number of previous/home medications (≥5 medicines; adjusted OR (AOR)=3.12; 95% CI 1.190 to 8.151), older age (≥75 years; AOR=1.62; 95% CI 1.054 to 2.495), and number of comorbidities (≥3; AOR=1.65; 95% CI 1.066 to 2.546) were associated factors with MDs.
This study revealed a high prevalence of MDs in the emergency department. Polypharmacy, comorbidities and older age were factors associated with MDs. The study findings show the need for a clinical pharmacist-led MedRec implementation to enhance patient safety.
by Kindu Alem, Mucheye Gizachew, Mulat Dagnew, Worku Ferede, Solomon Belay, Baye Gelaw, Feleke Moges
BackgroundKlebsiella pneumoniae, Acinetobacter species, and Pseudomonas aeruginosa are priority pathogens identified by the World Health Organization that have emerged as major causes of healthcare-associated infections. Their increasing resistance to multiple antimicrobial agents poses significant challenges to clinical management and infection control efforts.
ObjectiveThis study aimed to determine the prevalence, associated risk factors, antimicrobial resistance patterns, and carbapenemase production of K. pneumoniae, Acinetobacter spp., and P. aeruginosa among hospitalized patients with suspected bloodstream, urinary tract, and surgical site healthcare-associated infections at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.
MethodsA hospital-based cross-sectional study was conducted from August 2024 to June 2025 among 477 patients suspected of bloodstream, urinary tract, or surgical site healthcare-associated infections. Socio-demographic and clinical data were collected using a semi-structured questionnaire. Blood, urine, and wound/pus specimens were aseptically collected and inoculated on MacConkey, blood, and cysteine lactose electrolyte-deficient agar following standard microbiological techniques. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar according to Clinical and Laboratory Standards Institute guidelines. Data were analyzed using SPSS version 27. Bivariate and multivariate logistic regression analyzes were used to identify factors associated with healthcare-associated infections. P value Results
Among the 477 patients, 118 (24.7%) developed healthcare-associated infections caused by K. pneumoniae, Acinetobacter spp., and P. aeruginosa, with culture positivity rates of 14.9%, 4.8%, and 5%, respectively. Significant associated factors included age under five (AOR = 13.260, p K. pneumoniae, 69.6% of Acinetobacter spp., and 58.3% of P. aeruginosa isolates. Carbapenemase production occurred in 92%, 77.8%, and 57.1% of these carbapenem-resistant isolates, respectively. Amikacin, meropenem, and ciprofloxacin were the most effective antimicrobials, whereas chloramphenicol was effective only against K. pneumoniae.
ConclusionThis study showed high prevalence of multidrug resistance and carbapenemase production among K. pneumoniae, Acinetobacter spp., and P. aeruginosa in the study area, highlighting the urgent need to strengthen infection prevention and control measures and to promote antimicrobial stewardship programs.
To assess health-related quality of life (HRQoL), treatment satisfaction and associated factors among older adults with acute heart failure in Northwest Ethiopia.
Prospective, multicentre observational study.
Three tertiary hospitals in Northwest Ethiopia provide secondary and tertiary care services.
A total of 422 patients aged ≥60 years with a confirmed diagnosis of acute heart failure were consecutively enrolled between December 2024 and April 2025. Patients with unstable psychiatric conditions or advanced kidney disease were excluded.
HRQoL was assessed using the WHO Quality of Life – Brief Version questionnaire, and treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM). Multiple linear regression identified factors associated with HRQoL and treatment satisfaction.
95% of participants reported moderate HRQoL, and 3% reported poor HRQoL. Weight loss was positively associated with HRQoL (β=1.52; 95% CI 0.04 to 3.07; p=0.021), whereas asthma was negatively associated with HRQoL (β = –3.28; 95% CI 6.94 to 0.37; p=0.001). Regarding treatment satisfaction, 65% of patients were moderately satisfied, with notable concerns regarding medication safety and overall experience. Rural residents reported lower satisfaction than urban residents (β = –0.20; 95% CI 0.34 to 0.05; p=0.007). Patients with New York Heart Association (NYHA) class III had higher satisfaction (β=0.25; 95% CI 0.05 to 0.45; p=0.016). Effective hypertension management was linked to increased satisfaction (β=0.20; 95% CI 0.02 to 0.37; p=0.026), whereas coronary heart disease was associated with lower satisfaction (β = –0.40; 95% CI 0.64 to 0.88; p=0.012).
Among older adults with heart failure in Northwest Ethiopia, 98% reported moderate to low HRQoL. Asthma and polypharmacy negatively affected HRQoL, whereas weight loss was positively associated with HRQoL. An NYHA class III status and well-managed hypertension improved treatment satisfaction, whereas rural residency and coronary heart disease were associated with lower satisfaction. These findings underscore the need for targeted interventions to enhance outcomes and QoL in this vulnerable population.
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