Prevalence of potential drug- drug interactions and associated factors among outpatients and inpatients in Ethiopian Hospitals: a systematic review and Meta-analysis of observational studies
Abstract Background: Drug-drug interaction is an emerging threat to the public health. In Ethiopia, there is high possibility of occurrence of drug-drug interactions in the hospitals. This is because of increased comorbid disease, increased polypharmacy, and increased hospitalization. Therefore, this study aims to summarize the prevalence of potential drug-drug interactions and associated factors in Ethiopian hospitals. Methods: Literature search was performed through accessing legitimate databases in PubMed/MEDLINE, Google Scholar and Research Gate for English-language publications. Advanced search strategies were applied in Science Direct and HINARI to identify any additional papers and published reviews and to retrieve relevant findings closely related to prevalence of potential drug- drug interactions and associated factors with it. The search was conducted from August 3-25, 2019 and all published articles available online until the day of data collection were considered. The pooled estimate of the outcome measure were analyzed by Open Meta Analyst advanced software. By considering clinical heterogeneity among original studies, Der Simonian and Laird’s random effect model were used. I2 statistics were used to assess heterogeneity among each studies. The publication bias was assessed by CMA version-3 software and presented with funnel plot of standard error and precision with Logit event rate. Results: A total of 14 studies were included for systematic review and meta-analysis. From 14 studies, 5761 patients were included and a total of 8717 potential drug- drug interactions were found in 3259 of patients. The prevalence patients with potential drug- drug interactions in Ethiopian Hospitals were found to be 72.2% (95% confidence interval: 59.1%, 85.3%). Based on severity, the prevalence of potential drug- drug interactions were 25.1%, 52.8%, 16.9% and 1.27% for major, moderate, minor potential drug- drug interactions and contraindications respectively. The factors associated with potential drug- drug interactions were related to patient characteristics such as polypharmacy, age, comorbid disease and hospital stay. Conclusions: There is a high prevalence of potential drug- drug interactions in Ethiopian Hospitals. Polypharmacy, age, comorbid disease and hospital stay were the risk factors associated with potential drug- drug interactions.