The Burden of Inappropriate Prescriptions and Predictors for Hospitalized Patients with Liver Cirrhosis in Ethiopia

Figures & data

Table 1 Frequency of Socio-Demographic Characteristics Among Patients with Cirrhosis Hospitalized at Felege-Hiwot Specialized and Comprehensive Referral Hospital (FHSCRH), Amhara Ethiopia

Variable	Frequency (N)	Percent (%)
Age
18–39	34	27.6
40–59	40	32.5
≥60	49	39.8
Sex
Male	74	60.2
Female	49	39.8
Residence
Rural	63	51.2
Urban	60	48.8
Education Level
Unable to read and write	22	17.9
Literate with no formal education	29	23.6
Primary education	18	14.6
Secondary education	18	14.6
Higher education	36	29.3
Occupation
House wife	24	19.5
Farmer	33	26.8
Merchant	11	8.9
Governmental employee	32	26.0
Non-governmental employee	20	16.3
Other*	3	2.4
Monthly Income
<1670 ETB	265	65.1
≥1670 ETB	142	34.9

Note: *Student, jobless.

Table 2 Frequency of Clinical Characteristics Among Patients with Cirrhosis Admitted to Medical Wards at Felege-Hiwot Specialized and Comprehensive Referral Hospital (FHSCRH), Amhara Ethiopia

Variable	Frequency (N)	Percent (%)
Etiology
Hepatitis B	44	35.8
Hepatitis C	35	28.5
Alcohol	14	11.4
Drug Induced	10	8.1
Unknown	23	18.7
Child Pugh Severity
A	28	22.8
B	52	42.3
C	43	35.0
Complications
Ascites	101	82.1
Portal Hypertension	95	77.2
Spontaneous Bacterial Peritonitis	91	74.0
Variceal Bleeding	23	18.7
Encephalopathy	16	13.0
Acute Kidney Injury	13	10.6
Number Of Complications
Less Than 3	68	55.3
Three And Above	55	44.7
	Mean	Standard deviation
Albumin	2.8 mg/mL	0.5 mg/mL
Biluribulin	3.4 mg/mL	1.5 mg/mL
INR	2.2	0.5

Abbreviation: INR, International Normalized Ratio.

Table 3 Frequency of Medication Prescription Pattern Among Patients with Cirrhosis Admitted to Medical Wards at FelegeHiwot Specialized and Comprehensive Referral Hospital (FHSCRH), Amhara Ethiopia

Variable	Frequency (N)	Percent (%)
Type of medication
Furosemide	112	91.1
Spironolactone	96	78.0
Ceftriaxone	49	39.8
Metronidazole	35	28.4
Cefotaxime	17	13.8
Ciprofloxacin	10	8.1
Tenofovir	23	35.8
Propanol	76	61.8
Labetalol	3	2.4
Omeprazole	9	7.3
Paracetamol	16	13.0
Tramadol	12	9.8
Lactulose	5	4.1
Thiamine	6	4.9
Diazepam	8	6.5
Others	6	4.9
Number of medications
Less than four	53	43.1
Four and above	70	56.9

Note: *Others albumin, iron sulphate, vitamin K, bisacodyl.

Table 4 Pattern Inappropriate Medication Prescription Among Cirrhotic Patients Hospitalized at FelegeHiwot Specialized and Comprehensive Referral Hospital (FHSCRH), Amhara Ethiopia

	Variable		Frequency (n)	Percent (%)
Inappropriate selection	Tenofovir	Inappropriate selection for CHC**	15	34.0
	Lamivudine	Inappropriate selection for CHB*	3	6.8
	Metronidazole	Inappropriate selection for spontaneous bacterial peritonitis	12	27.2
	Labetalol	Inappropriate selection for prophylaxis and treatment of variceal bleeding and portal hypertension	2	4.5
Inappropriate dose/ duration	Paracetamol	Exceed recommended dose	5	11.3
	Tramadol	Exceed recommended dose	1	2.2
	Omeprazole	Exceed recommended dose	4	9.0
	Spironolactone to Furosemide ratio	Inappropriate dose ratio	9	20.4

Abbreviations: **CHC, chronic hepatitis C; *CHB, chronic hepatitis B.

Table 5 Factors Associated with Inappropriate Prescription Among Patients with Cirrhosis Hospitalized at Felege Hiwot Specialized and Comprehensive Referral Hospital (FHSCRH), Amhara Ethiopia

Variable	Appropriate Prescription (n)	Inappropriate Prescription (n)	Bi Variable Analysis			Multi Variable Analysis
			P	COR	CI	P	AOR	CI
Age
18–39	27	7		1			1
40–59	28	12	0.35	1.65	0.56–4.82	0.43	1.81	0.40–8.11
≥60	24	25	0.00	4.01	1.47–10.94	0.10	3.34	0.77–14.37
Sex
Male	53	21	0.03	0.44	0.21–0.95	0.45	0.63	0.19–2.07
Female	26	23		1			1
Residence
Rural	37	26	0.19	1.64	0.77–3.45	0.07	2.98	0.90–9.80
Urban	42	18		1			1
Educational level
Unable to read and write	13	9	0.56	1.38	0.46
Literate with no formal education	22	7	0.41	0.63	0.21
Primary education	10	8	0.42	1.60	0.50
Secondary education	10	8	0.42	1.60	0.50
Higher education	24	12		1
Occupation
House wife	13	11	0.68	1.69
Farmer	19	14	0.76	1.47
Merchant	7	4	0.92	1.14
Governmental employee	23	9	0.84	0.78
Non-governmental employee	15	5	0.76	0.66
Other	2	1		1
Number of complications
Less than 3	46	22		1
Three and above	33	22	0.38	1.39	0.66–2.92
Child-Pugh score
A	23	5		1			1
B	34	18	0.12	2.43	0.79–7.48	0.99	1.00	0.16–6.03
C	22	21	0.01	4.39	1.40–13.68	0.13	3.59	0.68–18.96
Number of medications
Less than four	43	10		1			1
Four and above	36	34	0.00	4.06	1.76–9.33	<0.001*	4.88	1.05–22.68
Albumin	2.87±0.48	2.76±0.50	0.23	0.62–1	0.28–1.35	<0.001*	0.18	0.04–0.72
Bilirubin	2.74±1.01	4.47±1.49	0.00	2.84	1.92–4.19	<0.001*	3.54	1.95–6.45
INR	2.02±0.58	1.92±0.50	0.79	0.91	0.45–1.81
Practitioners
General practitioner	34	33	0.00	3.97	1.75–8.96	<0.001*	3.57	1.07—11.44
Internist	45	11					1

Note: *Statistically significant.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio.

Data Sharing Statement

There are all the necessary details in the paper. The corresponding author can provide you with additional data that has been used to support the study’s conclusions if requested.