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192 Shegena et al. | Journal of Clinical and Translational Research 2024; 10(3): 191-200
associated with detrimental health outcomes, such as frequent Uganda. The medical inpatient ward comprises 50 beds with an
hospitalization and drug-related problems [4,5]. estimated monthly admission of 300 patients.
Over 40% of newly diagnosed cardiovascular disease (CVD) The study population included all inpatient HF patients
patients are HF patients [6]. The incidence and prevalence of who were hospitalized at MRRH during the study period. The
CVD in Africa are increasing, and CVD is predicted to overtake inclusion and exclusion criteria were:
communicable disease as the most common cause of death in (i) Inclusion criteria: All newly diagnosed or known HF
a few decades, especially in sub-Saharan Africa (SSA) [7]. patients who were hospitalized for any reason at MRRH
The impact of CVDs, including HF, is more prominent in the (internal medicine for adult and general pediatric wards)
working class from low- and middle-income countries, like during the study period and were willing to participate in
Uganda [8,9]. However, there is a lack of population-based the study.
incidence and prevalence of HF studies in SSA, including (ii) Exclusion criteria: Patients who were critically ill and/or in
Uganda. It was reported that HF is responsible for 9.4 – 42.5% intensive care units.
of all medical admissions and 25.6 – 30.0% of admissions into
the cardiac units [10]. 2.2. Sample size determination
A drug therapy problem (DTP) can be defined as any The sample size (n) was calculated using a single proportion
undesirable drug treatment-related event experienced by formula;
a patient, which potentially interferes with the desired n = Z² p (1–p)/w² (I)
goals of therapy and requires professional intervention to Where n is the required sample size, p is the prevalence of the
resolve [11]. DTPs can be classified using validated tools, DTP, w is the tolerated margin of error (5%), and Z is the level
like Cipolle’s [11], Pharmaceutical Care Network Europe of confidence (i.e., 1.96 at 95% confidence interval [CI]). The
[12], and APS-Doc [13]. Common DTPs can be classified prevalence of DTP among HF patients from a previous study in
accordingly as: “dosage too low,” “adverse drug reaction,” Ethiopia was 91.3% [26]. Since the study settings were similar,
“needs additional drug therapy,” “ineffective drug,” we used 91.3% as p of DTP among hospitalized HF patients,
“unnecessary drug therapy,” “dosage too high,” and “non- with a 0.05 significance level at a 95% CI (i.e., p: 91.3%; w:
adherence” [11]. DTPs are common in HF patients as HF 0.05; Z: 1.96 [95% CI]).
treatment involves multiple medications (poly-pharmacy), Using the above formula, the number of patients to be
coupled with its risk factors, i.e., comorbidities, advanced included in the study was 122. The post hoc power was 69 –
age, and poor continuity of care [3,14–19]. 96% for variables included in the logistic regression analysis,
The prevalence of DTPs among HF patients is reportedly with a generally acceptable level of type II errors.
29.8 – 88.66% [20,21]. HF patients are vulnerable to DTPs, A consecutive sampling technique was used during the
which raises their risk of mortality and morbidity [22]. DTPs study period, and data collection was continued for 3 months
are related to clinical outcomes, health-care costs, and quality of (November 2021 – January 2022) until the required sample size
life of CVD patients [23]. Reducing health-care costs, mortality, was achieved.
and hospitalization and improving quality of life can be achieved
through optimized drug therapy to prevent DTPs [24]. 2.3. Data quality control
The increase in HF prevalence in SSA [25] and
cardiovascular drug-related DTPs warrant further investigation Pre-testing of the data collection tool was conducted using
into the prevalence of DTPs and their associated factors in 10 patients who met the inclusion criteria. This was performed
HF patients for a better treatment outcome. Given the lack to identify any challenges or issues with the tool, allowing
of data regarding cardiovascular drug-related DTPs in HF for necessary modifications and refinements to be made
patients and undefined factors associated with DTPs, the thereafter. The principal investigator (E.A.S.) selected and
present study aimed to determine the prevalence and factors recruited research assistants, and training on data collection
associated with cardiovascular drug-related DTPs among HF protocols and ethical considerations was given before the
patients hospitalized at the Mbarara Regional Referral Hospital study’s commencement. The data collection tool was translated
(MRRH), Mbarara, Uganda. to Runyankole (the local language in western Uganda) by a
professional and then the results were back-translated to English
2. Methods to check for consistency.

2.1. Study design 2.4. Data collection
This study was a prospective observational study conducted All patients who presented to the medical and pediatric
among hospitalized HF patients at the MRRH medical and inpatient units with a diagnosis of HF were subjected to
pediatric wards from November 2021 to January 2022. MRRH preliminary screening and assessed for eligibility as potential
is a 600-bed tertiary hospital and is the largest referral center study participants. The research assistants and the principal
in southwestern Uganda, 280 km from the capital Kampala. investigator enrolled patients as study participants upon
The hospital serves a population of over four million people voluntarily consenting to participate by writing. Assent forms
in its catchment area comprising 13 districts of southwestern were prepared for the pediatric patients and their parents, and

DOI: https://doi.org/10.36922/jctr.23.00137