1. EFFECTS OF INTRODUTION OF INDIVIDUALISED DISPENSING ON MEDICATION RELATED PROBLEMS AT KENYATTA NATIONAL HOSPITAL. Dr Rugendo Birichi A Dr Karimi Peter N Dr Amugune Beatrice K

2. Medication related problems occur when outcome of medicine use is not optimal. Systems to prescribe, distribute and administer medicines have influence on medication safety by minimising medication related problems(MRP’s). BACKGROUND

3. Kenyatta National Hospital(KNH) has used a mixed system of dispensing to inpatients. associated with medication related problems(MRP) Shifted to individual order system in 2013 Effect of change on MRP’S not evaluated

4.  To compare the types of medication related problems before and after introduction of individualised dispensing.  To compare the frequency of medication related problems before and after. Specific objectives

5. A cross sectional study(pre-post) design. systematic random sample of 236 before and 207patient files for the after study arm. Study site- KNH medical wards ethical approval was sought and granted by the KNH/UON ethics committee. Methodology

6. Methodology...... Data was abstracted from patient’s files. The treatment chart, the medical notes, nursing notes and laboratory reports were assessed. Mediscape drug interaction checker was used. Data analysis was performed using Statistical Package for social scientist (SPSS) version20

8. Results:Socio-Demographic traits of patients characteristiccategoryFrequency/percentage BeforeAfter genderMale115(48.7 %)98( 47.3%) Female121( 51.3 %)109 (52.7 %) AgeMean31.4 years36.9 years Range13 to 84 years13 to 102 years

9. Results: TYPE AND FREQUENCY OF MRP traitcategoriesFrequency/percentage P Value BeforeAfter durationmissing195(83 %)149(72% ) 0.000001 ADRPresence26( 11 %)18( 8.7 %)0.0173 Non -adherence191(80.9%189(91.3%0.00182 DoseLow3(1.3%)2(1%) 0.4234 High02(1%) Adjustment25(10.6%)26(12.6%) Drug-drug interaction 191(80.9%165(69.9%0.8248

11. The mean drug availability was 87. 5 % (before) and 86.92 % (after) MEDICINE AVAILABILITY

12. DRUG-DRUG INTERACTION

13. BIVARIATE ANALYSIS Patients with 8-11 drugs per prescription had the highest prevalence of MRP’s while the 1-3 category had the lowest [p<0.001].

14. conclusion Study demonstrated a high prevalence of MRP before and after change of dispensing system There was a statistically significant difference in prevalence of non-adherence, adverse drug reactions and indicated treatment duration in the two study groups.

15. Research and programs department KNH Health information department KNH School of Pharmacy, UON. ACKNOWLEDGEMENT