Background: Adverse drug reaction (ADR) of medications remains an obstacle to achieving optimal disease outcomes. This study aimed to assess the prevalence and associated factors of ADR among Heart failure (HF) patients hospitalized at Mbarara Regional and Referral Hospital. Method: A prospective observational study was conducted among hospitalized HF patients from November 2021 to January 2022. Univariate and multivariate logistic regression was employed to determine factors associated with the ADR. Result: Overall, 118 HF patients were included in the study with a median age of 43 years. A total of 164 ADRs were identified during the follow-up period of 1011 days. The incidence of new ADRs was 106 ADRs/1000 person-days. The prevalence of ADR was 59.3%. Of the 164 ADRs, 118(71.9%) were probable. The gastrointestinal system was the most frequently (27.5%) affected system. Over half (86, 52.4%) of the ADRs were mild and 96(58.5%) were preventable. Age group 19–59(AOR 0.15[0.03–0.35] at 95%CI, p = 0.013), herbal use (AOR 3.07[1.01–9.32] at 95%CI, p = 0.048), polypharmacy (AOR 8.7[2.4–15.77] at 95%CI, p < 0.001) and drug-drug interaction (AOR 6.06[2.79–12.5] at 95%CI, p = 0.004) were significantly associated with ADRs among HF patients. Conclusion: More than half of the hospitalized HF patients experienced at least one ADR during their hospital stay. The use of herbal medicines, poly-pharmacy, and drug-drug interaction were associated with a high risk of ARDs whereas the age group 19–59 years was less likely to experience ADRs.
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