Future implications for clinicians and policymakers in Ethiopia
There is a paucity of studies related to deprescribing prescribing in
Ethiopia. In a limited-resource setting, inappropriate polypharmacy
poses poor clinical outcomes, including ADEs and a high economic burden
on the patients and the country at large. Polypharmacy is prevailing in
Ethiopian patients, particularly in the older population and patients
with cardiovascular disease (9, 32). This could be due partly because,
as to the recent studies done in Ethiopia, inappropriate prescribing of
medications has been pervasive in chronic patients such as patients with
antithrombotic therapy and patients with cardiovascular disease (33, 34)
.
Patients with inappropriate polypharmacy could also contribute to
suboptimal medication adherence as patients get trouble with remembering
to take multiple medications. The problem worsens when HCPs fail to make
the deprescribing decision for inappropriate medications, particularly
for older patients. Moreover, in a limited resource setting like
Ethiopia, medication unavailability, and out-of-pocket expenditure are
significant challenges in healthcare (35). The country cannot afford the
underutilisation of medications due to non-adherence, and wastage of
medications due to the inappropriate commission of medications.
Deprescription could optimise medication use and reduce inappropriate
polypharmacy, thereby improving medication adherence and utilising the
available medications cost-effectively in resource-limited settings.
Stakeholders such as the Ethiopian Ministry of Health and professional
associations should consider deprescription practice to integrate it
into the clinical practice. They could also take the lead and organise
to develop therapy-specific guidelines for deprescribing algorithm and
providing continuous professional development to HCPs.