Dose optimization of non-selective beta blockers among esophageal varices patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a hospital-based cross-sectional study.

Abstract

Background: Gastroesophageal varices are portosystemic collaterals formed due to portal hypertension. The primary consequence and leading cause of death in cases of gastroesophageal varices is bleeding. Although variceal hemorrhage mortality has decreased due to early diagnosis of gastroesophageal varices, prophylaxis, and therapy, these procedures are still difficult to perform in many underdeveloped nations. When the dose of nonselective b-blockers is optimized to the highest acceptable dosage to reach the therapeutic goal, the benefit of reducing the risk of variceal bleeding is greatest. B-blocker optimization is unknown in our nation and Africa.

Objective: To assess the optimization rate of non-selective B-blockers and associated factors among esophageal varices patients following at the University of Gondar referral hospital.

Methods: A hospital-based cross-sectional study was conducted at the University of Gondar referral hospital GI clinic, North West Ethiopia. A total of 150 patients were taken with consecutive sampling and the target populations of the study were all adult esophageal varices patients who were on non-selective B-blockers at the GI follow-up clinic. Data were collected with a structured questionnaire and both descriptive and analytical data analysis was performed. Frequency, tables, and graphs were used to represent the data.

Results: A total of 150 patients were included in the study. From these 30.7% of patients took optimal doses of non-selective B -blockers. Patients with poor drug adherence (AOR = 4.293, [95% CI = 1.191-15.484], p-value = 0.026) and hospital admission in the last 01 year (AOR = 2.915, [95%CI = 1.076-7.893], P-value = 0.035) were significantly associated with sub-optimization of non-selective B- blockers.

Conclusion: Only one-third of patients received the optimal dose of non-selective B-blockers. Poor drug adherence and previous admission in the last year were significantly associated with sub-optimal dosing of non-selective B-blockers.