# Prevalence of medication-related problems and its predictors among cancer patients in Ethiopia: A systematic review and meta-analysis

## TL;DR

This study estimates that nearly half of cancer patients in Ethiopia face medication-related problems, with comorbidities, complications, and polypharmacy as key predictors.

## Contribution

The study provides the first systematic review and meta-analysis on medication-related problems among cancer patients in Ethiopia.

## Key findings

- The pooled prevalence of medication-related problems among cancer patients in Ethiopia is 48%.
- Non-adherence to prescribed treatments was observed in 42% of patients.
- Comorbidities, complications, and polypharmacy are significant predictors of medication-related problems.

## Abstract

Preventable medication-related problems intensify the risk associated with cancer care and no data was available to represent the burden of medication-related problems among cancer patients in Ethiopia. Hence, this study was aimed to estimate the pooled prevalence of medication-related problems and identify its predictors among cancer patients treated in Ethiopia.

A systematic review and meta-analysis of studies retrieved from databases (Medline, EMBASE, Scopus, Cumulative Index to the Nursing and Allied Literature (CINAHL), Cochrane Library and Google Scholar) for relevant literature published before April, 2024 was made. We included observational studies conducted in Ethiopia that reported on the types, frequency, or risk factors of medication-related problems in cancer patients. Reviews, case reports, qualitative studies, and studies lacking relevant outcomes were excluded. The Newcastle-Ottawa quality assessment scale was used for quality assessment and the Egger’s regression test and the Galbraith plot were used to evaluate publication bias. The national prevalence of medication-related problems was estimated using a random-effects model meta-analysis. Moreover, subgroup analysis and meta-regression analyses were done to explore the reasons of statistical heterogeneity. The study protocol has been registered with PROSPERO under number CRD42024505218.

A total of 15 studies comprising of 3084 cancer patients were included in this study. The adjusted pooled prevalence of medication-related problems of cancer patients who experienced at least one medication-related problem was 48% [0.48 (95% CI: 0.39–0.57; I2 = 96%; p < 0.01)]. The study also revealed the pooled prevalence of non-adherence among the included studies to be 42% [0.42 (95% CI: 0.27–0.57; I2 = 97%; p < 0.01)]. The presence of comorbidities (AOR = 4.47, 95% CI: 3.26–5.69), complications (AOR = 5.78, 95% CI: 3.26–8.30) and polypharmacy (AOR = 3.75, 95% CI: 2.16–5.34) were found to be predictors of developing medication-related problems.

This review found a high pooled prevalence of medication-related problems among cancer patients in Ethiopia, with predictors including comorbidities, complications and polypharmacy. About two-fifths of patients were not fully adherent to their prescribed cancer treatments. These findings highlight the need for targeted interventions to improve medication safety and adherence, and underscore the importance of future research to identify effective strategies for reducing MRPs in oncology settings.