Exit knowledge about dispensed medications and associated factors among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia: a systematic review and meta-analysis

Abstract

Objective: This study aims to synthesise evidence on the pooled level of exit knowledge among outpatients served in public hospital pharmacies and private pharmacies in Ethiopia and to identify the associated factors associated with medication knowledge by conducting a systematic review and meta-analysis of primary articles focused on this area.

Design: This systematic review and meta-analysis study employed the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Data sources: Three electronic databases-MEDLINE, Scopus and Google Scholar-were searched for all English-language articles published from 2010 until 18 December 2024.

Eligibility criteria of selected studies: The review exclusively included studies that reported original data, were freely accessible in full text and were written in English, as well as those investigating the level of knowledge among outpatients and associated factors, irrespective of study design. Studies lacking abstracts and full texts, reports, qualitative research, and conference summaries were excluded from the analysis.

Data extraction and synthesis: Data from selected studies were extracted by three independent reviewers using a standardised data extraction format created using Microsoft Excel. Their results were cross-checked by two additional reviewers for consistency.

Results: Of the 521 identified studies, 9 met the inclusion criteria. The overall pooled knowledge level was 45%. Factors associated with knowledge included residence (OR=0.67, 95% CI: 0.27 to 0.71), adequacy of information provided (OR=0.87, 95% CI: 0.24 to 0.90), education level (OR=0.70 CI: 0.39 to 0.89), clarity of instructions (OR=0.80 CI: 0.14 to 0.99) and pharmacist politeness (OR=0.72 CI: 0.46 to 0.77).

Conclusion: The systematic review and meta-analysis showed that pooled patient knowledge regarding their dispensed medications in Ethiopia is about 45%. Key determinant factors of knowledge included education level, quality of pharmacist communication, urban versus rural residence and pharmacist politeness. Recommendations for improvement include enhancing pharmacist training, developing educational materials in local languages, outreach programmes for rural areas and implementing patient-centred care policies.PROSPERO number: CRD42024560816.

Keywords: Drug Therapy; Drug Utilization; Ethiopia; Health; Health & safety; Patients.

Figure 1. Diagram of study selection according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines.

Figure 2. Forest plot showing the pooled level of knowledge regarding dispensed medications among outpatients in Ethiopia.

Figure 3. Funnel plot showing the pooled level of knowledge regarding dispensed medications among outpatients in Ethiopia.

Figure 4. Results of a leave-one-out sensitivity analysis of the level of knowledge regarding dispensed medications among outpatients in Ethiopia.