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Item Pharmacists’ knowledge and counselling on fall risk increasing drugs in a tertiary teaching hospital in Nigeria(Springer Nature, 2020) Akande-Sholabi,W.; Ogundipe, F. S.; Adisa, R.Background: Falls and fall-related injuries are a foremost health concern among older adults aged 60 years and above. Fall-risk-increasing drugs (FRIDs) use by older adults is one related cause of falling, and it is frequently used among older adults. Pharmacist-led counselling is an aspect of patient education that has been associated with improved therapeutic outcome and quality of life in high income countries with scarcity of information in lowmiddle income countries. This study therefore aims to assess hospital pharmacists’ knowledge and counselling on fall-related medications using the list compiled by the Swedish National Board of Health and Welfare on FRIDs and orthostatic drugs (ODs). Methods: A cross-sectional survey was carried out among 56 pharmacists working in a teaching hospital in Nigeria, between July and August 2019, using a self-administered questionnaire. Data were summarized with descriptive statistics while chi-square test was used for categorical variables at p < 0.05. Results: Thirty-five (62.5%) were within 10 years of practice experience. Two-third (62.5%) of the pharmacists possessed an additional qualification to Bachelor of Pharmacy degree. Twenty-two (40.0%) were aware of the FRIDs and ODs list. In all, (89.3%) had “unsatisfactory” knowledge of classes of medications and specific medicines that could cause a fall. Most pharmacists 42 (80.8%) focused counsel on appropriate medication use, adverse effects of drugs and storage of medications. Knowledge score of both FRIDs and ODs were neither significantly associated with pharmacists’ years of qualification (χ 2 = 1.282; p = 0.733), (χ 2 = 2.311; p = 0.510) nor with possession of additional qualification (χ 2 = 0.854; p = 0.836), (χ 2 = 2.996; p = 0.392). Majority, 53 (98.1%) believed that patients will benefit from effective counselling on FRIDs and ODs. About half (25; 51.0%) suggested training through seminar presentation as a measure for FRIDs and ODs sensitization. Conclusion: A substantial gap in knowledge and awareness of FRIDs and ODs was noted among the hospital pharmacists. However, engagement of pharmacists on counsel that focus on medication use, adverse effect and storage was relatively better. Thus, there is a general need to create awareness about fall-risk-increasing drugs among hospital pharmacists, so as to help improve the therapeutic outcome particularly in the older adults.Item Extent of misuse and dependence of codeine-containing products among medical and pharmacy students in a Nigerian University(Springer Open, 2019) Akande-Sholabi, W.; Adisa, R.; Ilesanmi, O.S.; Bello, A. E.Background: Misuse and dependency of opioids especially codeine-containing products is of increasing global concern. Inappropriate use of opioids among healthcare students could affect quality of service and ethical conducts of these future professionals, thereby putting the society at risk. This study aimed to evaluate knowledge and perception of medical and pharmacy students in a Nigerian tertiary University on use of opioids with focus on codeine-containing products. Methods: A cross-sectional survey among 335-medical and 185-pharmacy students from University of Ibadan, Nigeria, between September and December 2018, using a self-administered semi-structured questionnaire. Results: A total of 178 (34.2%) in multiple responses had used opioid-containing products among the respondents, of this, 171 (96.1%) used codeine-containing formulation. Precisely, 146 (28.1%) of the students had used codeine-containing products before, of this, 16 (11.0%) used the products for non-medical or recreational purpose regarded as a misuse/ abuse. In all, 201 (38.7%) had good knowledge of opioid use, with 51 (34.9%) among those who had used opioids and 150 (40.1%) among those who had not used opioids (X2 = 1.186; p = 0.276). Majority (469; 90.2%) had good perception of risks associated with opioid use; comprising (130; 89.0%) among those who had taken opioids and (339; 90.6%) among those who had not taken opioids before (X2 = 0.304; p = 0.508). Logistic-regression shows that students who experienced some side effects to be experienced again 22.1 [AOR = 22.1, 95% CI: (5.98–81.72)] as well as those pressured into using codeine-containing products 10.6 [AOR = 10.6, 95% CI: (1.36–82.39)] had more tendency of misuse. Conclusion: There is a potential for misuse of codeine-containing products among medical and pharmacy students. Peer-influence and experience of some side effects are possible predictors of misuse among the students. Thus, healthcare students’ curriculum should incorporate preventive programme, while public education and policy that favours peer-support programme on medication misuse is advocated for healthcare students.Item Treatment Non-Adherence Among Patients With Poorly Controlled Type 2 Diabetes Am¬bulatory Care Settings In Southwestern Nigeria(2014) Adisa, R.; Fakeye, T . OBackground: Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which un¬dermines the benefits of current medical care. Objectives: To evaluate the pattern of treatment non-adherence among ambulatory patients with poorly controlled type 2 diabetes in southwestern Nigeria, and to determine the possible factor(s) that accounted for such non-adherence with a view to identifying areas of future intervention to improve outcome. Methods: A prospective cross-sectional interview using the concept of RIM (Recognize, Identify and Manage) model was used to evaluate adherence to treatment recommendations among 176 consented patients recruited from the endocrinology out-patient clinics of two teaching hospitals in southwestern Nigeria between November, 2010 and January, 2011. Results: Overlaps of non-adherence behavior were obtained. More than three-quarter (153; 88.4%) were not aware of in¬dication for each of the prescribed medications, 26 (15.3%) correctly described regimen as prescribed. The factorsidentified as possible barriers to medication adherence include practical (145; 40.1%), knowledge (103; 28.5%), and attitudinal (114; 31.5%) barriers. Dietary non-adherence was mostly due to inappropriate guidance (62; 33.7%). Conclusions. The arrays of non-adherence behavior among the cohort further emphasize the need for patient-centered approach as a reasonable strategy in resolving non-adherence problems in routine clinical practice.Item Correction to: Treatment adherence and blood pressure outcome among hypertensive out-patients in two tertiary(2020) Adisa, R.; Ilesanmi, O . A; Fakeye, T . OItem Pharmacists’ knowledge, Attitude and Involvement in Palliative Care in Selected Tertiary Hospitals in Southwestern Nigeria(2019) Adisa, R.; Anifowose, A.TBackground: The growing number of people living with life-limiting illness is a global health concern. This study therefore aimed to explore the involvement of pharmacists in selected tertiary hospitals in Nigeria in palliative care (PC). It also sought to evaluate their knowledge and attitude to PC as well as factors that hinder pharmacists’ participation in PC. Method: Questionnaire-guided survey among pharmacists working in three-tertiary hospitals in southwestern Nigeria. The self-administered questionnaire comprised 18-item general knowledge questions related to PC, attitude statements with 5-point Likert-scale options and question-items that clarify extent of involvement in PC and barriers to participation. Overall score by pharmacists in the knowledge and attitude domains developed for the purpose of this study was assigned into binary categories of “adequate” and “inadequate” knowledge (score > 75% versus≤75%), as well as “positive” and “negative” attitude (ranked score > 75% versus≤75%), respectively. Descriptive statistics, Mann-Whitney-U and Kruskal-Wallis tests were used for analysis at p < 0.05. Results: All the 110 pharmacists enrolled responded to the questionnaire, given a response rate of 100%. Overall, our study showed that 23(21.1%) had adequate general knowledge in PC, while 14(12.8%) demonstrated positive attitude, with 45(41.3%) who enjoyed working in PC. Counselling on therapy adherence (100;90.9%) was the most frequently engaged activity by pharmacists; attending clinical meetings to advise health team members (45;40.9%) and giving educational sessions (47;42.7%) were largely cited as occasionally performed duties, while patient home visit was mostly cited (60;54.5%) as a duty not done at all. Pharmacists’ unawareness of their need in PC (86;79.6%) was a major factor hindering participation, while pharmacists with PC training significantly felt more relaxed around people receiving PC compared to those without training (p = 0.003). Conclusion: Hospital pharmacists in selected tertiary care institutions demonstrate inadequate knowledge, as well as negative attitude towards PC. Also, extent of involvement in core PC service is generally low, with pharmacists’ unawareness of their need in PC constituting a major barrier. Thus, a need for inclusion of PC concept into pharmacy education curriculum, while mandatory professional development programme for pharmacists shouldnalso incorporate aspects detailing fundamental principles of PC, in order to bridge the knowledge and practice gaps.Item Prevalence, knowledge and perception of self‑medication practice among undergraduate healthcare students(2021) Akande‑Sholabi, W.; Ajamu, A .T; Adisa, R.Background: Globally, self-medication is a common practice, and an increasingly perceived necessity to relieve burdens on health services. However, inappropriate self-medication may result to reduced health outcomes, increased antimicrobial resistance and economic waste. Healthcare students are the future health professionals who will be consistently responsible for educating the public on rational use of medication. This study therefore aimed to assess the prevalence, knowledge and perception of self-medication practices among healthcare students. Methods: A cross-sectional study was carried out among 866 healthcare students in a Nigerian University, comprising medical, nursing and pharmacy students. Information was garnered from respondents using a self-administered questionnaire. Data were summarized with descriptive statistics, while Chi-square and logistic regression tests were used for categorical variables at p < 0.05. Results: Mean age was 21 ± 2.8 years, and female respondents were 447 (51.6%). Prevalence of self-medication among respondents was 473 (54.6%). A total of 288 (55.3%) demonstrated good knowledge of self-medication practices, comprising 250 (52.2%) among those who have previously self-medicated and 229 (47.8%) among those who had not. Reasons for engaging in self-medication practices were mentioned to include treatment of minor ailments (357; 32.4%), while 248 (22.5%) believed they had the medical knowledge of what to use. Analgesic (353; 30.1%), antimalarial (352; 30.0%), and antibiotics (182; 15.5%) were the commonest classes of medication used for self-medication. Headache (363; 18.4%), malaria (334; 16.9%), and cough (184; 9.3%) were the most frequently treated conditions. More than half (281; 59.4%) of the respondents’ purchased their self-medicated drugs from the community pharmacy. Gender and respondents’ disciplines were found to be the independent predictors for good knowledge of self-medication practice. Conclusion: Prevalence of self-medication among the studied healthcare students is moderately high, while approximately half demonstrates good knowledge and perception of self-medication practices. Stimulation for selfmedication practice largely arise from the perception of treating minor ailments. This underscores a need for advocacy on responsible self-medication practice during the formal training of these future health professionals, in order to avert its imminent/widespread negative consequences.Item Pharmacist-led Intervention in Treatment Non-adherence and Associated Direct Costs of Management Among Ambulatory Patients With Type 2 Diabetes in Southwestern Nigeria(2021) Ipingbemi, A .E; Erhun,W . O .; Adisa, R.Background: Non-adherence to recommended therapy remains a challenge to achieving optimal clinical outcome with resultant economic implications. Objective: To evaluate the effect of a pharmacist-led intervention on treatment non-adherence and direct costs of management among patients with type 2 diabetes (T2D). Method: A quasi-experimental study among 201-patients with T2D recruited from two-tertiary healthcare facilities in southwestern Nigeria using semi-structured interview. Patients were assigned into control (HbA1c < 7%, n = 95) and intervention (HbA1c ≥ 7%, n = 106) groups. Baseline questionnaire comprised modified 4-item Medication Adherence Questions (MAQ), Perceived Dietary Adherence Questionnaire (PDAQ) and International Physical Activity Questionnaire, to assess participants’ adherence to medications, diet and physical activity, respectively. Postbaseline, participants were followed-up for 6-month with patient-specific educational intervention provided to resolve adherence discrepancies in the intervention group only, while control group continued to receive usual care. Subsequently, direct costs of management for 6-month pre-baseline and 6-month post-baseline were estimated for both groups. Data were summarized using descriptive statistics. Chi-square, McNemar and paired t-test were used to evaluate categorical and continuous variables at p < 0.05Item Medication Adherence Among Ambulatory Patients With Type 2 Diabetes in a Tertiary Healthcare Setting in Southwestern Nigeria(2011-04) Adisa, R.; Fakeye, T.O; Fasanmade, A.Objective: To assess adherence to medication among ambulatory patients with type 2 diabetes, ascertain the level of glycemic control, and evaluate patients’ opinions on probable reasons for nonadherence with a view to identify areas of intervention to improve adherence. Methods: A prospective cross-sectional study was carried out at a 900-bed tertiary teaching hospital in Ibadan, Southwestern Nigeria between June and August, 2009. Out of 140 consented patients, 114 (81.4%) properly responded to the validated and pre-tested data collection tool and these were subsequently considered for analysis. Descriptive statistics were used to summarize the data. Means and proportions were compared using student t-test and chi-square or Kruskal-Wallis test as appropriate, with p<0.05 considered statistical significant. Results: Approximately sixty percent of the patients were adjudged adherent with prescribed medication. Out of 58.8% of the cohort who gave their recent fasting plasma glucose (FPG) values, 59.7% had FPG above 110mg/dL. The mean FPG for patients was 139.05 (SD=70.5)mg/dL, males and females significantly differed in their mean FPG, 146.55 (SD=85.0)mg/dL versus 133.33 (SD=57.6)mg/dL respectively (p=0.032). Also, the mean FPG values for adherent patients, 137.09 (SD=59.3)mg/dL was lower than their non-adherent counterparts, 143.92 (SD=87.6) mg/dL, but the difference was not statistically significant (p=0.095). Financial constraint (34.4%) was the major barrier to optimal adherence with medication. A significant association exist between genders and opinions on physician’s mode of approach during patientphysician interaction as a contributory factor for non-adherence (p=0.038). Conclusion: Medication adherence of ambulatory type 2 diabetes patients is considerable. However, the relatively high level of adherence did not appear to have significantly impacted on patients’ glycemic status due to a substantial number who had plasma glucose above the recommended targets. Multiple *Rasaq ADISA. B.Pharm, M.Pharm. Lecturer 1. Department of Clinical Pharmacy &Pharmacy Administration, Faculty of Pharmacy, University of Ibadan (Nigeria). Titilayo O. FAKEYE. B.Pharm, M.Sc, PhD. Senior Lecturer. Department of Clinical Pharmacy &Pharmacy Administration, Faculty of Pharmacy, University of Ibadan (Nigeria). Adesoji FASANMADE. MBBS, FWACP. Consultant endocrinologist. Department of Medicine, Endocrinology unit, College of Medicine, University of Ibadan, (Nigeria). methods may be required to detect patient who report adherence but who may in fact be nonadherent. Also, adherence to other aspects of diabetes management plan needs to be encouraged in order to accomplish optimal glycemic control. Initiatives targeting patient-specific intervention improve medication adherence should be considered.Item Knowledge about tuberculosis, treatment adherence and outcome among ambulatory patients with drug-sensitive tuberculosis in two directly-observed treatment centres in Southwest Nigeria(2021) Adisa, R.; Ayandokun, T. T.; Igez, O. M.Background: Tuberculosis (TB) remains one of the most common infectious diseases worldwide. Although TB is curable provided the treatment commenced quickly, appropriately and uninterrupted throughout TB treatment duration. However, high default rate, treatment interruption and therapy non-adherence coupled with inadequate disease knowledge significantly contribute to poor TB treatment outcome, especially in developing countries. This study therefore assessed knowledge about TB and possible reasons for treatment non-adherence among drugsensitive TB (DS-TB) patients, as well as evaluated treatment outcomes for the DS-TB managed within a 5-year period. Methods: A mixed-method design comprising a cross-sectional questionnaire-guided survey among 140-ambulatory DS-TB patients from January–March 2019, and a retrospective review of medical-records of DS-TB managed from 2013 to 2017 in two WHO-certified TB directly-observed-treatment centres. Data were summarized using descriptive statistics, while categorical variables were evaluated with Chi-square at p < 0.05. Results: Among the prospective DS-TB patients, males were 77(55.0%) and females were 63(45.0%). Most (63;45.0%) belonged to ages 18-34 years. A substantial proportion knew that TB is curable (137;97.9%) and transmittable (128; 91.4%), while 107(46.1%) accurately cited coughing without covering the mouth as a principal mode of transmission. Only 10(4.0%) mentioned adherence to TB medications as a measure to prevent transmission. Inaccessibility to healthcare facility (33;55.0%) and pill-burden (10,16.7%) were topmost reasons for TB treatment non-adherence. Of the 2262-DS-TB patients whose treatment outcomes were evaluated, 1211(53.5%) were cured, 580(25.6%) had treatment completed, 240(10.6%) defaulted, 54(2.3%) failed treatment and 177(7.8%) died. Overall, the treatment success rate within the 5-year period ranged from 77.4 to 81.9%.Item Tailored Intervention To Implement The Management Of Hypertensive And Type 2 Dia¬betes Mellitus Patients In Community Phar¬macies – A Pilot Study(2021) Ogunbeku, A.; Showande, S.J.; Adisa, R.; Fakeye, T.O.