Scholarly works in Clinical Pharmacy & Administration

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Author: search.filters.author.Fakeye, T.O

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    Clinical and Humanistic Outcomes of Pharmaceutical Care Interventions in Diabetes Mellitus: A Systematic Review and Meta-Analysis.
    (West African Postgraduate College of Pharmacists, 2019) Showande, J.S.; Akande-Sholabi, W.; Fakeye, T.O
    Background: Diabetes mellitus is a chronic disease for which life-long medications and care are needed. Effectiveness of care is related to good glycemic control, which is desired to forestall complications. Objective: This study evaluated the effectiveness of pharmaceutical care (PC) services provided by pharmacists in improving clinical and humanistic outcomes in diabetes mellitus patients. Method: Five databases (PubMed/Medline, Embase, Scopus, Cochrane Central Register of Control Trials and Google Scholar) were systematically searched for randomized controlled trials (RCTs) reported in English using free text and medical subject headings keywords. Studies which had PC intervention arm, a control group, type1 and type 2 diabetes mellitus patients; clinical and/or humanistic outcomes were included. For metaanalysis, standard mean difference evaluated with random effect model at P<0.05 was reported. Significant heterogeneity was further evaluated with sensitivity and subgroup analyses. Results: A total of 41 RCTs with 7,448 patients were eligible out of 1222 citations. PC intervention significantly lowered glycosylated hemoglobin, fasting blood glucose, systolic blood pressure, diastolic blood pressure, total cholesterol, and low density lipoprotein cholesterol (P < 0.05), with significant heterogeneity. PC intervention also improved self-care but medication adherence, disease knowledge and quality of life were not improved. PC services offered (patient education, identification and resolution of drug therapy problems, and pharmacotherapy evaluation) were not uniform across the studies. Conclusion: The review and meta-analysis showed that PC intervention is of great benefit to improve most clinical outcomes which may result in better disease management. A call is however made for standardized pharmaceutical care intervention.
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    Clinical and Humanistic Outcomes of Pharmaceutical Care Interventions in Diabetes Mellitus: A Systematic Review and Meta-Analysis.
    (West African Postgraduate College of Pharmacists, 2019) Showande, J.S.; Akande-Sholabi, W.; Fakeye, T.O
    Background: Diabetes mellitus is a chronic disease for which life-long medications and care are needed. Effectiveness of care is related to good glycemic control, which is desired to forestall complications. Objective: This study evaluated the effectiveness of pharmaceutical care (PC) services provided by pharmacists in improving clinical and humanistic outcomes in diabetes mellitus patients. Method: Five databases (PubMed/Medline, Embase, Scopus, Cochrane Central Register of Control Trials and Google Scholar) were systematically searched for randomized controlled trials (RCTs) reported in English using free text and medical subject headings keywords. Studies which had PC intervention arm, a control group, type1 and type 2 diabetes mellitus patients; clinical and/or humanistic outcomes were included. For metaanalysis, standard mean difference evaluated with random effect model at P<0.05 was reported. Significant heterogeneity was further evaluated with sensitivity and subgroup analyses. Results: A total of 41 RCTs with 7,448 patients were eligible out of 1222 citations. PC intervention significantly lowered glycosylated hemoglobin, fasting blood glucose, systolic blood pressure, diastolic blood pressure, total cholesterol, and low density lipoprotein cholesterol (P < 0.05), with significant heterogeneity. PC intervention also improved self-care but medication adherence, disease knowledge and quality of life were not improved. PC services offered (patient education, identification and resolution of drug therapy problems, and pharmacotherapy evaluation) were not uniform across the studies. Conclusion: The review and meta-analysis showed that PC intervention is of great benefit to improve most clinical outcomes which may result in better disease management. A call is however made for standardized pharmaceutical care intervention.
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    Pattern of Use of Water Beverage of Hibiscus sabdariffa Linn in a University Community in Southwest Nigeria.
    (West African Postgraduate College of Pharmacists (WAPCP),, 2017) Showande, J.S.; Udoh-Kalu, C.C.; Fakeye, T.O
    Background:Water beverages of Hibiscus sabdariffa is widely consumed in many parts of the world. Objective: Its pattern of use in a University community in southwest Nigeria was studied. Methods: A questionnaire-guided survey was conducted among randomly selected staff (398) and students (910) of University of Ibadan on the use of water beverage of Hibiscus sabdariffa (WBHS). The questionnaire garnered information on pattern of use, side effects experienced, and drugs coadministered with WBHS. Descriptive statistics, Chi-square, and Fisher's Exact Probability tests were used to describe the association between categories of participants and indications for using and side effects experienced with WHBS. Results: Most (96.9%) respondents who had used WBHS, used it as a relaxant 382(29.2%), as an antihypertensive 318(24.3%), for weight reduction 140(10.7%), infertility 127(9.7%), to cure liver disease 87(6.7%), and for the management of diabetes 151(11.5%). Side effects experienced with its use were; diarrhea 69(5.3), dizziness 44(3.4%), insomnia 27 (2.1%), decreased libido 24(1.8%), blurred vision 16(1.2%),and headache 19(1.5%).Some of the participants 164(12.5%) coadministered WBHS with their medications such as antibiotics 51(3.9%), antihypertensives 24(1.8%), antipsychotic 18(1.4%), antilipidemic drugs 16(1.2%), and antiretroviral drugs 11(0.8%). Out of those who coadministered WBHS with their medications, 93(7.1%) were on chronic medications. Conclusion: Water beverage of Hibiscus sabdariffa is used to treat diverse diseases with attendant side effects and is sometimes coadministered with medications for chronic diseases. This may predispose users to herb-drug interactions. Thus there is a need to investigate some of the drugs co-administered with the beverage for possible herb-drug interaction.
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    The Concept of Adverse Drug Reaction Reporting: Awareness among Pharmacy Students in a Nigerian University
    (AKS Publications., 2007) Showande, J.S.; Fakeye, T.O
    Adverse drug reaction (ADR) is poorly reported globally but more in developing countries with poor participation by health professionals. Currently, there is no known literature on the Nigerian pharmacy students’ knowledge on ADR reporting. Hence the purpose of this study was to find out the level of knowledge of pharmacy students on the concept of pharmacovigilance and adverse drug reaction reporting and also to evaluate their opinions on the National Pharmacovigilance Centre guidelines on adverse drug reaction reporting. A pretested 34-item semi-structured questionnaire was administered among 69 pharmacy undergraduate students in their penultimate and final years that consented to take part in the study, in one of the universities in Nigeria. The study was carried out strictly adhering to the principles outlined in the Helsinki declaration of 1964, which was revised in 1975. The questionnaire used had four sections which included a section on biographical data, a section which evaluated the students’ knowledge on the concept of pharmacovigilance and adverse drug reaction reporting, a section on students personal experiences of adverse drug reactions and modes of reporting them and the final section of the questionnaire evaluated the students’ opinions on the National Pharmacovigilance Centre guidelines for reporting adverse drug reactions. Descriptive statistics, Mann-Whitney U and Kruskal Wallis statistical tests were used to analyze the data obtained. None of the participants knew the sequence of reporting ADR. More than half, 40(58.0%) had heard about pharmacovigilance at symposiums, 7(10.1%) during clinical clerkship program and 18(26.1%) from media jingles. Twenty nine (42.0%) agreed that pharmacovigilance was in their curriculum, however only 16(23.2%) could define the term correctly. None of the participants had seen or used an ADR form prior to the study, but the students could easily identify and describe the type of ADR they had personally experienced in detail, however, they did not know the channel of reporting it. Only 3% reported incidences of personal experience of ADR to the physician while another 3% reported cases of such to the pharmacist. There was a significant difference comparing students’ year of study in the pharmacy program with their opinion scores on the National Pharmacovigilance Centre (NPC) guidelines on ADR reporting (p <0.05). The lack of pharmacovigilance and adverse drug reaction reporting courses in the pharmacy school curriculum result in the poor knowledge of the students on the concept of adverse drug reaction reporting, nonetheless the view and knowledge they had garnered from different sources helped the students in identifying and describing ADR but this is not enough in properly documenting cases of ADRs. Thus, the poor knowledge on ADR reporting among the students requires speedy implementation of new curriculum incorporating pharmacovigilance to enhance the involvement of pharmacists in ADR reporting in Nigeria.
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    Assessment of Compliance to Treatment among Ambulatory Asthmatic Patients in A Secondary Health Care Facility in Nigeria.
    (The Society of Pharmaceutical Sciences and Research (SPSR)., 2012) Obasan, A.A.; Showande, J.S.; Fakeye, T.O
    This study assessed the level of compliance using three different methods: pill count, self report and peak expiratory flow rate, in asthmatic patients attending a secondary health care facility. Self report (using a pre-tested structured questionnaire), peak expiratory flow rate and pill count were used to assess patient’s compliance and identify the factors which may be responsible for non compliance. Measurement of peak expiratory flow rate and the pill count were done at two different occasions. The data obtained was analysed using descriptive statistics. The study showed that the patients were prescribed a range of one to four drugs: 54% (3 drugs), 32% (2 drugs), 8% (4 drugs) and 2% (1 drug). The levels of compliance were 86.57% for self report and 83.56% for pill count (p > 0.05). Reasons given for non compliance were: apparent wellness (33.31%), forgetfulness (26.67%), cost of drugs (6.67%), dysphagia (6.67%), presence of non-disturbing symptoms (6.67%), side effects (6.67%), ignorance/fear of addiction (6.67%), perceived lack of benefit from treatment (6.67%), and lethargy towards chronic medication (6.67%). However, there was a significant difference in the readings of the peak expiratory flow rate measured at two different occasions (p < 0.05). The study showed no significant difference in the methods used to assess the level of compliance. Non compliance can be overcome by proper education of patients on the importance of complying with the administration of medication and proper usage of metered dose devices.
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    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.