Clinical Pharmacy & Administration

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450 Barriers and enablers to medication deprescribing among older patients attending a geriatric clinic in southwestern nigeria: a cross-sectional study
(2023) Akande-Sholabi W.; Ajilore C. O.; Olowookere O.O; Adebusoye L.A
Introduction: Polypharmacy is an increasing health problem, leading to rise in morbidity and mortality, especially among older patients. De prescribing has been recommended for managing polypharmacy, but deprescribing medication in older patients is still uncommon (1). Safe deprescribing interventions can reduce exposure to inappropriate polypharmacy among older patients. However, few empirical data exist on the barriers and enablers to medication deprescribing among older patients in sub-Saharan African countries. Aim: This study aimed to assess the barriers and enablers of medication deprescribing among older patients. Methods: A cross-sectional study of 415 older patients aged ≥60 years, selected consecutively at the geriatric clinic in a Tertiary Hospital was carried out between May and July 2022. An interviewer-administered semi-structured questionnaire was used to obtain information on their socio-demographic characteristics, and barriers and enablers
A giant
(2019-05) Valantine
Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University
(Springer Nature, 2021) Akande-Sholabi, W.; Ajamu, A. T.
Background: Inappropriate use of antibiotics is a major cause of antimicrobial resistance (AMR). Inadequate knowledge about AMR among healthcare students could affect their practice of antimicrobial stewardship as future healthcare professionals. This study aims to assess the use of antibiotics and knowledge of AMR among future healthcare professionals of a Nigerian University. Methods: Respondents’ knowledge of antimicrobial resistance, use of antibiotics, and source of antibiotics in the past 12 months was explored using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and respondents’ knowledge. Results: Of the 939 questionnaires administered to the students, 866 were filled given a response rate of 92.2 %. A total of (765; 88.3 %) of the respondents were aware that antimicrobial resistance makes it harder to eliminate the infection from the body as existing drugs become less effective. In all 824, (95.2 %) of the respondents had use antibiotics in the past 12 months. The use of antibiotics to treat malaria was self-reported by (175; 21.2 %). About half (432; 52.4 %) purchased the antibiotics from community pharmacies, while others obtained their antibiotics from the hospitals (192; 23.3 %), patent medicine stores (150; 18.2 %), and friends and family (50; 6.1 %) in the last 12 months. In all 506, (58.4 %) had good knowledge of antimicrobial resistance. Logistic regression shows that students in 3rd to 6th year 9.29 [AOR = 9.29, 95 % CI: (3.7–22.96)], had greater knowledge of antimicrobial resistance. Conclusions: The healthcare students demonstrated a moderate knowledge of AMR. This underscores the need to adopt several educational tactics to introduce the concepts of AMR to the students and ensure there are strict policies to regulate the flow of antibiotics.
"Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University"
(Springer Nature, 2021) Akande-Sholabi, W.; Ajamu, T.A.
Background: Inappropriate use of antibiotics is a major cause of antimicrobial resistance (AMR). Inadequate knowledge about AMR among healthcare students could affect their practice of antimicrobial stewardship as future healthcare professionals. This study aims to assess the use of antibiotics and knowledge of AMR among future healthcare professionals of a Nigerian University. METHODS: Respondents’ knowledge of antimicrobial resistance, use of antibiotics, and source of antibiotics in the past 12 months was explored using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and respondents’ knowledge. RESULTS: Of the 939 questionnaires administered to the students, 866 were filled given a response rate of 92.2 %. A total of (765; 88.3 %) of the respondents were aware that antimicrobial resistance makes it harder to eliminate the infection from the body as existing drugs become less effective. In all 824, (95.2 %) of the respondents had use antibiotics in the past 12 months. The use of antibiotics to treat malaria was self-reported by (175; 21.2 %). About half (432; 52.4 %) purchased the antibiotics from community pharmacies, while others obtained their antibiotics from the hospitals (192; 23.3 %), patent medicine stores (150; 18.2 %), and friends and family (50; 6.1 %) in the last 12 months. In all 506, (58.4 %) had good knowledge of antimicrobial resistance. Logistic regression shows that students in 3rd to 6th year 9.29 [AOR = 9.29, 95 % CI: (3.7–22.96)], had greater knowledge of antimicrobial resistance. CONCLUSIONS: The healthcare students demonstrated a moderate knowledge of AMR. This underscores the need to adopt several educational tactics to introduce the concepts of AMR to the students and ensure there are strict policies to regulate the flow of antibiotics.
Assessment of Attitude, Practice and Barriers to Pharmaceutical Care Among Community Pharmacists in Ibadan
(2022) Akande-Sholabi, W.; AKINBITAN, A.A.
Background: Pharmaceutical care (PC) is a professional responsibility of a pharmacist that involves medication management with the overall goal of improving the quality of life of patient. Objectives: To evaluate the attitude, practice, and barriers to PC among community pharmacists in Ibadan. Method: A cross-sectional survey was conducted among community pharmacists between May and July 2021, with the aid of a self-administered questionnaires, information on socio-demographic characteristics, practice, attitudes, and barriers to PC was obtained. A consecutive sampling technique was used for participants’ enrolment. Participating pharmacists must have had a minimum of one-year practice experience in a community pharmacy. Pharmacy students, interns, non-pharmacist attendants, and community pharmacists who were absent from their pharmacies during the study were excluded. Data were summarized with descriptive statistics. Results: Over 12 weeks, 120 survey were collected (90.9% response rate). About (115; 95.8%) of respondents had good practice of PC and reported that pharmaceutical care is a timely innovation to pharmacy practice. However, only (62; 52.0%) had positive attitude and (117; 97.5%) believed more pharmaceutical care could be provided. Regarding their practice, most respondents (118; 98.3%) stated pharmaceutical care involves monitoring improvement in patient response to treatment and adherence to treatment regime and counselling patients with drug therapy problems. The top detected barriers for PC provision included insufficient time (71; 59.2%), and inadequate collaboration with other healthcare professionals (56; 46.7%). Conclusion: Community pharmacists in Ibadan demonstrated good practice and positive attitudes towards PC provision. However, further work should emphasise on improving PC understanding, better collaboration among other healthcare professionals and overcoming system-related barriers.
Assessment of attitude, practice, and barriers to pharmaceutical care among community pharmacists in Ibadan
(Nigeria Association of Pharmacists in Academia (NAPA), 2022) Akande-Sholabi, W.; Akinbintan, A. A.
Background: Pharmaceutical care (PC) is a professional responsibility of a pharmacist that involves medication management with the overall goal of improving the quality of life of patient. OBJECTIVES: To evaluate the attitude, practice, and barriers to PC among community pharmacists in Ibadan. METHOD: A cross-sectional survey was conducted among community pharmacists between May and July 2021, with the aid of a self-administered questionnaires, information on socio-demographic characteristics, practice, attitudes, and barriers to PC was obtained. A consecutive sampling technique was used for participants’ enrolment. Participating pharmacists must have had a minimum of one-year practice experience in a community pharmacy. Pharmacy students, interns, non-pharmacist attendants, and community pharmacists who were absent from their pharmacies during the study were excluded. Data were summarized with descriptive statistics. RESULTS: Over 12 weeks, 120 survey were collected (90.9% response rate). About (115; 95.8%) of respondents had good practice of PC and reported that pharmaceutical care is a timely innovation to pharmacy practice. However, only (62; 52.0%) had positive attitude and (117; 97.5%) believed more pharmaceutical care could be provided. Regarding their practice, most respondents (118; 98.3%) stated pharmaceutical care involves monitoring improvement in patient response to treatment and adherence to treatment regime and counselling patients with drug therapy problems. The top detected barriers for PC provision included insufficient time (71; 59.2%), and inadequate collaboration with other healthcare professionals (56; 46.7%). CONCLUSION: Community pharmacists in Ibadan demonstrated good practice and positive attitudes towards PC provision. However, further work should emphasise on improving PC understanding, better collaboration among other healthcare professionals and overcoming system-related barriers.
Assessment of compliance to treatment among ambulatory asthmatic patients in a secondary health care facility in nigeria
(2012) Obasan A.A.; Showande S.J.; 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.
Assessment of knowledge and reasons for medication non-adherence in ambulatory elderly patients with hypertension and diabetes mellitus in a geriatric centre in nigeria
(2021) Akande-Sholabi W.; Ogini D.E; Adebusoye L .; Fakeye T
Assessment of knowledge and reasons for medication non-adherence in ambulatory elderly patients with hypertension and diabetes mellitus in a geriatric centre in Nigeria
(Oxford University Press, 2021) Akande-Sholabi, W.; Ogini, D. E.; Adebusoye, L.; Fakeye, T. O.
Introduction: Hypertension and type 2 Diabetes mel¬litus are global health disorders afflicting millions of elderly patients worldwide with an ever-increasing incidence and prevalence. Non-adherence to medications affects the quality and length of life, and has been associated with negative health outcomes and increasing healthcare costs especially in the elderly [1]. Few empirical data exist on the know¬ledge and medication adherence among elderly patients in sub-Saharan Africa countries. Aim: This study aimed to assess the knowledge, medi¬cation adherence, and the factors associated with patient’s knowledge on diabetes mellitus and hypertension. Methods: A cross-sectional study of 423 elderly patients aged ≥60 years diagnosed with hypertension and diabetes mellitus, selected consecutively at the Geriatric centre in the University College Teaching Hospital, Ibadan was car¬ried out between October 2019 and January 2020. Socio-demographic information, knowledge of the indication of the medications, possible side effects, and details of medi¬cation adherence level with reasons for non-adherence were obtained using interviewer-administered semi-structured questionnaire. Bivariate and multivariate analyses were car¬ried out using SPSS 23. Alpha was set at 0.05. Results: The mean age (±SD) of the older patients was 69.6 ± 6.4 years and 253 (59.8%) were females. About three-quarter of participants (320; 75.7%) were retired. Majority of the elderly (381; 90.1%) were hypertensive, while 270 (63.8 %) were diabetic, and 85 (20.1%) had multimorbidity of both hypertension and diabetes mel¬litus. Patients that were non-adherent with their medication were 138 (32.6%). The most common reasons reported for non-adherence included patient slept off (41; 56.6%), pre-occupation (24; 33.1%) and unavailability of medications (12; 16.6%). Thirty-seven (8.7%) participants intentionally missed doses, out of which 22 (59.5%) reported pill burden as its reason for medication non-adherence. All patients 423 (100.0%) knew the indication for their medications and 20 (4.7%) experienced medication-related side effects. Overall, 299 (70.6%) and 309 (73.0%) of patients with hypertension and diabetes mellitus showed good knowledge about their conditions. Adherence to medication was associated with good knowledge in hypertensive patients (p=0.002), while being male (p=0.002), age-group of 60–69 (p=0.001) and poor adherence (p=0.001) were associated with good knowledge in diabetes mellitus patients. Conclusion: We found non-adherence was mainly as a result of patients’ behaviors, attitude, and unavailability of medications which could be the cause of low medication adherence among the elderly patients. A systematic review on factors associated with medication adherence in older patients reported medication review aimed at simplifying regimens and educating patients about their treatment as intervention.
Assessment of the knowledge of community pharmacists regarding common phytopharmaceuticals sold in South Western Nigeria
(Pharmacotherapy Group, 2006-12) Adisa, R.; Fakeye, T.
Purpose: The study was carried out to assess the knowledge of community pharmacists who sell herbal/phytopharmaceutical formulations in pharmacy retail outlets. Method: Questionnaires were administered to the pharmacists to gather information on phytopharmaceuticals regarding their use, side effects, potential drug-herb interactions and contraindications of the phytopharmaceuticals sold in their retail outlets. Opinions on regulation, safety and efficacy of herbal remedies were also obtained. Descriptive statistical tests and median scores were used to evaluate the distribution of responses, opinions and perception of the pharmacists on their level of knowledge of the phytopharmaceuticals, and effects of demographic data on the pharmacists’ knowledge of the herbal remedies. Results: The study revealed that 31 (62%) sold imported herbal remedies and nutritional supplements. Seventy-two (72) % had received no postgraduate training on herbal medications. Most of the community pharmacists agreed that they did not possess adequate knowledge of potential interaction profiles and side effects of the herbal remedies sold. The training in pharmacy schools on herbal drugs and sale of phytopharmaceuticals in their outlets also had no influence (p>0.05) on desired knowledge. Community pharmacists with less than 10 years of experience in the practice however possessed better knowledge than pharmacists with more than ten years of professional practice (p=0.05) Conclusions: There was gross inadequacy in the pharmacists’ knowledge of the phytopharmaceuticals sold in pharmacies indicating an urgent need for intensive training in order to render better services to their clients.
Associated With Hospitalisation of Hypertensive in-patients in a Tertiary Hospital, Southwestern Nigeria
(2023-05) Ipingbemi, E . L; Erhun, W . O; Rasaq, A.
The study aimed at estimating the cost of hospitalisation associated with medication non-adherence (MNA) among hypertensive in-patients in a tertiary healthcare facility in southwestern Nigeria. It involved a cross-sectional retrospective review of 322 medical records of hypertensive in-patients at the University College Hospital between 2013 and 2015. Physician’s documentation of MNA in the patients’ medical records prior to admission determined the eligibility into the study. Direct medical costs mainly consultation, medications, laboratory costs for individual patients during hospitalisation were calculated using out-of-pocket payer’s perspective approach. Data were summarised with descriptive statistics, Pearson’s product moment correlation coefficient was used to determine relationship between length of stay in hospital, cost of management and number of comorbidities at p < 0.05 considered statistically significant. Of the 322 medical records of hypertensive in-patients evaluated within the 3-year study period, 230 (71.4%) had a documentation of MNA. The average age was 55.9 ± 15.7 years old. Artisans/self-employed (n = 82; 35.7%) and petty traders (n = 61; 26.5%) made up the majority of the patients. The total cost of hospitalisation for the period studied was USD100,461.40 for all the patients, with an average of USD52.00 ± 28.10/patient/day, more than a quarter of which was spent on pharmaceuticals. Similarly, the costs of management also increased with increase in length of hospitalisation (Pearson’s product moment correlation r = 0.539, p = 0.000). The number of comorbid diseases increased the length of hospitalisation (r = 0.133, p = 0.044). Cost associated with hospitalisation in relation to MNA is high among the studied participants. There is a need to develop strategies to enhance medication adherence among patients with hypertension.
Attitude and opinion of nigerian community pharmacists to self medication practices
(2012) Fakeye T. O.; Adisa R.; Showande S. J. S.
This study evaluated the attitude and opinion of Nigerian community pharmacists on self medication practices with respect to the definition, advantages and disadvantages of self medication, ailments for which self medication should be allowed, as well as measures that may be instituted to ensure appropriate self medication practices. Pretested structured questionnaires were administered to licensed community pharmacists practicing in Southwestern Nigeria between December, 2009 and July, 2010. Descriptive statistics were used to summarize the data. Mann Whitney U and Kruskal Wallis tests were used to evaluate the respondents’ opinions in ordinal variables with p < 0.05 considered statistically significant. Respondents with postgraduate qualification (p < 0.05) believed that self medication solely done by patients without guidance of a health care professional may lead to mismanagement or subtherapeutic management of diseases (66; 91.66%), medication errors and likelihood of disease complications (68; 93.15%). Years of practice had a significant effect on community pharmacists’ perception of advantages of self medication (p < 0.05). Rigorous monitoring of drug advertisement in the media might help in controlling the practice of self medication (63, 86.30%). Respondents believed that keeping the identity of the medications (29; 39.73%) and diagnosis details (19; 27.14%) unknown to patients is unethical. Self medication may be acceptable for fever (53; 74.65%), diarrhea (46; 67.65%) and cough (39; 53.62%), but with specific time limits, for patients on chronic medication who have stable clinical conditions, including asthma (46; 66.67%), hypertension (36; 51.43%) and diabetes (37; 52.86%). Community pharmacists in Southwestern Nigeria possess a good understanding of the concept of self medication, believed the practice should not be discouraged in totality, but should be practiced under controlled conditions, and that public enlightenment may help to ensure safe self medication practices.
Attitude and use of herbal medicines among pregnant women in Nigeria
(Biomed central ltd, 2009-12) Fakeye, T. O.; Adisa, R.; Musa, I. E.
Background: The use of herbal medicines among pregnant women in Nigeria has not been widely studied. Methods: Opinion of 595 pregnant women in three geopolitical zones in Nigeria on the use of herbal medicines, safety on usage, knowledge of potential effects of herbal remedies on the fetus and potential benefits or harms that may be derived from combining herbal remedies with conventional therapies were obtained using a structured questionnaire between September 2007 and March 2008. Descriptive statistics and Fisher's exact tests were used at 95% confidence level to evaluate the data obtained. Level of significance was set at p < 0.05. Results: More than two-third of respondents [67.5%] had used herbal medicines in crude forms or as pharmaceutical prepackaged dosage forms, with 74.3% preferring self-prepared formulations. Almost 30% who were using herbal medicine at the time of the study believed that the use of herbal medicines during pregnancy is safe. Respondents' reasons for taking herbal medications were varied and included reasons such as herbs having better efficacy than conventional medicines [22.4%], herbs being natural, are safer to use during pregnancy than conventional medicines [21.1%], low efficacy of conventional medicines [19.7%], easier access to herbal medicines [11.2%], traditional and cultural belief in herbal medicines to cure many illnesses [12.5%], and comparatively low cost of herbal medicines [5.9%]. Over half the respondents, 56.6% did not support combining herbal medicines with conventional drugs to forestall drug-herb interaction. About 33.4% respondents believed herbal medicines possess no adverse effects while 181 [30.4%] were of the opinion that adverse/side effects of some herbal medicines could be dangerous. Marital status, geopolitical zones, and educational qualification of respondents had statistically significant effects on respondents views on side effects of herbal medicines [p < 0.05)] while only geopolitical zones and educational qualifications seemed to have influence on respondents' opinion on the harmful effects of herbal medicines to the fetus [p < 0.05]. Conclusion: The study emphasized the wide spread use of herbal medicines by pregnant women in Nigeria highlighting an urgent need for health care practitioners and other health care givers to be aware of this practice and make efforts in obtaining information about herb use during ante-natal care. This will help forestall possible interaction between herbal and conventional medicines.
Barriers and Enablers to Medication Deprescribing among older patients attending a Geriatric Clinic in Southwestern Nigeria: A Cross-Sectional Study.
(Oxford University Press, 2023) Akande-Sholabi, W.; Ajilore, C. O,; Olowookere, O,; Adebusoye, L. A.
Introduction: Polypharmacy is an increasing health problem, leading to rise in morbidity and mortality, especially among older patients. Deprescribing has been recommended for managing polypharmacy, but deprescribing medication in older patients is still uncommon (1). Safe deprescribing interventions can reduce exposure to inappropriate polypharmacy among older patients. However, few empirical data exist on the barriers and enablers to medication deprescribing among older patients in sub-Saharan African countries. Aim: This study aimed to assess the barriers and enablers of medication deprescribing among older patients. Methods: A cross-sectional study of 415 older patients aged ≥60 years, selected consecutively at the geriatric clinic in a Tertiary Hospital was carried out between May and July 2022. An interviewer-administered semi-structured questionnaire was used to obtain information on their sociodemographic characteristics, and barriers and enablers.
Beers criteria and potentially inappropriate medications in elderly: awareness, practice, knowledge and barriers among community pharmacists in Nigeria
(Springer Open, 2022) Akande Sholabi,W.; Fafemi, A.
Background: Potential inappropriate medications (PIMs) used in the elderly are an avoidable source of disease and death. Beers Criteria is among the commonly used measures that document PIMs. Community pharmacists’ knowl edge on PIMs and existing criteria are essential to moderate the use of PIMs which would enhance overall health outcomes and costs. This study investigates awareness, knowledge, practice, and barriers of PIMs among community pharmacists in Ibadan, Nigeria. Methods: A cross-sectional study was carried out on 109 community pharmacists with the use of a self-administered questionnaire. Nine clinical vignettes based on the 2019 Beers Criteria were used to evaluate PIMs knowledge. Prac tice behavior regarding elderly clients was evaluated using a 5-point Likert scale with six items. Data were summa rized by descriptive and inferential statistics. Results: Respondents who knew guidelines that listed specifc PIMs were (49; 47.1%), and of these, (21; 42.9%) were aware of Beers Criteria. From all the respondents, only 45 (41.3%) demonstrated good knowledge of Beers Criteria, while 82 (75.2%) narrated good practice when dealing with elderly clients in terms of asking suitable questions and contemplating their ages while dispensing medications. Major barrier identifed was lack of knowledge of Beers Crite ria (80; 73.4%). Pharmacists who were aware of Beers Criteria statistically had better knowledge than others (p=0.003). Conclusion: Beers Criteria awareness among community pharmacists is sub-optimal in Ibadan, Nigeria. Although practice when dealing with elderly customers was satisfactory, the knowledge was unsatisfactory. This underscores the need to intensify the awareness and use of guidelines that document specifc PIMs such as Beers Criteria among community pharmacists.
Beers criteria and potentially inappropriate medications in elderly: awareness, practice, knowledge and barriers among community pharmacists in Nigeria
(Springer Nature, 2022) Akande-Sholabi, W.; Fafemi, A.
Clinical and humanistic outcomes of pharmaceutical care interventions in diabetes mellitus: a systematic review and meta-analysis
(2019) Segun J. Showande; Akande-Sholabi W.; Titilayo O. Fakeye.
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.
Clinical and Humanistic Outcomes of Pharmaceutical care Interventions in Diabetes mellitus: A systematic review and meta-analysis.
(West African Postgraduate College of Pharmacists (WAPCP), 2019) Showande, J. S.; Akande-Sholabi, W.; Fakeye, O.T.
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 meta-analysis, 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.
Community Pharmacists’ Perception about Mental Healthcare and Barriers to providing Pharmaceutical Care Services to Patients with Mental Disorder in Ibadan, Nigeria
(Biomedical Journal Consult, 2023) Akande-Sholabi, W.; Bakare, O. E.
Community pharmacists play a significant role by providing pharmaceutical care for patients with mental disorders. Mental disorder is a health priority in national health strategies around the world, including in Nigeria. However, personal perception and practice-related barriers may prevent full involvement. This study therefore aims to assess community pharmacists’ perception and level of comfort towards mental healthcare, as well as the barriers in providing pharmaceutical care to patients with mental disorder in Ibadan. A cross-sectional study among 120 community pharmacists in Ibadan, using a self-administered questionnaire. Descriptive statistics including frequency and percentage were used to summarize the data. The majority (99;82.5%) agreed they will deal with mentally ill patients, while 81 (67.5%) feel confident and comfortable to provide pharmaceutical care to patients with mental illness. Major barriers to pharmaceutical care cited includes inability to monitor outcomes as patients may never return to the pharmacy again (88; 73.3%) and having only limited patient information (85;70.8%). This corresponds with the revelation that (88; 73.3%) believe that follow up for adverse drug related problem is not easy. About 23% community pharmacies do not stock psychotropic medication at all, mainly due to few requests and tough regulations of record keeping required by law. Despite willingness to provide services to patients with mental illness, reduced stockings of psychotropics and practice-related barriers prevent full participation of community pharmacists.
Community Pharmacists’ Perception of the Relevance of Drug Package Insert as Source of Drug Information in Southwestern Nigeria
(Pharmacotherapy Group, 2013-04) Adisa, R.; Omitogun, T. I.
Purpose: To evaluate the opinions of community pharmacists on the usefulness and reliability of drug package inserts (DPI) as drug information source, and necessary modifications needed to improve their contents. Methods: A prospective cross-sectional study using a pretested questionnaire was administered to sixty-one superintendent community pharmacists (CP) across two cities in southwestern Nigeria. Descriptive statistics was used to summarize the data and evaluate respondents’ opinion. Kruskal-Wallis test was used to evaluate the rank variables with p < 0.05 considered significant. Results: A majority of CP believed that information from DPI was precise and may be helpful in achieving therapeutic success (n = 42; 72.8 %). CP believed there is need for the modification of DPI content with respect to patient-related information (n = 52; 92.8 %) and health provider-related information (n = 52; 94.5%), non-uniformity of information on the same generic medicines (n = 31; 50.8%), and ambiguity of content (n = 29; 47.5 %). Years of experience in practice significantly influenced respondents’ perception of precision and satisfaction with DPI as source of information. Conclusions: Community pharmacists in southwestern Nigeria believed that a properly modified drug package insert could be a useful and reliable source of drug information in daily practice.