Clinical Pharmacy & Administration

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    Evaluation of the Extent and Pattern of Use of Herbal Bitters among Students in a Tertiary Institution in Southwestern Nigeria
    (Pharmacotherapy Group, University of Benin., 2014) Showande, J.S.; Amokeodo, O.S
    Purpose: To evaluate the extent and pattern of use of herbal bitters among students. Methods: This was a cross-sectional study where pre-tested structured questionnaires were administered to 1000 students. The questionnaire elicited information on the extent and pattern of use, self-reported indications, side effects experienced and possible drugs that were concomitantly coadministered with herbal bitters. Pearson Chi square, Fisher exact test and Relative risk ratio were used to detect association between gender and self-reported indications and side effects experienced with herbal bitters at a level of significance of p < 0.05. Results: The response rate and extent of use were 96 % and 40.9 % respectively. Herbal bitters were used for claims such as cleansers 88 (40.2 %), anti-infectives 48 (21.1 %), for rejuvenation 32 (14.0 %), and for weight loss 14 (6.1 %). Self-reported side effects included dizziness 49 (22.0 %), loss of taste 46 (20.6 %) and nausea and vomiting 22 (9.7 %). Herbal bitters were also co-administered with antimalarials 22 (6.3 %); analgesics 16 (4.5 %) and herbal supplements 13 (3.7 %). Reports of students using two different types of herbal bitter concurrently 15 (3.9 %) were also garnered. Male students experienced more side effects than females (p < 0.05). Conclusion: The co-administration of herbal bitters with allopathic medicines and the use of more than one herbal bitter at a time reported in this study can be addressed by the appropriate health authorities through proper educational program.
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    Use of Antibiotics among Non-Medical Undergraduate Students in a Nigerian University.
    (Makerere University, Faculty of Medicine.Kampala, Uganda., 2013) Sanya, E.; Fakeye, T.O.; Adisa, R.; Showande, J.S.
    Background: Antibiotic misuse is a major contributory factor to treatment failure, antibiotic resistance and high healthcare costs. Objectives: To evaluate level of self-reported antibiotic misuse among non-medical undergraduate students of a Nigerian university. Methods: Respondents’ knowledge of antibiotics and disposal system for left-over antibiotics were explored using a structured questionnaire. Data were summarized with descriptive statistics. Chi square was used to evaluate relationship between specific categorical variables and respondents’ opinions with p<0.05. Results: More than half the respondents obtained their antibiotics through doctor’s prescriptions (273;68.3%). The study revealed gross antibiotic misuse with majority, (298;74.5%) either by keeping left-over antibiotics for future use or throwing it away with refuse. Respondents (289; 72.3%) sometimes forgot to take the antibiotics. Financial constraints (73; 18.3%), long duration of treatment (70; 17.5%), side effects experienced (60;15.0%), polypharmacy (56;14.0%), tablet size (45;11.3%), and perceived low level of confidence in the prescriber (11; 2.8%) were major reasons for non-adherence. Course of study of respondents had no significant effect on respondents’ knowledge or adherence (p>0.05). Conclusion: Misuse of antibiotics among non-medical undergraduate students in a Nigerian university setting is pervasive suggesting an urgent need for enlightenment on rational use and disposal of antibiotics.
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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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    Pharmacy students’ knowledge of psychotropic medicines and their attitude towards providing pharmaceutical care to patients with anxiety in Nigeria
    (Nigeria Association of Pharmacists in Academia (NAPA), 2022) Akande-Sholabi, W.|| || ||; Bakare, O. E.; Adebisi, A. Y.; Odeku, O.
    Background: Healthcare professionals, such as pharmacists, play critical roles in the management of mental disorders by assessing the potential for adverse reactions, providing medication counseling, and medication review optimize treatment regimens. Objectives: This study aims to assess the knowledge of pharmacy students in a Nigerian university regarding psychotropic medicines and their attitude towards providing pharmaceutical care to patients with anxiety. Method: A cross-sectional web-based survey was conducted in May 2021 among fourth- and fifth-year pharmacy students in a Nigerian university. The data were summarized using descriptive statistics, such as frequencies and percentages. Chi square was utilized to examine the association between the demographic characteristics and the respondents' overall knowledge and attitude. Results: The response rate was 85%, as 126 responses were received. About half of the respondents 69 (54.8%) reported that they have received training on psychotropic medicines and 9 (9.1%) have been previously diagnosed with anxiety disorders. Only 53 (42.1%) and 71 (56.3%) of our respondents knew that escitalopram and alprazolam are categorized as anxiolytics respectively. Most respondents would like to talk to patients with anxiety about their medications 110 (87.3%), attend training on pharmaceutical care for patients with anxiety 103 (81.7%), and obtain a medication history for people with anxiety 113 (89.7%). Ninety-four (74.6%) pharmacy students would like to suggest prescription medication for a patient with anxiety and only 88 (69.8%) would like to correct any errors in prescription in any anxiety cases. Our findings also revealed that there is a significant association between the students’ attitude and year of study (p=0.038) and previous training on psychotropic medicines (p=0.004). Conclusion: Findings from this study suggested that participants require improved knowledge and training of psychotropic medicines.
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    Therapeutic lifestyle strategies taught in Nigerian pharmacy schools
    (West African Postgraduate College of Pharmacists (WAPCP), 2022) Akande-Sholabi, W.; Adebisi, A. Y.; Odeku O.
    Background: Therapeutic lifestyle modifications are the basis of treatment and prevention of numerous chronic diseases. Objectives: To describe the therapeutic lifestyle modifications taught in Nigerian pharmacy schools. METHODS: A short self-administered online questionnaire (using Google Form), to ascertain the curricular coverage of therapeutic lifestyle modification in undergraduate pharmacy training programs was sent to the Deans of all accredited schools of pharmacy in Nigeria (n = 20). The collected data were summarized using descriptive statistics. RESULTS: Thirteen schools of pharmacy participated in the study. All the schools taught at least one of the 10 specified therapeutic lifestyle strategies. Less than a third taught smoking cessation (2.0, 15.4%), lifestyle modifications for pregnant women (2.0, 15.4%) and patients with mental health issues (1.0, 7.7%). CONCLUSIONS: There are variations in the content of teaching of therapeutic lifestyle approaches in Nigerian pharmacy schools. To enhance therapeutic lifestyles, it is essential to improve the content and teaching of therapeutic lifestyle strategies in Nigerian pharmacy schools. All schools should do more to ensure that they are providing adequate training to enable students to be prepared for delivering support to all patients (including pregnant women and mental health patients) on therapeutic lifestyles.
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    Promoting Cessation and a Tobacco Free Future: Knowledge and Attitude of Pharmacy Students Regarding Smoking Cessation in a Nigerian University
    (Universiti Sains Malaysia (USM), 2022) Akande-Sholabi, W.; Adebisi, A. Y.
    Tobacco smoking is a global public health threat and the largest single driver of health inequalities. Currently, there are over a billion smokers worldwide with approximately 80% of the smokers living in low-and-middle-income countries like Nigeria. Knowledge gaps on smoking cessation among pharmacy students might impact the quality of service these future pharmacists would provide in practice. Therefore, this study aimed to evaluate the knowledge and attitude of pharmacy students regarding smoking cessation in a Nigerian university. A University-based cross-sectional study was conducted among 277 pharmacy students of a Nigerian university using a pretested self-administered questionnaire between August and December 2019. Data were summarised descriptively using IBM SPSS (version 23). Most of the pharmacy students 203 (73.2%) agreed it is the pharmacists’ responsibility to support patients with smoking cessation. The majority of our respondents 226 (81.6%) reported pharmacy students need more training on smoking cessation. Thirty-three (11.9%) pharmacy students knew nicotine does not cause cancer. Less than one-tenth 27 (9.7%) of the pharmacy students were aware of smoking cessation products. Overall, 203 (73.2%) respondents had poor knowledge (score < 60%) and an average positive attitude about smoking cessation. Pharmacy students have suboptimal knowledge about smoking cessation. However, they revealed a positive attitude towards smoking cessation. Therefore, there is a need for educational interventions to address the deficit in smoking cessation knowledge, as well as equip future healthcare providers. Thus, improving the quality of public health especially among smokers in Nigeria.
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    Toward pharmacy-based smoking cessation services in Nigeria: Knowledge, perception and practice of community pharmacists
    (European Publishing, 2021) Akande-Sholabi, W.; Adebisi, A. Y.
    Introduction Worldwide, tobacco smoking is one of the leading causes of avoidable deaths. In Nigeria, there is currently no clinical guidelines for tobacco dependence treatment. However, globally, pharmacy-based smoking cessation intervention has been associated with improved cessation rates and quality of life. This study aims at assessing the knowledge and perception of community pharmacists about smoking cessation and tobacco harm reduction as well as barriers to the practice of pharmacy-based smoking cessation intervention. METHODS A cross-sectional survey was carried out among 104 community pharmacists, between August and December 2019, using a self-administered paper questionnaire. Data entering, cleansing, and analysis were done using IBM SPSS (version 23). Descriptive statistics including frequencies and percentages were used to summarize the data. RESULTS Thirteen pharmacists (12.5%) were providing smoking cessation services. One-tenth (10.6%) of the pharmacists were aware of tobacco harm reduction. The majority (89.4%) were willing to attend smoking cessation training. Among the respondents, 65 (62.5%) had poor knowledge regarding smoking cessation and tobacco harm reduction. Lack of knowledge and skills were reported by all (100%) as a barrier to providing the service. However, 101 (97.1%) community pharmacists agreed that smoking cessation treatment is an important role of pharmacists. CONCLUSIONS A suboptimal level of knowledge of smoking cessation and tobacco harm reduction was noted among the community pharmacists. However, they believed smoking cessation intervention is an important role of pharmacists. It is advocated that smoking cessation training should be included as part of the Pharmacists’ Council of Nigeria Mandatory Continuing Professional Development Training. Thus, it is imperative to establish basic national smoking cessation guidelines that can be functional towards reducing mortality and morbidity associated with tobacco smoking in Nigeria.
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    Medications and the risk of falls among older people in a geriatric centre in Nigeria: a cross-sectional study
    (Springer Nature, 2021) Akande-Sholabi, W.; Ogundipe, F.; Adebusoye, L
    Background Falls are a major cause of morbidity and hospitalization in older people. Many drugs have been shown to increase the risk of falls in this population. Few empirical data exist on the use of fall-risk-increasing drugs among older people of sub-Saharan Africa countries. Objective This study aimed to assess the prevalence and predictors of falls, and the association between FRIDs, drugs causing orthostatic hypotension and falls. Setting Geriatric center, University College Hospital, Ibadan, Nigeria. Methods A cross-sectional study of 400 older patients aged ≥ 60 years selected consecutively at the geriatric centre, between September and November 2019, were interviewed using a semi-structured questionnaire. Socio-demographic information, medication utilization, and history of falls were obtained. Bivariate and multivariate analyses were carried out using SPSS 23. Alpha was set at 0.05. Main outcome measure Prevalence and predictors of falls among ambulatory older patients. Results The mean age of the older patients was 72.4 ± 7.3 years and 255 (63.7%) were females. The total number of FRIDs and ODs used by older patients was 578 (35.2%). The prevalence of fall was 181 (45.3%) which was significantly higher among the females compared with the males (51.8% vs 33.8%) p = 0.01. Classes of medications such as anti-Parkinson’s (p = 0.027), sedatives (p = 0.033), antipsychotics (p = 0.011) and anticholinergic (p = 0.027) were significantly associated with fall. Predictive factors for falls on logistic regression were female [OR = 2.375; 95% CI 0.274–3.704, p = 0.001] and use of antipsychotics [OR = 5.132; 95% CI 1.352–19.480, p = 0.016]. Conclusion The prevalence of falls was high and being a woman ≥ 60 years is a major risk factor for falling. Interventions to decrease falls in older patients by drug modification and deprescribing of FRIDs and ODs might reduce fall-related injuries. Thus, a multidisciplinary approach is essential for intervention to reduce the risk of falls and improve therapeutic outcomes among older patients.
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    The impact of COVID-19 pandemic on medicine security in Africa: Nigeria as a case study
    (Pan African Medical Center for Public Information and Research, 2020) Akande-Sholabi, W.; Adebisi, A. Y.
    COVID-19 is an unprecedented pandemic posing major threat to global public health. In the past decades of years or so, one could have heard of how dangerous it is to be virtually reliant on medicine supply from other countries. Nonetheless, no action was taken because it seemed to many that the global trade system was operational and Nigerians as well as citizens of African countries appear to have sufficient supply of the medications required at quite appealing cost. Currently in 2020, this apprehension has revolved from an imaginary problem to an actual challenge that might have consequences for millions nationwide due to COVID-19 pandemic. Now, African countries can realize that putting all our eggs in one basket was not such a good idea. In Nigeria, over 70% of the prescribed medications are produced from active ingredients (API) primarily sourced from firms in China and India. Access to medicine is an integral part of healthcare systems, uninterrupted access to medicine is much needed and essential for the well-being of the population. We are now approaching the conclusion that it is more reasonable to probably invest a little more to resuscitate a domestic pharmaceutical synthesis and herbal medicine research capacity in Nigeria and across African countries to improve public health.
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    Prescribing Pattern of Antihypertensive Medications in a Geriatric Center In Southwestern Nigeria
    (Nigeria Association of Pharmacists in Academia (NAPA), 2019) Akande-Sholabi, W.; Adebusoye, L.
    Background: Hypertension is a prominent public health problem, with considerable health consequences. Recommended guidelines encourage use of antihypertensive medications with the best evidence of reducing cardiovascular risk. Data on antihypertensive medications use among older Nigerians is limited. Objective: This study evaluated the antihypertensive medication use among older persons with hypertension in compliance with the Eighth Joint National Committee guidelines (JNC 8). Method: A retrospective cross-sectional study, of older patients diagnosed with hypertension between the 1st January 2017 and 31st December 2017 at the geriatric center, University College Hospital, Ibadan. Results: The mean age was 70.2 ± 7.2 years and 62% were female. The mean number of medications used by the patient was 4.5 ± 1.4. Of the patients, 56% were receiving combination therapy, 42% two drugs and 14% three drugs. Most patients were receiving calcium channel blockers (33.8%), followed by diuretics (29.6%), angiotensin receptor blockers (23.4%) and angiotensin-converting enzyme inhibitors (10.8%). Commonest combination therapy was calcium channel blockers and thiazide diuretics (28.3%), while the commonest multi-morbidities were osteoarthritis (32.7%), diabetes (17.3%) and dyslipidemia (8.7%). Conclusion: This study showed that more than half of older persons with hypertension were on combination therapy, and the most frequently used class of antihypertensive drugs were calcium channel blockers, followed by diuretics. The guidelines and data for black ≥60 years indicate that lower doses of combination therapy are more effective in achieving blood pressure target. Despite the numerous advantages of ACEIs, they remain underutilized.