FACULTY OF PHARMACY

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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
Acetylated starch of ofada rice as a sustained release polymer in microsphere formulations of repaglinide
(Pharmaceutical Society of Nigeria, 2015) Okunlola, A.; Ogunkoya, T. O.
Background: Acetylated starches with degrees of substitution (DS) of > 2 have been found suitable for sustained release applications because of their hydrophobic nature and thermoplasticity. The short half-life and high dosing frequency of repaglinide make it an ideal candidate for sustained release. Objectives: To formulate and evaluate repaglinide microspheres using acetylated starch of the indigenous rice species Oryza glaberrima Steud (Ofada) as polymer. Materials and Methods: Ofada rice starch was acetylated with acetic anhydride in pyridine (DS 2.68) and characterized for morphology (Scanning electron microscope, SEM), Crystallinity (Fourier Transform Infra-Red spectroscopy, FTIR, and X-ray diffraction crystallography, XRD), density and swelling. Microspheres of repaglinide were prepared by emulsification solvent-evaporation method, varying the drug-polymer ratio (1:2, 1:4, 1:8 and 1:10) and polymer type (ethyl cellulose as standard). Microspheres were characterized for particle size, wall thickness, swelling, entrapment efficiency, time taken for 80% drug release (t80) and permeability. Data obtained from in-vitro drug release studies were fitted to various kinetic models. Results: Repaglinide microspheres were near spherical, discrete and of size range 23.45 ± 4.25 to 44.55±3.85 μm. FTIR spectra revealed the absence of drug–polymer interaction and complete drug entrapment. Particle size, swelling, entrapment and wall thickness increased with drug: polymer ratio and were generally higher in microspheres containing acetylated Ofada rice starch while t80 (195±6.60 - 395± 24.75 min) was lower. Drug release fitted the Hixson-Crowell kinetic model. Conclusions: The acetylated starch of Ofada rice was found suitable as a polymer to sustain the release of repaglinide in microsphere formulations.
ANTI-DIABETIC AND ANTI-OXIDANT EVALUATION OF ANTHOCLEISTA DJALONENSIS A. CHEV AND ANTHOCLEISTA VOGELII PLANCH
(2014-12) OLUBOMEHIN, O. O.
Diabetes a major degenerative disease of global concern accounts for about 3.2 million deaths annually. Alpha-amylase inhibitors from plants are effective in managing postprandial hyperglycaemia which is significant in Type 2 diabetes. Search for natural anti-oxidants has increased recently because free radicals production has been linked to a number of diseases including diabetes. Anthocleista djalonensis and Anthocleista vogelii are used traditionally in Nigeria and parts of Africa to treat diabetes. This study was aimed at evaluating the α-amylase inhibition, anti-oxidant and anti-diabetic effects of extracts and compounds of both plants to verify their traditional use. The leaves, stem bark and roots of both plants were collected along Ijebu-Ode – Benin road and authenticated at the Herbarium of the Forestry Research Institute of Nigeria, Ibadan. The plant samples were macerated in 80% aqueous methanol for 72 h. Each crude extract, suspended in water: methanol (4:1) was partitioned into ethyl acetate. The crude extracts and ethyl acetate fractions of the leaves and stem bark of both plants were subjected to in vitro α-amylase inhibition assay with acarbose as positive control. The anti-oxidant activity was evaluated using 2, 2’-diphenyl-1-picrylhydrazyl with α-tocopherol as control, while anti-diabetic properties of the crude extracts were studied in vivo using 45 albino wistar rats (150-200 g) of both sexes. The rats were made diabetic with 80 mg/kg of alloxan and treated with the extracts (1 g/kg) for seven days; glibenclamide 2.5 mg/kg was used as reference. Blood glucose levels (BGL) were monitored daily. Bioassay-guided fractionation and chromatographic methods were used to isolate active compounds from the ethyl acetate fractions of both plants. Structures of the isolated compounds were elucidated using spectroscopic techniques: infra-red, mass spectrometry, nuclear magnetic resonance (one-dimensional and two-dimensional). Data were analysed statistically using ANOVA at p<0.001. Anthocleista djalonensis leaf and stem bark crude extracts gave highest α-amylase inhibition of 42.8% and 41% with their ethyl acetate fractions also producing the highest α-amylase inhibition of 50.0% and 36.6% at 1.0 mg/mL while acarbose gave 54.9%. The crude extract and ethyl acetate fraction of A. vogelii leaf gave 80.7% and 87.4% inhibitions at 1.0 mg/mL in the anti-oxidant assay while α-tocopherol gave 89.5%. Peak reduction in BGL was observed for A. djalonensis stem bark and leaf crude extracts at 72.6% and 45.7% on day-6 of treatment while the stem bark and leaf extracts of A. vogelii gave 68.9% and 60.4%, respectively on day-7. The root extracts of both plants also caused peak reduction in BGL at 48.5% on day-7 while glibenclamide had 57.4%. Bioassay-guided fractionation furnished djalonenol, a monoterpene diol with a significant α-amylase inhibition of 53.7% from fraction 11 of the stem bark of A. djalonensis and decussatin, a xanthone with significant inhibition of 78.0% from fraction 5 of the leaves and stem bark of A .vogelii. The presence of α-amylase inhibitors, djalonenol and decussatin from both plants makes them important in the treatment of type 2 diabetes and could be responsible for their anti-diabetic effect. Anthocleista vogelii could be a source of anti-oxidant compounds.
Anti-Inflamatory and analgesic activities of securidaca longepedunculata fers (Polygalaceae) leaf and stem bark methanolic extract
(2014-09) Alafe, A. O.; Elufioye, T. O.; Faborode, O. S; Moody, J. O.
Securidaca longepedunculata Fers (Polygalaceae) is commonly used in many parts of Africa for the treatment of rheumatic conditions, fever, headache and various other inflammatory based diseases. The present study was carried out to evaluate the anti-inflammatory and analgesic activity of Securidaca longepedunculata leaf and stem bark methanol extracts using animal model. The anti-inflammatory activity of the methanolic extracts were evaluated using carrageenan induced paw edema in rats while the analgesic activity was determined using acetic acid induced writhing in mice. Both the leaf and stem methanol extracts exhibited anti-inflammatory activity greater than 70% at all doses tested. This activity was dose dependent with the highest being at 800 mg/kg Po and significant at P< 0.05. The analgesic activity of both extract was however below 50%, though comparable with that of aspirin used as the standard. This study has justified the inclusion of Securidaca longepedunculata in remedies used for the management of inflammatory based diseases traditionally.
Antifungal capacity of lactic acid bacteria isolated from salad vegetables
(2011-05) Adeniyi, B.; Damsa, I.
This study explores the use of lactic acid bacteria from fresh salad vegetables to inhibit fungal growth. The antifungal assay was done using the agar well diffusion method as reported by Schillinger and Lucke (1989). The largest zone of inhibition (25mm) was recorded by the antagonistic activity of the isolate identified to Lactobacillus plantarum against Candida albicans ATCC 90029. No activity was recorded against Candida parapsilosis ATCC 22019, C. valida UCH 1508, C. pseudotropicalis UCH1408, C. tropicalis UCH 1308 and Trichophyton interdigitalis UCH1708. The cell free supernatant (CFS) of the isolate described to be Lactobacillus brevis was exceptional as it was the only CFS that inhibited the growth of Epidermophyton floccosum UCH 1908. The results show that LAB isolated from salad vegetables can inhibit some fungi pathogens by developing zones around agar well that contain LAB metabolites and can probably be a feasible option for the chemotherapy of fungal infections given the drug resistance exhibited to antifungal agents currently in use.
Antimicrobial activity of garcinia kola (Heckel) seed extracts and isolated constituents against caries-causing microorganisms
(2014-09) Ajayi, T. O.; Moody, J. O.; Fukushi, Y.; Adeyemi, T. A.; Fakeye, T. O.
Garcinia kola Heckel (Guttiferae) seed, has found use in folkloric medicine of Southern Nigeria for the treatment of toothache and prevention of dental caries. The crude ethanolic extract, chromatographic fractions and isolated constituents of Garcinia kola seed against clinical strains of dental-caries-causing and related microorganisms is being evaluated. Antimicrobial evaluations were done by testing different concentrations of the crude extract, vacuum liquid chromatographic (VLC) fractions and pure isolates against Streptococcus mutans, Streptococcus viridans and Staphylococcus aureus in already set blood agar with gentamicin as the reference standard. The zones of inhibition and minimum inhibitory concentrations (MIC) were determined as appropriate. Fraction N, eluted with (hexane: ethyl acetate 70: 30), exhibited the highest activity with MIC’s of 1.50 mgml⁻¹ and 0.33 mgml⁻¹ while the pure isolates 1 (cycloartenol) and 2 (24-methylenecycloartanol) gave MIC’s of 0.17 mgml⁻¹ and 0.38 mgml⁻¹ against Streptococcus mutans and Streptococcus viridans respectively. Isolate 3 (garcinianin) gave MIC of 1.0 mgml⁻¹ against Streptococcus mutans but there was no significant activity against Streptococcus viridans and Staphylococcus aureus. The results provide justifications for the folkloric use of Garcinia kola Heckel (Guttiferae) for dental caries-related health problems while the isolated compounds may also serve as templates for future antimicrobial drug development.
Antimicrobial and pharmaceutical properties of the seed oil of leucaena leucocephala (Lam.) de wit (Leguminosae)
(2011-01) Aderibigbe, S. A.; Adetunji, O. A.; Odeniyi, M. A.
The seed oil of Leuconia leucocephala was investigated for its antimicrobial activity and the pharmaceutical properties of its lotion formulation determined. The oil was extracted from the pulverised dried seeds of the Leuconia leucocephala plant by cold maceration in n-hexane. The oil was tested against four bacteria (Staphylococcus aureus, Esherichia coli, Bacillus subtilis and Pseudomonas aeruginosa) and four fungi (Aspergilus niger, Rhizopus stolon, Penicillum notatum and Candida albicans) isolates. Gentamycin and tioconazole were the reference drugs respectively. The oil was later formulated as a lotion and the pharmaceutical properties of the formulation determined.The oil was found to have a concentration-dependent activity against both Gram-positive and Gram-negative bacteria, while showing no activity against the fungi tested. The lotion formulation of the oil containing oleic acid had good pharmaceutical properties and was stable over the test period. Leucaena leucocephala seed oil extract had a concentration-dependent activity against both Gram-positive and Gram-negative bacteria and the lotion formulation had good pharmaceutical properties.
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.
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 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 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.
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.
Characterization and evaluation of acid-modified starch of Dioscorea oppositifolia (Chinese yam) as a binder in chloroquine phosphate tablets
(2013) Okunlola, A.; Akingbala, O.
Chinese yam (Dioscorea oppositifolia) starch modified by acid hydrolysis was characterized and compared with native starch as a binder in chloroquine phosphate tablet formulations. The physicochemical and compressional properties (using density measurements and the Heckel and Kawakita equations) of modified Chinese yam starch were determined, and its quantitative effects as a binder on the mechanical and release properties of chloroquine phosphate were analyzed using a 23 full factorial design. The nature (X1), concentration of starch (X2) and packing fraction (X3) were taken as independent variables and the crushing strength–friability ratio (CSFR), disintegration time (DT) and dissolution time (t80) as dependent variables. Acid-modified Chinese yam starch showed a marked reduction (p<0.05) in amylose content and viscosity but increased swelling and water-binding properties. The modified starch had a faster onset and greater amount of plastic flow. Changing the binder from native to acid-modified form led to significant increases (p<0.05) in CSFR and DT but a decrease in t80. An increase in binder concentration and packing fraction gave similar results for CSFR and DT only. These results suggest that acid-modified Chinese yam starches may be useful as tablet binders when high bond strength and fast dissolution are required.
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.
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.