FACULTY OF PHARMACY
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Item Knowledge of Malaria Management in Pediatrics among Undergraduate Pharmacy Students in University of Ibadan, Nigeria(2022-09) Ipingbemi. A.E.; Akande-Sholabi,W.; Osarenmwinda, M.I.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 signifcantly 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 signifcantly 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 modifcation 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.Item Toward pharmacy-based smoking cessation services in Nigeria: Knowledge, perception and practice of community pharmacists(2021) Akande-Sholabi,W.; Adebisi, 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 pharmacybased 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.Item Polypharmacy and factors associated with their prevalence among older patients attending a geriatric centre in South-West Nigeria(2018) Akande-Sholabi,W.; Adebusoye,L.; Olowookere,O.Background: Polypharmacy among older people in Nigeria are prominent issues of public health dimension. Polypharmacy especially in older people with multiple diseases often results in poor health status and outcomes. Objectives: To determine the prevalence and factors associated with polypharmacy among older patients attending the geriatric clinic. Methods: Cross sectional study of 400 elderly patients aged 60 years and above who presented at geriatric clinic, UCH, Ibadan. Polypharmacy was taken as concurrent consumption of =5 medications. Sociodemographic characteristics, lifestyle habits, attitudinal factors on medication understanding, medication pattern and intake were assessed through a questionnaire. Bivariate and multivariate analyses were carried out using SPSS 20 and alpha was set at 0.05. Results: Mean age of the respondents was 70.2 ± 5.9 years and 240 (60.0%) were females. The point prevalence of polypharmacy was 23.8%. The averagemedications consumed were 4 without sex difference. Logistic regression analysis showed that taking too many prescription medications (OR = 2.188; 95% CI = 1.014 – 4.808, p = 0.05), intentionally skipping my medications because they are too many (OR = 3.756; 95% CI = 1.354 – 10.424, p = 0.01) and receiving prescriptions from more than one physicians on regular basis (OR = 2.336; 95% CI = 1.058 – 5.155, p = 0.04) were the most significant factors associated with polypharmacy. Conclusion: Polypharmacy is common among older people in this setting. Healthcare workers should address the attitudinal, social and health related factors, which could lead to polypharmacy.Item Pharmacists’ knowledge and counselling on fall risk increasing drugs in a tertiary teaching hospital in Nigeria(Springer Nature, 2020) Akande-Sholabi,W.; Ogundipe, F. S.; Adisa, R.Background: Falls and fall-related injuries are a foremost health concern among older adults aged 60 years and above. Fall-risk-increasing drugs (FRIDs) use by older adults is one related cause of falling, and it is frequently used among older adults. Pharmacist-led counselling is an aspect of patient education that has been associated with improved therapeutic outcome and quality of life in high income countries with scarcity of information in lowmiddle income countries. This study therefore aims to assess hospital pharmacists’ knowledge and counselling on fall-related medications using the list compiled by the Swedish National Board of Health and Welfare on FRIDs and orthostatic drugs (ODs). Methods: A cross-sectional survey was carried out among 56 pharmacists working in a teaching hospital in Nigeria, between July and August 2019, using a self-administered questionnaire. Data were summarized with descriptive statistics while chi-square test was used for categorical variables at p < 0.05. Results: Thirty-five (62.5%) were within 10 years of practice experience. Two-third (62.5%) of the pharmacists possessed an additional qualification to Bachelor of Pharmacy degree. Twenty-two (40.0%) were aware of the FRIDs and ODs list. In all, (89.3%) had “unsatisfactory” knowledge of classes of medications and specific medicines that could cause a fall. Most pharmacists 42 (80.8%) focused counsel on appropriate medication use, adverse effects of drugs and storage of medications. Knowledge score of both FRIDs and ODs were neither significantly associated with pharmacists’ years of qualification (χ 2 = 1.282; p = 0.733), (χ 2 = 2.311; p = 0.510) nor with possession of additional qualification (χ 2 = 0.854; p = 0.836), (χ 2 = 2.996; p = 0.392). Majority, 53 (98.1%) believed that patients will benefit from effective counselling on FRIDs and ODs. About half (25; 51.0%) suggested training through seminar presentation as a measure for FRIDs and ODs sensitization. Conclusion: A substantial gap in knowledge and awareness of FRIDs and ODs was noted among the hospital pharmacists. However, engagement of pharmacists on counsel that focus on medication use, adverse effect and storage was relatively better. Thus, there is a general need to create awareness about fall-risk-increasing drugs among hospital pharmacists, so as to help improve the therapeutic outcome particularly in the older adults.Item The impact of COVID-19 pandemic on medicine security in Africa: Nigeria as a case study(PanAfrican Medical journal, 2020) Akande-Sholabi,W.; Adebisi,Y. A.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.Item Inappropriate prescribing among ambulatory elderly patients in a geriatric centre in Southwestern Nigeria(Research Square, 2019) Akande-Sholabi,W.; Ajilore, O.; Showande, S. J.; Adebusoye,L. A.0.05. Results: Mean age of patients was 69 ± 0.4 years (range 60-85 years) and 219 (65.4%) were females. An average of 4.2 medications per patient prescription was found. The Beers criteria identified 26.5% PIMs, while STOPP criteria identified 57.1% PIMs. START detected 29 PPOs in 15 (4.4%) of the patient’s prescription. The most prevalent disease conditions were hypertension 235 (70.1%) and osteoarthritis 64 (19.3%). Polypharmacy was significantly associated with PIMs use in both Beers (p=0.002) and STOPP (p=0.001) criteria. Conclusions: The prevalence of PIP is high among the elderly patients. The STOPP/START criteria identified a higher proportion of PIMs among elderly patients compared with Beers criteria. The frequency of PIP should stimulate efforts to curtail potentially inappropriate prescribing and may require the need for advocating for a national criteria to be adopted by health care professionals in Nigeria.