INTRODUCTION Cardiovascular disease has been leading cause of early disability and worldwide, and hypertension is the most important preventable risk factor for the development of cardiovascular disease Oliveira-Filho et al., 2014; Irazola Adherence to blood pressure lowering agents has been shown to be the cornerstone for achieving hypertension control, h developing countries, the effective treatment of blood pressure among people taking antihypertensive medication, wa average, particularly due to ABSTRACT Adherence to antihypertensive medication is the cornerstone for achieving hypertension control. Morisky Medication Adherence Scale (MMAS reported medication adherence measures. The aim of this study was to examine the evidence of the validity of adapted Hausa MMAS hypertensive patients in North individuals with hypertension, self treatment was measured using the Morisky Medication Adherence Scale consistency of the Morisky Medication Adherence Scale factorial validity was assessed by identifying the underlying components using principal component analyses (PCA). A total of 130 individuals completed the study. Cronbach's alpha was 0.79. Two components were identified. One component comprised medication when hypertension is under control, stopping when feeling hassled abou to the prescription. The second component comprised two other items that were all related to forgetfulness. A significant relationship between MMAS and control (t = 2.2; p = .030), (χ specificity, with positive and negative predictive values were respectively. The results suggest that the adapted Hausa Morisky Medication Adherence Scale-8 is a two-dimensional scale assessing intentional (first co (second component) non-adherence to the antihypertensive drug treatment. The findings of this validation study indicate that the Hausa version of the MMAS is a reliable and valid measure of medication adherence among hypertensive
Sachet water is a form of packaged water commonly sold in West Africa [1]. It refers to water of approximately 500 ml volume that is purified, packaged and sold for drinking in heat-sealed plastic sleeves ('sachets'). Nationally representative surveys show that up to 18% of urban households in Nigeria depend on sachet water for drinking, cooking and other domestic uses with only a small fraction utilising bottled water products [2]. The year-on-year increase in sachet water consumption observed in West Africa is driven in part by consumer purchasing behaviour, relative affordability, inadequate water supply infrastructure due to increasing urbanisation and limited access to safe and sustainable
Objectives Studies show that clinical pharmacy services are effective in optimizing medicines use and patients' outcomes. This study aimed to determine the clinical pharmacy services provided in public sector hospitals in Nigeria. Methods This was an online survey of 296 primary, secondary and tertiary care hospitals sampled purposively across the 36 States and Federal Capital Territory in Nigeria. Data analysis was conducted descriptively via χ 2 test and multivariate analysis of variance (MANOVA). Key findings Responses were obtained from 272 hospitals in the country with a survey completion rate of 88%. This included 55 tertiary, 72 secondary and 145 primary healthcare centres (PHCs). Pharmacists provided pharmaceutical care services in all the tertiary care hospitals, 94% of the secondary and in only 6% of the PHCs surveyed. Most of the secondary and tertiary care hospitals provided medicines information, patient education and counselling, and in-patient dispensing services [n = 97 (79%), 116 (94%), 88 (72%)], respectively. However, fewer than a third reported involvement in multidisciplinary ward rounds, medication chart review and antibiotic stewardship programmes [n = 18 (15%), 33 (27%), 22 (18%), respectively]. Furthermore, medication error reporting and pharmacovigilance services were each routinely provided in only about half of the secondary and tertiary care hospitals [n = 62 (50%)], and this was not associated with the level of care (P > 0.05). Conclusions The findings of this study demonstrate disparity in clinical pharmacy service availability across the various levels of care in Nigeria and emphasize the need to prioritize their integration within the primary care sector.
Background Medication counselling is an important activity that improves patient therapeutic outcomes. After this activity has been carried out, patients should be satisfied with counselling, and possess adequate knowledge about their medications. Objectives To describe outpatient/caregiver medication knowledge and satisfaction with medication counselling at the main outpatient pharmacies of eight public secondary and tertiary hospitals located in two states in Northwestern Nigeria. Methods Exit interviews were conducted from December 2019 to March 2020 with randomly sampled patients/caregivers who had just been dispensed one or more prescription medications from the main pharmacies of the hospitals. The questionnaire used contained 31 questions in three sections. The first section collected demographic information. The second section assessed respondents’ experiences and overall satisfaction with the counselling they had received. The last section evaluated respondents’ knowledge of one randomly selected prescription medication that had been dispensed to them. Data collected were coded and analyzed to generate descriptive statistics. To explore associations between respondent characteristics and overall satisfaction, non-parametric tests were used, and statistical significance set at p<0.05. Results A total of 684 patients/caregivers were interviewed. Majority of respondents agreed that the time spent (97.1%) and quantity of information (99.1%) provided during counselling was adequate. However, over 60% of them also agreed that dispensers did not assess their understanding of information provided or invite them to ask questions. Despite this, their average overall satisfaction with counselling on a 10-point scale was 8.6 ± 1.6. Over 90% of them also correctly identified the routes and frequency of administration of the prescribed medication selected for the knowledge assessment. Although, more than 60% of respondents did not know the duration of therapy or names of these medications. Conclusion Respondents’ satisfaction with medication counselling was fairly high even though they did not seem to know much about their medication.
Poor adherence to medication is a major public health concern, especially in patients with hypertension because it is sometimes difficult to convince them to take medication in the absence of symptoms. The aim of this study was to assess the relationship between patients' beliefs about their antihypertensive drugs and adherence to treatment. The study was a cross-sectional study on hypertensive patients in General Hospital Katsina State. The data were collected using patient administered questionnaires. Data were analyzed using SPSS version 20.0.The study recorded a total of 127 hypertensive patients, majority of whom were females (58%) and mostly above 40 years (76%). Significant number of the respondents (98%) agreed their antihypertensives were effective in protecting them from the effects of high blood pressure. All adherent patients (100%) were strongly concerned about possible future effects of their medication, suggesting a high counterbalancing effect of this belief on their adherence. Majority (77%) believed they were receiving the necessary advice about their medicines from the pharmacist. Overall adherence to treatment was excellent (80%). A statistically significant relationship (p<.05) was established between patient's beliefs and adherence. In conclusion, the study revealed that adherence to antihypertensive medication is attributed to patients' beliefs and the role of pharmacists cannot be overemphasized.
It is also common that the safety of most herbal products is further compromised by lack of suitable quality controls, inadequate labeling, and the absence of appropriate information. 7 The most common sources of information on adverse events and reactions to medicines are clinical trials and spontaneous reports. The latter ordinarily far exceed the former in numbers and type, especially serious reports, over the lifetime of a product. 8 Given the reality of global use of TMs, monitoring safety of such medicines becomes a priority for all stakeholders. Traditional medicines are not always safe, particularly when used in combination with other medicines. 5 An Adverse drug reaction (ADR) is defined as a response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modifications of physiological function. 6 Adverse drug reactions are a leading cause of morbidity and mortality globally. 9 It was reported that up to 20% of patients on drug therapy experience ADR. 10 It is therefore important that medication monitoring systems like pharmacovigilance (PV) are put in place to ensure safety. Pharmacovigilance is the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem. 11 Reporting ADRs constitutes an integral part of PV process. Spontaneous reporting helps to detect serious and unusual adverse effects previously undetected during clinical trials. 10 In many countries, providers of herbal medicines other than physicians, dentists, pharmacists and nurses are excluded from reporting systems. 12 If adequate coverage of herbal medicines is to be achieved, national reporting schemes should be developed to include all
Background: Despite the importance of medication counselling for patients, it is common knowledge that it is often sub-optimally carried out by pharmacy staff. While some interventions have been designed to help improve counselling, no study till date has used the Capability Opportunity and Motivation behavior model (COM-B) or Theoretical Domains Framework (TDF) as a basis for identifying evidence-based intervention strategies to improve medication counselling. Objective: To understand barriers/facilitators to optimal medication counselling by conducting a behavioral analysis using the COM-B model and TDF, and use the Behavior Change Wheel (BCW) as a basis for identifying evidence-based intervention strategies and policy categories that could be used to improve outpatient medication counselling by pharmacy staff in hospital settings located within Northwest Nigeria. Methods: Semi-structured interviews were used to collect data from 25 purposively sampled pharmacy staff working at eight major public hospitals, from January till March 2020. Data from the interviews were then transcribed and deductively coded using the COM-B model and TDF. These findings were then used to identify areas requiring change, as well as the intervention type and policy functions required to support these changes. Results: Findings from the behavioral analysis revealed shortfalls in pharmacy staff capability, opportunity and motivation with respect to outpatient medication counselling. To improve their counselling behaviors, change was identified as necessary in eight TDF domains namely ‘knowledge’, ‘interpersonal skills’, ‘memory’ ‘environmental context’, ‘social influences’, ‘intentions’, ‘reinforcement’ and ‘beliefs about capabilities’. Seven intervention functions including ‘education’, ‘training’, ‘modelling’, ‘enablement’ and ‘environmental restructuring’, in addition to three policy categories (‘guidelines’, ‘regulations’ and ‘environmental/social planning’) were also identified as relevant to future intervention design. Conclusions: Various factors were identified as affecting medication counselling by the pharmacy staff, with several of them requiring changes if counselling was to be improved upon. Multi-component interventions combining several of these intervention functions are recommended for hospital authorities and other relevant stakeholders to improve outpatient medication counselling.
Objective The main objective of this study was to conduct a modified e-Delphi study to achieve consensus on the minimum content of medication counselling required by majority of outpatients in North-Western Nigeria. A secondary objective was to collect feedback from the panel members. Methods A two round e-Delphi study was conducted between March and May 2020 with pharmacists working in hospital, community or academic settings in North-Western Nigeria. During the first round, panel members were asked to use a five point scale to rate how important they felt it was to provide information about 17 items during medication counselling. Consensus was defined as any item that 90% or more of respondents rated as ‘essential or important’. Items that did not reach this level of consensus were re-rated again during the second round, where respondents were also asked to rate their level of agreement with nine statements. Key findings Thirty-four panel members completed the first round, while 29 completed the second round. Majority of them (76.5%) had practiced for between 5–10 years. After the first round, eight items achieved consensus, and were retained. After the second round, three of the initially equivocal items also achieved consensus. Majority of respondents believed that a minimum medication counselling standard would be useful for both dispensers and patients. Conclusions Consensus was achieved for 11 of the 17 items rated by the panelists. Feedback received about the research process was also largely positive, with many of them agreeing that the study's proposed outcome would encourage better medication counselling.
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