BackgroundThe use of herbal medicines among pregnant women in Nigeria has not been widely studied.MethodsOpinion 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.ResultsMore 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].ConclusionThe 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.

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Adisa R, Fakeye TO, Fasanmade A. Medication adherence among ambulatory patients with type 2 diabetes in a tertiary healthcare setting in southwestern Nigeria. Pharmacy Practice (Internet) 2011 Apr-Jun;9(2):72-81.www.pharmacypractice.org (ISSN: 1886-3655) 72 ABSTRACT * Objective: To assess adherence to medication among ambulatory patients with type 2 diabetes, ascertain the level of glycemic control, and evaluate patients' opinions on probable reasons for nonadherence with a view to identify areas of intervention to improve adherence. Methods: A prospective cross-sectional study was carried out at a 900-bed tertiary teaching hospital in Ibadan, Southwestern Nigeria between June and August, 2009. Out of 140 consented patients, 114 (81.4%) properly responded to the validated and pre-tested data collection tool and these were subsequently considered for analysis. Descriptive statistics were used to summarize the data. Means and proportions were compared using student t-test and chi-square or Kruskal-Wallis test as appropriate, with p<0.05 considered statistical significant.Results: Approximately sixty percent of the patients were adjudged adherent with prescribed medication. Out of 58.8% of the cohort who gave their recent fasting plasma glucose (FPG) values, 59.7% had FPG above 110mg/dL. The mean FPG for patients was 139.05 (SD=70.5)mg/dL, males and females significantly differed in their mean FPG, 146.55 (SD=85.0)mg/dL versus 133.33 (SD=57.6)mg/dL respectively (p=0.032). Also, the mean FPG values for adherent patients, 137.09 (SD=59.3)mg/dL was lower than their non-adherent counterparts, 143.92 (SD=87.6) mg/dL, but the difference was not statistically significant (p=0.095). Financial constraint (34.4%) was the major barrier to optimal adherence with medication. A significant association exist between genders and opinions on physician's mode of approach during patientphysician interaction as a contributory factor for non-adherence (p=0.038). Conclusion: Medication adherence of ambulatory type 2 diabetes patients is considerable. However, the relatively high level of adherence did not appear to have significantly impacted on patients' glycemic status due to a substantial number who had plasma glucose above the recommended targets. Multiple methods may be required to detect patient who report adherence but who may in fact be nonadherent. Also, adherence to other aspects of diabetes management plan needs to be encouraged in order to accomplish optimal glycemic control. Initiatives targeting patient-specific intervention to improve medication adherence should be considered.Keywords: Medication adherence. Diabetes Mellitus. Nigeria. ADHERENCIA A LA MEDICACIÓN ENTRE PACIENTES CON DIABETES TIPO 2 EN ESTABLECIMIENTOS SANITARIOS TERCIARIOS EN EL SUROESTE DE NIGERIA RESUMENObjetivo: Evaluar la adherencia a la medicación entre pacientes ambulatorios con diabetes tipo 2, determinar el nivel de control glucémico, y evaluar las opiniones de los pacientes sobre las probables razones de la no adherencia con vista a identificar ...

Objective:The overall goal of the study was to evaluate the probable reasons for patients’ nonadherence to prescribed oral hypoglycemic medications in an ambulatory care setting in Nigeria with a view to identifying points for necessary intervention to improve adherence and treatment outcomes. Also, the recommended non-drug management options for diabetes patients with emphasis on self monitoring of blood glucose were assessed.Methods:A cross-sectional study was conducted at a 200-bed secondary health care facility in Southwestern Nigeria between 2nd April and 31st May 2008. Copies of pre-tested questionnaire were administered directly to 121 ambulatory patients with type 2 diabetes at the study site. Information on socio-demographic characteristic, probable barriers that affect adherence to prescribed oral hypoglycemic medications, non-drug treatment options for diabetes, and patients’ self management efforts were obtained. Descriptive and chi-square statistics were used to evaluate the distribution of respondents’ opinion.Results:The response rate was almost 100%. The commonly cited intentional nonadherence practice included dose omission (70.2%). Almost 50% respondents were fed up with daily ingestion of drugs and 19.8% were inconvenienced with taking medications outside home and gave these as reasons for the dose omission. Forgetfulness (49.6%) and high cost of medication (35.5%) were mentioned as major non-intentional reasons for nonadherence. Aside oral medications, 82.6% and 95.0% of respondents respectively, reported moderate exercise and dietary restrictions as part of the prescribed treatment modalities. More than two third of respondents (81.8%) had never monitored blood glucose by themselves. Significant association exist between sex, occupation and patients’ tendencies to forget doses of prescribed oral medications (p<0.05).Conclusion:Nonadherence behaviors among ambulatory patients with type 2 diabetes occur mostly, as omission and forgetfulness of doses of medication. Efforts are needed to increase the medication adherence and self management practices of these patients in Nigeria so they can realize the full benefits of prescribed therapies.

BackgroundTreatment adherence play important roles in blood pressure control leading to reduction in morbidity and mortality. This study therefore assessed adherence to pharmacological and non-pharmacological therapies among ambulatory hypertensive patients. Reasons for treatment non-adherence, and association between adherence and blood pressure were also investigated.MethodsCross-sectional questionnaire-guided interview and retrospective review of medical records of 605-patients from two-tertiary healthcare institutions in Sokoto, Northwestern Nigeria. Nine-item modified Morisky adherence scale was used to assess medication adherence. Overall adherence score to lifestyle modifications was obtained from the total scores from 4-domains of non-pharmacological measures including cigarette smoking and alcohol cessation, salt-restriction and exercise. Patient-specific adherence education was provided at contact to resolve the knowledge gap(s). Clinical-parameters were retrieved at contact and subsequent 2-months appointment. Descriptive statistics, Chi-square and Student’s t-test were used for analysis at p < 0.05.ResultsFifty-four (8.9%) patients were adherent to medications. Forgetfulness (404; 35.2%) was the most common reason for medication non-adherence. Use of buddy/companion reminder (605, 30.2%) top the list of adherence education. Overall adherence to lifestyle modifications was 36(6.0%). Mean systolic blood pressure (SBP) at contact was 149.6 ± 22.5 versus 134.2 ± 15.8 mmHg at 2-months with a 10% reduction. There were significant associations in baseline SBP for patients with or without adherence to medication, cigarette smoking cessation, and exercise (p < 0.05).ConclusionsOverall adherence to antihypertensive medications and lifestyle modifications is suboptimal, underscoring the need for continuous patient-specific adherence education to ensure better therapeutic outcomes.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0934-x) contains supplementary material, which is available to authorized users.