Department of Clinical Pharmacy and Biopharmacy
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Browsing Department of Clinical Pharmacy and Biopharmacy by Author "Aderemi-Williams, R.I."
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- ItemOpen AccessAdolescents and Young Adults knowledge, adherence and experiences while on antiretroviral therapy in a tertiary hospital in Lagos, Nigeria: a Mixed-Method Study(SAGE, 2021) Aderemi-Williams, R.I.; Razaq, A.R.; Abah, I.O.; Opanuga, O.O.; Akanmu, A.S.In Nigeria, there is a paucity of data on knowledge and experiences of adolescents and young adults (AYAs) with HIV and ART, as well as their challenges maintaining optimal adherence. A mixed-method study was carried out between August and September 2018 among AYAs attending Lagos University Teaching Hospital, Nigeria. Data collection was via AYAs’ hospital records, standardized questionnaires, and in-depth interviews (IDIs). The 4-day ACTG tool was used to measure adherence. Collected data were analyzed descriptively. Assessment of 34 AYAs comprising 18 (52.9%) males with 28 (82.4%) students revealed an overall knowledge score about ART and its effect of 73.6%. Twenty-five (73.5%) had poor knowledge of the development of resistant strains of HIV due to non-adherence recorded. Optimal adherence (≥95%) was recorded in 20 (58.8%) AYAs. IDI produced 4 themes: (i) reasons for non-adherence, (ii) ensuring optimal adherence, (iii) Social support systems and disclosure, and (iv) stigmatization. Our study provided formative data and revealed areas for intervention to improve knowledge and adherence to ART.
- ItemOpen AccessAdverse drug reactions amongst adult patients admitted in Lagos State University Teaching Hospital Lagos, Nigeria(Bentham Science, 2015) Aderemi-Williams, R.I.; Awodele, O.; Boyle, C.A.BACKGROUND: Adverse drug reaction (ADR) is a global drug therapy problem. It has been rated as one of the top leading causes of morbidity and mortality. In Nigeria, not much is known about ADRs especially with the existing weak post marketing surveillance for monitoring drug use, and its effect on the population. OBJECTIVES: The study is aimed at determining the incidence of ADRs, presentations of ADRs, classes of drugs that frequently cause ADRs and predictors of ADRs in adult medical in-patients in LASUTH. METHOD: A retrospective study of six hundred and twenty four (624) case notes of all patients admitted to the medical wards in LASUTH between January 1, 2009 and December 31, 2009 was carried out. Information obtained included age, gender, and adverse drug reaction and drug details. The results obtained were analyzed using SPSS version 16 statistical software. Level of significance was set at p ≤ 0.05. RESULTS: A total of 624 case notes consisting of 358 males and 266 females were assessed. The number of patients who experienced adverse drug reactions was 67 (n = 624, 10.7%). The incidence rate of ADRs in LASUTH from the study was 10.7 per 100 patients' population. Most of the ADRs observed were type A reactions (97.8%). Mostly implicated classes of drugs were antidiabetics (26.7%) and NSAIDs (29.3%). CONCLUSION: The incidence rate of ADRs was 10.7%. ADRs which are predictable and preventable occur in hospitalized patients, such may be prevented or minimized by implementing measures to target specific drugs that are commonly suspected.
- ItemOpen AccessAssessment of Caregivers' Adherence to ARV Drugs Administration in HIV-Infected Children(2012) Aderemi-Williams, R.I.; Ajagbe, A.Texts attached
- ItemOpen AccessBaseline Assessment of HIV Sero-Status disclosure among Patients Attending a Military treatment Site in Nigeria(2009-04) Aderemi-Williams, R.I.; Tayo, F.; Sagoe, A.; Zachariah, M.; Ibitoye, A.Texts attached
- ItemOpen AccessClients’ Perception of Community Pharmacists’ services in Owerri, Imo State, Nigeria(West African Postgraduate College of Pharmacists, 2017) Aderemi-Williams, R.I.; Igwe, C.N; Soremekun, R.OBackground Client satisfaction has become an important and commonly used indicator for measuring quality in health care. There is paucity of data with regards clients’ satisfaction with community pharmacy practice in Nigeria. Objectives This study objectives included assessing clients’ perception and knowledge of pharmacists, their professional services and their satisfaction with these services. In addition, the factors contributing to their satisfaction were assessed. Methods A cross-sectional study was conducted between December 2014 and February 2015, involving clients visiting community pharmacies in Owerri city, Imo state, Nigeria using self-administered questionnaire. Clients’ knowledge, perception and satisfaction with services provided by community pharmacists were assessed. Factors associated with clients’ satisfaction were analyzed using Chi-square. A p-value of <0.05 was considered statistically significant Results The response rate to the 422 questionnaires distributed was 91.0% (384). A little above half (194, 50.5%) of the clients were males. Less than half (40.6%) of the clients could correctly identify the roles of community pharmacists. Generally, respondents indicated a high (317, 82.6%) level of overall satisfaction with the services provided by community pharmacists. Deficiencies that exist in attitude of the pharmacist left reported by the clients. Significant associations were found between clients’ satisfaction and availability of drugs (p=0.025) and all the items on pharmaceutical care services rendered by pharmacists (p<0.05). Conclusion Clients visiting community pharmacies in Owerri have a positive perception of the services provided by pharmacists. Ensuring that the drug needs of clients are met and provision of comprehensive pharmaceutical care have been identified as possible key factors that ensures patient satisfaction.
- ItemOpen AccessCommunity pharmacies as possible centres for routine immunization(AJOL, 2007) Aderemi-Williams, R.I.; Igwilo, C.I.Background: Nigeria has embraced the primary healthcare movement and has committed its resources to the provision of cost effective community based primary healthcare strategy which recognizes the need for effective partnership between public and private sector1. Immunizations are important part of this effort, especially the provision of the vaccines incorporated into the national Expanded Programme on Immunization (EPI) which has now metamorphosis to National Programme on Immunization (NPI) due to decline in immunization coverage. Community pharmacies can be involved in immunization to improve coverage as has been shown in the United States of America (U.S.A) that this led to great improvement in immunization coverage2, 3. The need to find out if this can also be adopted in Nigeria is the objective of this work. Objectives: This study therefore aimed to have an insight into current interest of community pharmacists to be involved in routine immunization and assess their physical structures for possible adaptation for use in routine immunization. Method: Sixty (60) pre-tested questionnaires were randomly administered to community pharmacists. Forty-three (43) questionnaires were retrieved for analysis. Results: The study revealed that the use of community pharmacies as places where routine immunization services can be provided is feasible as shown by 95.3% interest expressed by community pharmacists. Most of the required infrastructures to carry out these services are on the ground as shown by availability of adequate space (88.4%), stand-by generator (83.7%) and functional fridge/freezer (95.3%). Community pharmacists (88.4%) expect to be remunerated for providing this service. Conclusion: This study has shown the willingness of community pharmacists to participate in immunization efforts and the possibility of using pharmacies in routine immunization.
- ItemOpen AccessComparative incidence of adverse drug reaction during the first and subsequent year of antiretroviral therapy in a Nigerian HIV infected Cohort(2021) Abah, I.O.; Dayom, W.D.; Dangiwa, D.A.; Aderemi-Williams, R.I.; Anejo-Okopi, J.; Agbaji, O.O.; Kanki, P.; Aguiyi, J.C.Background: Despite close to two decades of antiretroviral therapy (ART) in Nigeria, data on late on-onset ART-associated adverse drug reactions (ADRs) are sparse. Objectives: To describe early and late-onset ADRs and compare their incidence in an outpatient HIV positive Cohort on ART. Method:We described the incidence of clinical ADRs identified and documented in an outpatient clinic cohort of HIV-pos- itive patients treated between June 2004 and December 2015 at a tertiary health facility in Nigeria. Incidence rates of ADRs during the first and subsequent years of ART were compared. Results: of the 13,983 patients’ data analyzed, 9317 were females (66%), and those in the age bracket of 25 to 45 years made up 78% of the studied population. During 52,411 person-years (py) of ART, 1485 incident ADRs were recorded; Incidence rate (IR) 28.3 (95% confidence interval [CI] 26.9:29.8) ADRs per 1000 person-years (py) of ART. The IR of ADRs was about two times higher in the first year of ART compared to subsequent years of treatment; crude incidence rate ratio (IRR) 1.77 (95% CI 1.59:1.97). Anemia, hypersensitivity reactions, and nervous system disorders had 7, 23, and 5 times higher incidence, respectively, in the first year of therapy, compared to subsequent years. Conclusion: The first year of ART is the period of highest risk of ADRs. Individual and programmatic treatment success in resource-limited settings requires strategies for early identification and management of ADR during the period of greatest risk of ADRs.
- ItemOpen AccessComparative incidence of adverse drug reactions during the first and subsequent year of antiretroviral therapy in a Nigeria HIV infected cohort(African Health Sciences, 2021) Abah, I.O.; Dayom, W.D.; Dangiwa, D.A.; Aderemi-Williams, R.I.; Aguiyi, J.; Anejo-Okopi, J.; Agbaji, O.O.; Kanki, P.; Aguiyi, J.C.Background: Despite close to two decades of antiretroviral therapy (ART) in Nigeria, data on late on-onset ART-associated adverse drug reactions (ADRs) are sparse. Objectives: To describe early and late-onset ADRs and compare their incidence in an outpatient HIV positive Cohort on ART. Method: We described the incidence of clinical ADRs identified and documented in an outpatient clinic cohort of HIV-positive patients treated between June 2004 and December 2015 at a tertiary health facility in Nigeria. Incidence rates of ADRs during the first and subsequent years of ART were compared. Results: of the 13,983 patients’ data analyzed, 9317 were females (66%), and those in the age bracket of 25 to 45 years made up 78% of the studied population. During 52,411 person-years (py) of ART, 1485 incident ADRs were recorded; Incidence rate (IR) 28.3 (95% confidence interval [CI] 26.9:29.8) ADRs per 1000 person-years (py) of ART. The IR of ADRs was about two times higher in the first year of ART compared to subsequent years of treatment; crude incidence rate ratio (IRR) 1.77 (95% CI 1.59:1.97). Anemia, hypersensitivity reactions, and nervous system disorders had 7, 23, and 5 times higher incidence, respectively, in the first year of therapy, compared to subsequent years. Conclusion: The first year of ART is the period of highest risk of ADRs. Individual and programmatic treatment success in resource-limited settings requires strategies for early identification and management of ADR during the period of greatest risk of ADRs.
- ItemOpen AccessA comparative study of prescribing patterns in two tertiary care teaching hospitals in Lagos, Nigeria(2013) Aderemi-Williams, R.I.; Joda, A.E.Worldwide, it is estimated that over half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take their medicine correctly. Measuring drug use is a requirement for improving drug use either at the individual facility or national level. Much work has been done by World Health Organization (WHO) and the International Network on Rational Use of Drugs (INRUD) in providing tools for such measurements. The main objective of this work was to document and compare prescribing patterns in two teaching hospitals in Lagos State using WHO/INRUD developed indicators. The survey was conducted in the Lagos State University Teaching Hospital (LASUTH) and the Lagos University Teaching Hospital (LUTH). Prescriptions were sampled in both facilities and data required to document prescribing patterns collected. A total of 933 prescriptions were surveyed. Results obtained revealed that in the two facilities the average drugs used per encounter was 3.55, generic prescribing was less than 50% and encounters with antibiotics are high. On analysis, statistically significant differences existed on average number of drugs prescribed, use of generic nomenclature, percentage antibiotic use and percentage injection use in the two facilities. Long-term, intensive interventions should be carried out to ensure rational use of drugs in these facilities that are centers of excellence in medical and pharmaceutical care.
- ItemOpen AccessA comparative study of prescribing patterns in two tertiary care teaching hospitals in Lagos, Nigeria(International Journal of Pharmacy and Pharmacology, 2013) Joda, A.E.; Aderemi-Williams, R.I.Worldwide, it is estimated that over half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take their medicine correctly. Measuring drug use is a requirement for improving drug use either at the individual facility or national level. Much work has been done by World Health Organization (WHO) and the International Network on Rational Use of Drugs (INRUD) in providing tools for such measurements. The main objective of this work was to document and compare prescribing patterns in two teaching hospitals in Lagos State using WHO/INRUD developed indicators. The survey was conducted in the Lagos State University Teaching Hospital (LASUTH) and the Lagos University Teaching Hospital (LUTH). Prescriptions were sampled in both facilities and data required to document prescribing patterns collected. A total of 933 prescriptions were surveyed. Results obtained revealed that in the two facilities the average drugs used per encounter was 3.55, generic prescribing was less than 50% and encounters with antibiotics are high. On analysis, statistically significant differences existed on average number of drugs prescribed, use of generic nomenclature, percentage antibiotic use and percentage injection use in the two facilities. Long-term, intensive interventions should be carried out to ensure rational use of drugs in these facilities that are centers of excellence in medical and pharmaceutical care.
- ItemOpen AccessDrug Therapy Problems and Adherence amongst HIV-Positive Patients Attending a Treatment Site in Middle Belt Nigeria(2014) Aderemi-Williams, R.I.; Akoji, E.; Ogbo, P.Background: With the expansion in the accessibility of antiretroviral drugs (ARVs) in the management of people living with HIV and AIDS in resource limited environment, drug therapy problems (DTPs) can be a possible challenge. Hence the need to identify DTPs and the possible causes amongst HIV-positive patients on highly active anti- retroviral Therapy (HAART). Methods: This was a 6-month prospective study using a form designed to extract the relevant data that met the study objectives. The data col- lated were analyzed using descriptive statistical methods. Results: Most (76%) of the patients affected by DTPs were females and aged more than 15 years old (73%). A total of 18 DTPs were iden- tified. The major 5 were: unavailable prescribed medicines (30; 13.95%), undesirable effects (24; 11.16%). use of non-prescribed sedatives (23; 10.70%), use of non-prescribed antimalarial drugs (21; 9.77%) and use of herbal medicines (20; 9.30%). The major causes of the identified DTPs were: unnecessary drug therapy (59; 27.44%), non-adherence (47; 21.86%). patient needed additional therapy (36; 15.74%). and adverse drug reactions (30; 13.95%). Conclusions: DTPs exists in this treatment center and the causes include non-adherence. There is need for continual pharmacist mon- itoring and intervention with other healthcare providers as part of the pharmaceutical care plan when patients come for drug refill.
- ItemOpen AccessEffect of 2 models of care and factors predicting patients' adherence to doctor's appointment attendance in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria(SAGE, 2016) Aderemi-Williams, R.I.; Tayo, F.; Sagoe, A.; Zachariah, M.P.Background: Provision of antiretroviral therapy in resource limited settings has put pressure on the available infrastructure. Objectives: The study examined patients’ adherence to Doctor’s appointment attendance after an intervention changing the model of care and factors that predicted adherence. Methods: Observational study was carried out over four years. The model of care was changed in the last year and the effect assessed. SPSS version 15.0 was used for analysis. Predictors of adherence were determined using logistic regression model. Results: Over half 148 (59.7%) of the patients were females, with a mean age of 40.4+8.8 years and baseline CD4 cells of 143.5+92.7cells/microliters. ‘‘Adherence’’ rates were 51.3% in 2007, 35.9% in 2008 and 14.9% in 2009 giving patients’ average adherence to Doctor’s appointment attendance of 34.03%. Intervention changing the model of care in 2010 recorded an adherence rate of 93.1%. Conclusions: The change in model of care greatly improved patients’ ‘‘adherence’’. Patients’ knowledge of management, adherence, and smoking and drinking habits were identified as statistically significant predictors of adherence.
- ItemOpen AccessEffect of Patients' Knowledge of HIV and Antiretroviral Therapy on Adherence in a Treatment Site in Lagos, Nigeria(2016) Sagoe, A.; Tayo, F.; Aderemi-Williams, R.I.Background: Patients' knowledge about HIVand antiretroviral therapy has been found to have varying effect on patients' adherence to treat- ment. This study assessed various aspects of patients' knowledge and the effect on adherence. Methods: This was part of the longitudinal observational study carried out from December, 2006 to December, 2010. Validated questionnaires set to meet study objectives were administered to 294 eligible patients on whom on-going adherence counseling and monitoring of patients' clinical data were done. Pharmacy refill record measure of adherence was used. Data from 248 patients that completed the study were ana- Iyzed using SPSSversion 15.0 statistical package. Logistic regression model was used to determine the effect of knowledge on adherence. Results: Social and clinical demographic data analysis of study patients showed that 134 (54%) were married, 148 (59.70%) female, 106 (42.70%) had secondary school education and 208 (56.40%) employed. Their mean age was 40.39 :t8.78 years and mean baseline CD4 cell counts was 143.46 :t92. 72 cells/pl, At baseline 66.10% of the patients were on 12- hourly regimen while 33.90% were on 24-hourly regimen. Mean patients' pharmacy refill record of adherence at the end of the study was 96.64% :t 6.95%. In the twelfth month of study patients' knowledge of drug management and drug adherence were significantly predictive of adherence at p <0.05. Conclusion: Continuous patient education on HIV,antiretroviral treatment and need for adherence can contribute significantly in HIV+patients' adherence.
- ItemOpen AccessEthanol content of Alcoholic and herbal beverages in Nigerian Market(2019) Ogah, C.O.; Nwaeze, K.U.; Aderemi-Williams, R.I.; Ambrose, P.O.Background: Alcoholic and herbal beverages contain varied amounts of ethanol expressed as percent volume by volume (%v/v). Alcohol is a modifiable risk factor in many diseases and the products are hardly tested in Nigeria for verification of their label claims. Objective: This study was carried out to determine the concentration of ethanol in various brands of alcoholic and herbal beverages and compare values with the label claims. Methods: Fifteen brands each of alcoholic and herbal beverages were non-alcoholic solvent, tri-n-butyl phosphate and centrifuged to obtain a clear supernatant. T Only 20% of the herbal samples had ethanol contents that matched their label claims. Conclusion: Many of the samples (67%) had ethanol concentrations that were statistically different from their label claims.
- ItemOpen AccessFavourable socio-economic factors reduce HIV related stigma and improve quality of life(2010) Ebiere, H.; Aderemi-Williams, R.I.; Ezechi, O.C.; Odunukwe, N.N.; Onwujekwe, D.I.; Musa, S.O.; Addeh, J.E.; Okwuonu, D.U.; Idigbe, O.E.BACKGROUND: Stigma is described as "an attribute that is deeply discrediting" and results in the reduction of a person or group "from a whole and usual person to a tainted, discounted one." Discrimination is the societal response to the negative value attached to the stigma an individual may carry. Stigma has consequences on the prevention of HIY infection and care of d in eren 'ally, on quality of life. Quality of life a is popularly used to convey an overall se o~ ...e I be' g and i des aspects such as happiness d s isfocti . li e as a whole. OBJECT1VE: e level of stigmatization in PlWHA and its effect on quality of life. METHOD: This was a cross sectional study. Data collection was done by randomly administering the questionnaire. The study instrument is a questionnaire adapted from a combination of the Tanzania Stigma questionnaire and the WHOQOl-HIY questionnaire. The sample size is 70. RESULT: The study showed that there was stigma among PlWHA to the magnitude of 51 %. This discovery could be attributed to the favourable socio-economic characteristics of the respondents such as their level of educati
- ItemOpen AccessGlycemic Control and its Determinants among Patients with Type 2 Diabetes in a Specialist Hospital in Northeast, Nigeria(Schoarena, 2019) David, E.A; Aderemi-Williams, R.I.; Soremekun, R.O; Nasiru, I.Y; Auta, ABackground: Nigeria currently bears the highest burden of diabetes in Africa. Strict glycemic control is an important strategy employed to delay disease progression and /or prevent complication.
- ItemRestrictedHerbal medicine use among Type 2 diabetes mellitus patients in Nigeria: understanding the magnitude and predictors of use(Springer International Publishing, 2018-04) Amaeze, U.O.; Aderemi-Williams, R.I.; Ayo-Vaughan, M.A.; Ogundemuren, M.A.; Ogunmola, D.S.; Anyika, E.N.Background Patients with chronic diseases exploit complementary and alternative treatment options to manage their conditions better and improve well-being. Objective To determine the prevalence and predictors of herbal medicine use among Type 2 Diabetes patients in Lagos, Nigeria. Setting Secondary healthcare facilities in Lagos state, Nigeria. Method The study design was a cross sectional survey. A twostage sampling approach was used to select the health facilities and patients were recruited consecutively to attain the sample size. Data was collected using a structured and standardized interviewer administered questionnaire. Characteristics, prevalence and predictors of herbal medicine use were assessed using descriptive statistics and multivariate regression analyses. Main outcome measure Herbal medicine use among Type 2 diabetes mellitus patients. Results 453 patients were surveyed, 305 (67.3%) reported herbal medicine use, among whom 108 (35.4%) used herbal and conventional medicines concurrently; 206 (67.5%) did not disclose use to their physician. Herbal medicine use was significantly associated with age (p = 0.045), educational level (p = 0.044), occupation (p = 0.013), duration of diabetes disease (p = 0.007), mode of diabetes management (p = 0.02), a positive history of diabetes (p = 0.011) and presence of diabetes complication (p = 0.033). Formulations or whole herbs of Vernonia amygdalina, Moringa oleifera, Ocimum gratissimum, Picralima nitida, and herbal mixtures were the commonest herbal medicine. Beliefs and perceptions about herbal medicine varied between the users and non-users. Conclusion The use of herbal medicine among Type 2 diabetes mellitus patients in Lagos, Nigeria is high. There is dire need for health care practitioners to frequently probe patients for herbal medicine use and be aware of their health behaviour and choices, with a view to manage the disease better.
- ItemOpen AccessImpact of Pharmacist-led Care on Glycaemic Control of Patients with Uncontrolled Diabetes: A Randomised Controlled Trial In Nigeria(2021-08) David, E.A; Soremekun, R.O; Abah, I.O; Aderemi-Williams, R.I.Full texts attached
- ItemOpen AccessImpact of pharmacist-led care on glycaemic control of patients with uncontrolled type 2 diabetes: a randomised controlled trial in Nigeria(2021-04) David, E.A.; Soremekun, R.O.; Abah, I.O.; Aderemi-Williams, R.I.Background: Diabetes mellitus is a chronic, degenerative disease, requiring a multi-dimensional, multi-professional care by healthcare providers and substantial self-care by the patients, to achieve treatment goals. Objective: To evaluate the impact of pharmacist-led care on glycaemic control in patients with uncontrolled Type 2 Diabetes. Methods: In a parallel group, single-blind randomised controlled study; type 2 diabetic patients, with greater than 7% glycated haemoglobin (A1C) were randomised into intervention and usual care groups and followed for six months. Glycated haemoglobin analyzer, lipid analyzer and blood pressure monitor/apparatus were used to measure patients' laboratory parameters at baseline and six months. Intervention group patients received pharmacist-structured care, made up of patient education and phone calls, in addition to usual care. In an intention to treat analysis, Mann-Whitney U test was used to compare median change at six months in the primary (A1C) and secondary outcome measures. Effect size was computed and proportion of patients that reached target laboratory parameters were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each arm. Mean age was 51 (SD 11.75) and majority were females (68.5%). Participants in the intervention group had significant reduction in A1C of -0.75%, compared with an increase of 0.15% in the usual care group (p<0.001; eta-square= 0.144). The proportion of those that achieved target A1C of <7% at 6 months in the intervention and usual care group was 42.6% vs 20.8% (p=0.02). Furthermore, intervention patients were about 3 times more likely to have better glucose control; A1C<7% (aOR 2.72, 95% CI: 1.14-6.46) compared to usual care group, adjusted for sex, age, and duration of diabetes. Conclusions: Pharmacist-led care significantly improved glycaemic control in patients with uncontrolled T2DM. Keywords: Blood Glucose; Diabetes Mellitus, Type 2; Glycated Hemoglobin A; Glycemic Control; Intention to Treat Analysis; Nigeria; Patient Education as Topic; Pharmaceutical Services; Pharmacists; Randomized Controlled Trials as Topic.
- ItemOpen AccessKnowledge of HIV Transmission and Experience of Caregivers Administering ARVs to HIV infected Children(2012) Aderemi-Williams, R.I.; Ajagbe, L.O.