Clinical Pharmacy and Biopharmacy- Scholarly Publications

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    Pre and Post-natal drug therapy in Lagos University Teaching Hospital - A 5 year retrospective study
    (1997) Eniojukan, J.F.; Maduagwu, E.E.; Aina, B.A.
    Texts attached
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    Patients Views about Level of their Interactions with Pharmacists
    (Nigerian Journal of Pharmacy, 2004) Joda, A.E; Eniojukan, J.E
    A number of dissatisfied clients from pharmacies had been encountered and this led to an interest in the researcher to actually document the level of interactions between pharmacists and patients in hospital and community pharmacies. The main purpose of this study was to determine the level of interactions between patients and pharmacists hereby serving as a baseline for future intervention studies. Using an exit survey method, one hundred and eighty two patients/customers had a pre-tested questionnaire administered to them (82 in hospital practice and 100 in community practice). There was 100% recovery of responses. The results obtained revealed that though patients signified their satisfaction with the current level of interaction they had with the pharmacists, they also believe that there exists a need for improvement. It is imperative for pharmacists and pharmacy managers to rise up to their responsibility by providing the facilities and services required for the improvement of the level of interactions presently attained.
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    A Review of Malaria in Nigeria
    (Pharmaceutical Society of Nigeria, 2005) Joda, A.E.; Kola-Mustapha, A.T.; Folawewo, I; Jatto, B.E.; Quadri, U.F.
    Malaria is an important disease in developing countries. It causes significant morbidity and mortality, especially to children and pregnant women. Currently the anti-malaria policy is being reviewed and so this article is written with the view of refreshing our knowledge about malaria and highlighting some salient issues pertaining to the effect of anti-malarials on the heart.
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    Knowledge, Attitudes, Beliefs and Practices of In-School Youth in Tertiary Institutions in Lagos State to HIV/AIDS
    (Lagos University Medical Society, 2005) Joda, A.E.; Ogbeni, O.
    HIV/AIDS seriously affects adolescents throughout the world. One third of all currently infected individuals are youth between the ages of 15 to 24 and half of all new infections occur in youth of the same age. People of this age range can be found abundantly in tertiary institutions studying for degrees in various professions. It therefore, is necessary to document their level of awareness in order to assess their role in the spread or, otherwise of the infection in the state. 2 tertiary institutions were randomly selected from a list from the Lagos State Ministry of Education. 135 pre-tested questionnaires were administered to students in the Lagos State University, Ojo Campus (LASUO) and the University of Lagos, Idiaraba Campus (MEDILAG). A percentage recovery of 91.9% and 97.8% respectively was obtained. 233 respondents fell in the age bracket of 16 to 25, the target age range for HIV/AIDS. Majority of the respondents in both institutions could accurately define HIV and AIDS and they could also accurately indicate the body fluids in which HIV can be detected. Most of the students in both institutions indicated correct ways through which HIV could be contracted. Unfortunately some respondents still picked mosquito bite, kissing and casual contact. In prevention, a high proportion of the respondents chose correct options. At least 60% protect themselves correctly from HIV infection. About 50% of the respondents didn't know their HIV status and at least a quarter of them did not want to know. From the results, the level of awareness of the students is high concerning the basic knowledge of HIV/AIDS. The results were usually better in MEDILAG compared to LASUO though this was not always statistically significant. It can be concluded from this study that the level of awareness is high among youth in tertiary institutions. However, targeted education is still necessary to reach the remaining students whose awareness, and therefore behavior, is still non-compliant.
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    Community 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.
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    Cigarette smoking among healthcare professional students of University of Lagos and Lagos University Teaching Hospital (LUTH), Idi-araba, Lagos, Nigeria
    (Nigerian Quarterly Journal of Hospital Medicine, 2009-01) Aina, B.A.; Oyerinde, O.O.; Joda, A.E.; Oyetunde, O.O.
    Background: It is a known fact that health professionals can play a critical role in reducing tobacco use. In fact, it has been shown that even brief and simple advice from health care professionals can substantially increase smoking cessation rates. Students in healthcare professions are future healthcare professionals, identifying and documenting their knowledge, attitudes and practices with regards to tobacco smoking would shed light as to their future effectiveness in providing this much needed public health initiative in their practices. Objective: This research was carried out to determine cigarette smoking habit among healthcare professional students of University of Lagos and Nursing students of Lagos University Teaching Hospital. Methods: The study was a cross-sectional descriptive survey. Data was collected by the use of a structured, self administered questionnaire which was aimed at determining their smoking status and their attitudes. The target population was first and final professional year students representing the two class extremes and attempt was made to survey all the students that fell within this identified target population without randomization. Data was collected between March and June 2007 Results: Out of 814 qualified participants, 433 responded to the questionnaire (53%). Smoking prevalence was highest among dental students (8.48%) while both Physiotherapy and Nursing students had nil prevalence rates. Overall, the current smoking prevalence was 3.93%. There was no statistically significant difference between the smoking habits of first year and final year students (p= 0.99). Based on Fagerstrom nicotine addiction test, only a small proportion of the current smokers can be classified as being maximally addicted (6.0%). Conclusions: From this study it can be concluded that smoking prevalence is low among healthcare professional students at the University of Lagos and this is a good indication that they would play critical role in reducing tobacco use. It is recommended that a tobacco counselling unit should be set up by the school authorities.
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    Assessment of communication skills among Pharmacy students of the University of Lagos, Lagos, Nigeria
    (J Basic Clin Pharm., 2011) Aina B.A; Ogunbiyi O.O
    BACKGROUND: Communication skill is the bridge between the pharmacists and the patient. Communication in health can contribute to all aspects of disease prevention and health promotion. In order to become successful pharmacists, one needs to possess excellent communication skills to serve clients. This study was conducted at the University of Lagos to assess communication skills of Pharmacy students. METHOD: The study was descriptive and cross sectional. It was carried out between May and July 2009. Questionnaires were used for data collection. The questionnaire had two sections - the bio data section and pre-formulated questions on communication skills which has three options and one of these is the best option. RESULTS: A total number of 125 respondents were involved in the study which included 25 students from 200level, 50 from 300level and 50 from 500 level. Majority of them were between 18-25 years old (89.6%). There were more females (71.2%) than males (28.8%). Also most of them were Christians (71.2%). Among the respondents, about 62% picked the best options as their answer while the rest picked other options. There was no statistical difference in the choice of best options between the different levels of study. CONCLUSIONS: It can be concluded from the results of this study that majority of Pharmacy Students at the University of Lagos had good communication skills and they will be able to discharge their duties as pharmacists when they eventually graduate.
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    Knowledge of HIV and its transmission by women living with HIV/AIDS (WLWHA) attending HIV clinic in Lagos University Teaching Hospital (LUTH), Nigeria
    (Journal of Applied Pharmaceutical Science (JAPS), 2011) Joda, A.E.; Bamkefa, B.O.; Olugbake, O.A.
    The scourge of HIV/AIDS is a serious problem that cannot be overemphasized. Half of all HIV infections occur in women in Africa. Young women are particularly at risk and they are the child-bearing population. About 90% of MTCT infections occur in Africa. MTCT of HIV can occur at any stage of pregnancy. The study was designed to be a baseline survey which would help document the knowledge of Women living with HIV/AIDS and its transmission modes and the PMTCT programme of the HIV Clinic in the Lagos University Teaching Hospital can be used as template for future work. A survey of women attending the HIV Clinic in the Lagos University Teaching Hospital, Idiaraba (LUTH) was carried out. Pretested questionnaires were administered to the target population at the HIV Clinic to document their knowledge of HIV and its transmission including awareness of the PMTCT services in the hospital. The results obtained revealed that though many of them are knowledgeable about the modes of transmission of HIV, most of them do not know of the existence of a PMTCT service in the hospital. It can be concluded that respondents in this survey were knowledgeable about HIV and the ways it can be transmitted. The study recommends that staff of the HIV Clinic should be involved in counselling PLWHAs, especially WLWHAs and informing them about all the service components available in the Clinic so that clients that may need these services are already aware and can utilize it as needed.
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    Assessment of Pharmacy Students' Willingness to Practice after Graduation
    (West African Journal of Pharmacy, 2011) Joda, A.E.; Nwaokomah, S.O.
    Background: Emigration of pharmacists is a problem in many parts of sub-Saharan Africa. Objectives: To identify if the tendency to emigrate (internal and external) is already determined during the undergraduate training. Methods: A cross-sectional survey was conducted in the four faculties of pharmacy in Southwestern Nigeria. A sample of 200 to 400 Level students in the Faculty in Lagos was also surveyed. Pretested questionnaires with mainly Likert-type questions were administered to the target population. Results: It was found that an average 70% of final year students surveyed expressed a willingness to practice after graduation (74%, 54%, 75% and 76% in Unilag, UI, OAU and OOU respectively) while 55.3% of the Junior Undergrads expressed a willingness to practice the profession, post graduation. The results also revealed that the final year respondents believe that pharmacists in practice are not fulfilled (79%, 55%, 73% and 71% in Unilag, UI, OAU and OOU respectively). 23.3% of the Junior Undergraduates also have this belief Conclusion: It can be concluded from this study that pharmacy students are willing to practice the profession after graduation either within or outside the country. The study recommends motivation of pharmacists and review of the academic curriculum.
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    Knowledge and use of insecticide treated nets as a malaria preventive tool among pregnant women in a local government area of Lagos state, Nigeria
    (Journal of Applied Pharmaceutical Science, 2011) Ayeni, F.A; Aina, B.A
    Malaria has been described as the foremost public health concern in tropical and subtropical regions of the world, Nigeria inclusive. This survey set out to assess the knowledge, attitude and practice on the use of ITNs as a malaria preventive tool among pregnant women and to determine its level of recommendation and proper instructions given by pharmacists. Structured questionnaires were administered to pregnant women attending antenatal clinics at two selected hospitals in Alimosho Local Government Area (ALGA) of Lagos State and also to community pharmacists practicing in the same ALGA. Data was analyzed using Epi Info 2002 and Microsoft Excel. Forty eight community pharmacists and 163 pregnant women participated in the study. About 77 and 91% of pregnant women were aware of ITNs at Igando GH and the private hospital respectively. Only 11.2% and 37.5% actually used it. Majority of the pharmacists (95.8%) recommended the use of ITNs and 95% of them also gave counsel on ITN use while 5% did not. There is a wide difference between the level of awareness and the rate of use of ITNs by pregnant women. More emphasis should be placed on ownership and use of ITNs so that the benefit of its protection can be derived.
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    Halitosis amongst students in tertiary institutions in Lagos state
    (African Health Sciences (AHS), 2012-12) Joda, A.E.; Olukoju, O.O.
    Background: Halitosis is defined as a noticeable unpleasant odor from the mouth. It is a medico-social problem that affects a significant number of people around the world. Research reveals that nearly 50% of the adult population has halitosis. Objectives: To determine level of awareness of halitosis and prevalence of the condition amongst students in tertiary institutions as a baseline survey. Methods: For this project, 100 students from three tertiary institutions in Lagos state were chosen: University of Lagos, Lagos State University, Ojo campus and Yaba College of Technology. A semi-structured questionnaire and practical testing/diagnostic tool were utilized. Data collected was collated and analyzed using Microsoft Excel 2007 and SPSS statistical software. Results: Most of the respondents were single and Christian. Level of awareness of halitosis was high. Results showed that 15%, 2% and 22% from UNILAG, LASU and YCT respectively said they had halitosis. Using the diagnostic tool, 6%, 8% and 2% respectively were positive for halitosis. Conclusions: There is high level of awareness of halitosis among the respondents. The prevalence of the disorder is low, however, it is recommended that enlightenment campaigns be mounted in schools to improve level of awareness and treatment seeking.
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    A 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.
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    A Survey of Antibiotic use in Respiratory Tract Infections in a Community in Zaria, Kaduna State
    (West African Postgraduate College of Pharmacy, 2013) Olurishe, T.O.; Olurishe, C.O.; Adeyemi, O.C.
    Background: Appropriate use of antibacterial drugs is important to effect a cure in infections and to forestall resistance development. Objectives: This study was undertaken to assess the use of antibiotics for respiratory tract infections (RTI) among respondents in a community in Zaria, Nigeria.

    Methods: Random sampling of individuals within Zaria was done, and consenting participants were recruited. A total of 440 participated in the study. A forty-two item questionnaire was self-administered to the majority of the respondents who were literate while those that were not literate were assisted in filling out copies of their questionnaire.

    Results: Over 90% of the study population was between 12-50 years, of which 60.6% reportedly had an RTI in the previous six months. Females were more likely to have an RTI (p<0.05 Chi-square) while living conditions did not affect the development of RTIs. About 40% of respondents had laboratory investigations before antibiotic therapy. Total and partial affordability was reported by 72% and 18.9% of respondents respectively, with only about 20% obtaining their drug from the hospital. However, only about 50% were counselled about their medication. While the majority of respondents obtained their antibiotics from community pharmacies, about 40% of patients were not asked about previous medication for a recent infection.

    Conclusions: This study shows that rational antibiotic use is not fully practised, with large numbers of patients receiving empirical therapy. Improvement in counselling and discouragement of patronage of nonapproved drug outlets will improve antibiotic utilization. Studies into the factors responsible for increased female risk for RTI are advocated.

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    Accessibility of Antimalarials in Secondary Health Care Facilities and Community Pharmacies in Lagos State – A Comparative Study
    (Journal of Community Medicine and Primary Health Care, 2013) Soremekun, R.O; Ogunbanjo, O.A; Ogbo, P.U
    BackgroundThe attainment of the 6th Millennium Development Goal to halt and reverse the effects of malaria and other diseases by 2015 depends on the accessibility of Artemisinin Combination Therapy (ACT) which is now the first line antimalarial therapy for uncomplicated malaria. The main Objective of this study was to assess the availability and affordability of ACTs in Secondary Health Care (SHC) facilities in Lagos State and community pharmacies located within 200 meters of these facilities. Method Two SHC facilities each were randomly selected from four (4) geographical zones and the only one (1) in the fifth zone was selected, making a total of nine (9) facilities which were surveyed. The eleven (11) community pharmacies located within 200 meters of these health care facilities were also used for the study. A modified HAI was used for data collection on medicine price and availability was used for the study. Results: ACTs (artemisinin/lumefantrine) were prescribed 90% of the time as first line antimalarial. About thirty seven percent (37.5%) of the hospitals did not have the drug in stock at the time of visit and drugs had been out of stock for upward of three weeks. Private partnership pharmacies do not stock antimalarials as a matter of policy, since the drugs are supposed to be obtained free from the hospital. This first line antimalarial cost about six hundred and forty naira (N640) in the private community pharmacies. Conclusion: ACTs are not always available in the hospitals in Lagos State; patients therefore depend on community pharmacies and patent medicine stores for their ACT supply. Since 93.9% of Nigerians live in subjective poverty, the cost of first line ACT antimalarial remains unaffordable and inaccessible.
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    A 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.
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    Drug Therapy Problems and Pharmacist intervention in Lagos State General Hospitals
    (2013) Onifade, M.; Oreagba, I.; Usman, S.; Onwuchuluba, E.E.
    Background: The role of pharmacists in health care delivery continues to evolve from dispensing functions to greater involvement in pharmaceutical care. Objectives: The purpose of this study was to identify drug therapy problems, types often encountered in Lagos State Hospitals, southwest Nigeria, document and analyze them as well as the interventions taken by pharmacists in preventing and resolving them. Methods: A one-year retrospective study was conducted using 651 randomly selected prescriptions that were associated with drug therapy problems. The types of drug therapy problems, interventions taken by pharmacists, and the outcomes of the interventions were identified, documented, and analyzed. This was followed by a one-month prospective study of 66 similar prescriptions from three general hospitals in Lagos State, southwest Nigeria. Results: The retrospective and prospective studies revealed, respectively, the identification of a lot (781, 96) of drug therapy problems which had both major (70.4%, 65.6%) and minor (29.2%, 33.3%) potentials to cause harms, the most common of which was wrong drug/drug combination. Most (98.2%, 87.6%) of the prescribers accepted the interventions and the outcomes included change in drug regimen (72.2%, 25.5%), clarification of prescription (7.7%, 2.3%), dosage adjustment (4.2%, 15.1%) and drug discontinuation (2.4% 12%). Conclusion: The most commonly encountered drug therapy problem in Lagos State General Hospitals was the wrong drug-drug combination. Pharmacists' therapeutic interventions in these hospitals prevented potential adverse drug reactions and resulted in better therapeutic outcomes. However, pharmacists, doctors, and nurses require further training in order to achieve optimum pharmaceutical care.
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    A Comparative Survey of Pharmacists’ Perception of Community Pharmacy Services Provided in Two Local Government Areas in Lagos State
    (International Journal of Biology, Pharmacy and Allied Sciences, 2013) Joda, A.E.; Oyenekan, O.S.
    Community pharmacists work according to legal and ethical guidelines to ensure rational use of medicines. Recently, the professional role of pharmacists is changing to one in which they assist the public to get the best possible outcome from medication use through various interventions. In response to this change, various kinds of services are provided by ] pharmacists. The main objective was to document community pharmacists’ perception of services rendered, patients’ satisfaction and their satisfaction with the services they render to patients. Study settings are community pharmacies from two LGAs in Lagos State (Surulere representing Mainland LGA and Eti-Osa representing Island LGA). Pretested, semi-structured questionnaires were administered to 60 pharmacists in 30 pharmacies in the LGAs. Results obtained were analyzed using EPIinfo and SPSS. Descriptive and inferential statistics were carried out as required at 95% confidence interval. Response rate obtained was 87%. Most of the respondents were male and married. The results showed that the perception of respondents on services rendered were similar in the 2 areas though slightly more respondents on the Island had higher frequencies. Most of the respondents believed that their patients are satisfied with their interactions. Most of them are also satisfied with the interaction with patients. No statistically significant differences were obtained. The survey showed that the pharmacy services rendered can be categorized into clinical pharmacy or pharmaceutical care services. It also showed that their perception of patient satisfaction as well as their own satisfaction with patient interaction is generally good.
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    Undergraduate Students’ Knowledge and Practice of Gonorrhea and other Sexually Transmitted Infections
    (Nigerian Quarterly Journal of Hospital Medicine, 2013-10) Joda, A.E.; Tayo, F.; Aina, B.A.
    Background: Sexually transmitted infections (STIs) are a major public health issue. Adolescents and youth (15-24 years) are the age groups at the greater risk for acquiring them. Also a large percentage of new STIs occur in this age group with 7000 young people worldwide acquiring the infection every day. Sexually transmitted infections (STIs) are poorly recognized and inadequately treated in Nigeria despite the fact that they constitute a major risk factor for sexual transmission of HIV infection. The shortage of trained human resources is among the most important obstacles to strengthening health systems in low-income countries. Objective: This study is to document the knowledge and practice of undergraduate students about gonorrhoea and other STIs as a baseline survey for future intervention work. Methods: It was a questionnaire-based, cross sectional descriptive study of the knowledge and practice of STIs among students in the seven public tertiary academic institutions in Lagos State using list obtained from the Lagos State Ministry of Education. Thirty (30) students who agreed to be surveyed were conveniently selected from each school. Pre-tested, semi-structured, validated questionnaires were administered and collected back. Data was entered into Microsoft Excel and analysed using EPI Info, SPSS version 15 and Microsoft Excel. Results were considered to be statistically significant if p < 0.05. Results: Majority of the respondents were of the 21 - 25 year age range (48%) and were mainly single (95%), Christian (61%) and Yoruba (81%). About 51% of the respondents had at least good knowledge of gonorrhoea and other STIs. Knowledge about symptoms and transmission was higher than knowledge of prevention, consequences and drugs. Among those that are sexually active 24% do not use condom while 10% reuse condom. Use of both modern and traditional medical practitioners (TMP) was documented among the students. Conclusions: Awareness programs with key messages about gonorrhoea and other STIs should be developed and circulated widely in tertiary institutions in the state to improve students' practice. Also strategies to embrace TMP for STI management should be evolved.
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    Self-Reported Adherence to Antihypertensive Drugs in a Nigerian Population Using the Morrisky Medication Adherence Scale
    (Lagos University Medical Society, 2014) Amadi, C; Adeyemi, O.C.; Joda, A.; Mbakwem, A.; Ajuluchukwu, J.
    Background: Poor adherence to medications is one of the reasons for dismal outcomes in hypertensives. Only about one-third of hypertensives have good BP control, largely caused by poor adherence to medications. Although there are few studies in Nigeria that have studied self-reported medication adherence in hypertensives none was done with a validated instrument. Objective: This study was done to assess self-reported adherence to medication in Nigerian hypertensives using the Morisky Medication Adherence Scale. Methods: A cross-sectional study involving adult hypertensives attending the Medical Outpatient Clinics of three District Hospitals in Lagos, Nigeria was carried out between September and October 2012. A standard, structured and self-administered questionnaire containing socio-demographic data and relevant medical history was administered to consenting participants. The outcome measure was the 8-item Morisky Medication Adherence Scale (MMAS-8). Good adherence was defined as an MMAS score of 8. Results: Complete data from 768 respondents were analysed. The mean age of the study population was 57.53 years, with a female preponderance of 69.1%. The mean adherence value on the MMAS-8 instrument was 6.31± 1.56 while the prevalence of good adherence i.e. MMAS-8 score of 8 was 22.8%. Two hundred and twenty-seven (29.6%) of the study population had good BP control (BP<140/90mmHg). Age and to a lesser degree female gender were predictors of adherence. Conclusion: Using the MMAS-8 instrument adherence level to antihypertensives is lower than previously reported and control of BP is still poor. Effective communication with patients is advocated to improve adherence.
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    Antimalarial prescribing under the National Health Insurance Scheme (NHIS)
    (West African Journal of Pharmacy, 2014) Joda, A.E.; Ologunagba, M.O.
    Background: Malaria is still a dreaded disease in many developing countries. Artemisinin-based Combination Therapy (ACT) was adopted for malaria control as it offers better efficacy to previous chloroquine-based remedies. The National Health Insurance Scheme (NHIS) was established to provide access to qualitative care at an affordable cost from different professional members of the healthcare team. Enrollees access care for approved health conditions in accredited facilities. Objectives: The objective was to document the antimalarial prescribing practices on prescriptions from NHIS-accredited medical facilities received in an NHIS-accredited community pharmacy in Lagos. Methods: A retrospective review of all the prescriptions received at the target NHIS-accredited pharmacy from four NHIS-accredited clinics over a 3-year period (2006-2008) was carried out using a modified WHO/INRUD prescribing indicator form. Data obtained was analyzed using descriptive and inferential statistics at p=0.05. Results were presented as frequency tables and charts. Results: About 51% of the prescriptions were for female patients. Over 60% of the prescriptions included an antimalarial. About 45% of the antimalarials prescribed was sulphadoxine/pyrimethamine (syrups and tablets). The use of ACTs increased over the 3-year period from about 9% to about 46% mainly as Artesunate plus a sulphadoxine-pyrimethamine product. Conclusion: Most of the antimalarial prescriptions did not comply with the antimalarial treatment policy of the country. Continuing Medical Education programs are required to improve prescriber knowledge and practice. Supervision of facilities by NHIS officials to ensure sustainability and good health outcome is recommended.