Medication Counselling Practice in Community Pharmacies in Lagos State, Nigeria.
A Thesis Submitted to the School of Postgraduate Studies, University of Lagos.
Community pharmacies are major sources of medicines in most communities in Nigeria. Clients visit community pharmacies to seek help in medication therapy from community pharmacist,who has a professional responsibility to protect the public from the dangers of self medication through provision of adequate medication counselling. It is however not known to what extent community pharmacists fulfil this roles. The aim of this study was to examine the nature, extent and adequacy of medication counselling practice in community pharmacies and the factors influencing counselling practice. A cross sectional survey of community pharmacies using simulated clients visit (Observational study) and cross sectional survey of community pharmacists using self administered questionnaire were carried out. Documents containing policy statements, laws and regulations were also reviewed. Educational intervention involving training of pharmacists in a workshop and on-site practical demonstration was carried out. A total of 185 community pharmacies had complete data for inclusion in the analysis, representing 89.9% response rate. Pharmacist in 65 % of the pharmacies provided counselling. None of the pharmacist asked more than two questions, Information on dosage and frequency were the most (48%) frequently mentioned medication information items and information on adherence to medication least mentioned (3.6%). Only 10% pharmacies provided adequate medication counselling. Workload in the pharmacy (number of clients seen daily), and time of the day in which the pharmacy was accessed were found to be predictors of the amount of counselling offered by pharmacy staff (R= -0.268 & -0.329 ; p= 0.01 & 0.002 respectively). Weak regulatory framework on counselling practice, inadequate knowledge of medication counselling among many (72.3%) community pharmacists and lack of medication counselling guide/aids were also identified as potential factors influencing counselling practice. Medication counselling practice in community pharmacies in Lagos State is grossly inadequate. Workload in the pharmacy, inadequate knowledge of pharmacists and weak regulatory framework should be targeted as intervention by various pharmacy and public health stakeholders in order to improve the practice.