Introduction: active involvement of patients in the management of their health has been suggested as a major means of curtailing medication errors. This study aimed to assess the steps taken by hypertensive patients in avoiding medication errors before, during and after clinic visits.
Objective: To evaluate drug therapy problems in asthma patients visiting a secondary and tertiary hospital in South-Eastern Nigeria.Methods: This study was a retrospective, cross-sectional analyses of the medical records of adult asthmatic patients receiving care in two hospitals in Enugu State, within a 15-year period. The Pharmaceutical Network Care Europe (PCNE) tool version 6.2 was used to assess drug therapy problems. The IBM Statistical Product for Services Solution (SPSS) version 20.0 was used for analysis. For all results, P ≤ 0.05 was considered statistically significant.Results: Majority of the patients were below 60 y old (81.2%); female (68.8%) and were on more than two drugs (95.3%). Majority of the identified drug therapy problems (DTPs) were adverse reactions (65.7%). The inappropriate drug combination was the major cause of DTPs (65.6%). Only about 23.4% of the intervention outcomes were known. University of Nigeria Teaching Hospital (UNTH) had more interventions (35.9%) than Medical Centre (8.0%) (χ2 = 6.323; df = 1; **P = 0.012); and more of the outcomes of their interventions known (38.5%) compared to Medical Centre (0.0%) (χ2 = 12.559; df = 1; **P ˂ 0.001).Conclusion: Adverse reactions and inappropriate drug selection were the major identified DTPs and major cause of DTPs, respectively. Most DTPs had no interventions. The documented interventions included stopping of the drugs, change of drugs or dosage, change of instructions for use and starting of new drugs. Most interventions had unknown outcomes. UNTH had more interventions with known outcomes than the University of Nigeria Medical Centre.
Abstract 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.
AMA Isah A, Igboeli N, Adibe M, et al. Cost-effectiveness of antiretroviral regimens used in post-exposure prophylaxis program at United States' PEPFAR-APIN clinics in a developing country: a retrospective pharmaco-economic analysis. HIV & AIDS Review. International Journal of HIV-Related Problems. 2024:15-20. doi:10.5114/hivar.2024.135690. APA Isah, A., Igboeli, N., Adibe, M., Ukwe, C., Anosike, C., & Amorha, K. et al. (2024). Cost-effectiveness of antiretroviral regimens used in post-exposure prophylaxis program at United States' PEPFAR-APIN clinics in a developing country: a retrospective pharmaco-economic analysis. HIV & AIDS Review. International Journal of HIV-Related Problems, 15-20. https://doi.org/10.5114/hivar.2024.135690 Chicago Isah, Abdulmuminu, Nneka Uchenna Igboeli, Maxwell Ogochukwu Adibe, Chinwe Victoria Ukwe, Chibueze Anosike, Kosisochi Chinwedu Amorha, and Lawal Waisu Umar. 2024. "Cost-effectiveness of antiretroviral regimens used in post-exposure prophylaxis program at United States' PEPFAR-APIN clinics in a developing country: a retrospective pharmaco-economic analysis". HIV & AIDS Review. International Journal of HIV-Related Problems: 15-20. doi:10.5114/hivar.2024.135690. Harvard Isah, A., Igboeli, N., Adibe, M., Ukwe, C., Anosike, C., Amorha, K., and Umar, L. (2024). Cost-effectiveness of antiretroviral regimens used in post-exposure prophylaxis program at United States' PEPFAR-APIN clinics in a developing country: a retrospective pharmaco-economic analysis. HIV & AIDS Review. International Journal of HIV-Related Problems, pp.15-20. https://doi.org/10.5114/hivar.2024.135690 MLA Isah, Abdulmuminu et al. "Cost-effectiveness of antiretroviral regimens used in post-exposure prophylaxis program at United States' PEPFAR-APIN clinics in a developing country: a retrospective pharmaco-economic analysis." HIV & AIDS Review. International Journal of HIV-Related Problems, 2024, pp. 15-20. doi:10.5114/hivar.2024.135690. Vancouver Isah A, Igboeli N, Adibe M, Ukwe C, Anosike C, Amorha K et al. Cost-effectiveness of antiretroviral regimens used in post-exposure prophylaxis program at United States' PEPFAR-APIN clinics in a developing country: a retrospective pharmaco-economic analysis. HIV & AIDS Review. International Journal of HIV-Related Problems. 2024:15-20. doi:10.5114/hivar.2024.135690.
Rationale:The pharmacist charged with the responsibility of drug administration and counseling should have the basic knowledge and skills necessary to demonstrate the use of metered dose inhalers (MDIs) to asthma patients for the maximization of treatment outcomes.Objective: This study was designed to evaluate the community pharmacists' knowledge of the appropriate use of MDIs in Anambra State, Nigeria.Methods: The study was carried out in two major cities in Anambra State, Nigeria, using 41 registered community pharmacists.A simulated patient approach utilizing two adequately trained pharmacy students were used.Obtained data were analyzed using independent t-test and one-way ANOVA through SPSS version 18. Results: The pharmacists had a mean demonstration score of 45.45%.Step number seven of the correct use of MDI, which involves breathing in and depressing the canister was the most demonstrated step (90.2%) while step 4 which involves tilting the head back slightly was the least demonstrated (14.6%) by the pharmacists.Among five identified critical steps in asthma guideline used, two were well demonstrated (75.6% and 90.2%): one averagely demonstrated (51.2%) and two poorly demonstrated (39% and 31.7%).Sociodemographic characteristics did not influence the demonstration ability of the pharmacists in this study. Conclusion:The study indicated that community pharmacists lacked the adequate knowledge of appropriate use of MDI.Training programs for pharmacists focusing on the use of such devices will enable them to educate patients on the effective use of MDIs in patients with asthma.
The chronic and comorbid nature of HIV infection necessitate the use of multiple drugs including herbs to relieve symptoms with a possible increase in herb–drug interaction cases. This study was designed to evaluate the effect of Millettia aboensis (Hook. f.) Baker, Fabaceae, on cytochrome P450 3A isoenzyme and the influence of this effect on the bioavailability of two antiretroviral agents. In vitro effect of ethanol extract of M. aboensis on intestinal and liver microsomes extracted from female rats was assessed using erythromycin-N-demethylation assay method while in vivo effects were determined by estimating simvastatin plasma concentrations in rats. The effect of the extract on pharmacokinetic parameters of orally administered efavirenz (25 mg/kg) and nevirapine (20 mg/kg) was determined in rats divided into groups (n = 5). Plasma drug concentrations were assayed using HPLC and pharmacokinetic parameters determined through a non-compartmental analysis as implemented in WinNonlin pharmacokinetic program. The extract inhibited both intestinal and liver microsomal cytochrome P450 3A isoenzyme activities in vitro and enhanced simvastatin absorption in vivo with possible inhibition of metabolizing enzymes as indicated by significant (p < 0.05) increase in maximal concentration, area under curve and mean resident time of the drug. However, further in vivo interaction studies in animal model did not produce significant (p > 0.05) changes in the pharmacokinetic parameters of efavirenz and nevirapine. HPLC fingerprinting indicated the presence of quercetin and kaempferol in the extract. These findings revealed M. aboensis as an inhibitor of cytochrome P450 3A enzyme but, with no significant effect on the bioavailability of orally administered nevirapine and efavirenz.
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