Sensitivity and Responsiveness of Health Utility Indices (HUI2 and HUI3) Among Type 2 Diabetes Patients

Purpose: To assess the sensitivity and responsiveness of HUI2 and HUI3 among Type 2 diabetes patients.Methods: This cross-sectional study was conducted in two purposively selected Nigerian tertiary hospitals. Six hundred and thirty-eight (638) adult patients were surveyed following their consent using the HUI2 and HUI3 (HUI23S4En.40Q) questionnaire. Patients’ clinical characteristics such as age, comorbidity, severity of disease, and utilization of hospital resources were postulated a priori to be associated significantly with utility scores of HUI2 and HUI3. Student’s t-test and bivariate analyses were conducted to determine the diabetes-severity discriminatory ability of HUI2 and HUI3. The analyses were conducted with SPSS 14.0. A two-tailed significance level of 0.05 was used.Results: Older patients had lower quality of life than younger patients. The overall health deficit of increasing age for HU13 was -0.2950 and that of overall HUI2 was -0.1553. The respondents without eye problem had higher quality of life than those with eye problem, in both HUI3 and HUI2 utility scores. Stroke was the most important patients’ characteristic that negatively affected HRQOL. Patients with duration of diabetes > 4 years had lower quality of life scores than their counterparts (≤ 4years).Conclusion: Health Utility Index Mark 2 and Mark 3 were sufficiently sensitive and responsive to diabetes severity among Type 2 diabetes patients.Keywords: Health utility index, HUI2, HUI3, Quality of life, Diabetes

Discriminatory Attitudes of Pharmacy Students and Pharmacists against People Living with HIV/AIDS

Purpose: To evaluate the level and predictors of discriminatory attitudes of pharmacy students and pharmacists towards people living with HIV/AIDS (PLWHA).Methods: A cross-sectional survey of pharmacy students and pharmacists (n = 523) to assess discriminatory attitudes towards PLWHA was conducted using a self completed questionnaire. Correlation and regression analyses were conducted.Results: Pharmacists were more knowledgeable and had less negative perceptions than students towards PLWHA. Level of professional training (p < 0.0001), knowledge status (p < 0.0001) and five negative perception items, namely, (a) people who got HIV through sex deserve it (p = 0.003), (b) PLWHA would make their colleagues apprehensive (p < 0.0001), (c) PLWHA have poor hygiene (r = 0.082, p = 0.032), (d) PLWHA should feel ashamed of themselves (p < 0.0001), and (e) people who behave promiscuously should be blamed for AIDS (p = 0.031), were all significantly associated with higher discrimination. However, being a student and having negative perceptions such as “PLWHA should feel ashamed of themselves and “PLWHA would make their colleagues apprehensive” were independent predictors of discrimination.Conclusions: Discriminatory attitudes against PLWHA among pharmacy students and pharmacists who participated in this study were high and level of training and their perceptions were contributory.Keywords: Discrimination, HIV/AIDS, Pharmacists, Perception, Professionalism, Stigmatization

The Construct Validity of an Instrument for Measuring Type 2 Diabetes Self-Care Knowledge in Nigeria

Purpose: To develop an instrument (DSCKQ-30) for measuring type 2 diabetic patients’ knowledge of self-care practices.Methods: A 30-item questionnaire (DSCKQ-30) consisting of close ended questions was developed for this study. DSCKQ-30 was self administered to a cross-section of randomly selected 400 ambulatory adult diabetic patients (≥ 18 years), who were attending endocrinology clinics at the hospitals included in this study. The sex distribution for female and male was 56.7 and 43.3% respectively. Factor analysis and item analysis were performed to test the construct validity and reliability of the instrument. Item performance was measured by item discrimination (item-to-total correlation) and percent correctness (%C).Results: The response rate was 78.5%. Factor analysis identified three scales of knowledge of self-care management. Chronbach’s alpha of the 30 questionnaire items was found to be 0.89. The item-to-total correlation coefficients and ranges for component 1 - 3 were 0.36 (0.25 - 0.48), 0.28 (0.23 - 0.35), and 0.34 (0.23 - 0.41), respectively, with overall average of 0.33 (0.23 - 0.48). Items percent correctness (% C) ranged from 16.7 to 86.7 % with an overall average of 55.6 %. Item factor loadings averaged 0.62 for the total items; averages of the three scales ranged from 0.59 to 0.68.Conclusion: The DSCKQ-30 provided a quantitative measure of patient's knowledge of self-care practices.Keywords: Diabetes self-care knowledge, DSCKQ-30, Knowledge instrument, Nigeria

Effect of Occupational Factors on the Quality of Life of Workers in Governmental and Non-Governmental Sectors in Southeastern Nigeria

Purpose: To assess the effect of occupational factors on quality of life (QOL) of workers in Governmental and non-Governmental sectors in southeastern Nigeria.Methods: A total of 2025 workers (both governmental and non-governmental sectors) were selected from across five southeastern states of Nigeria by convenient sampling. The Medical Outcomes Survey Short Form-36 (SF-36) alongside twenty closed questions was administered to the two groups of respondents to assess their quality of life and determine other factors that affected their quality of life.Results: Having a job that is tasking (r = -0.209, p < 0.05) contributed significantly to low Physical Component Summary (PCS ) in non-governmental sector but having job that raises enough finances for one’s comfort (r = 0.228, p < 0.05) impacted positively on their PCS. Being overly stressed by the job (r = -0.225, p < 0.01) was the only factor that significantly impacted negatively on Mental Component Summary (MCS) of respondents in Governmental sector while having a job that exposes one to a lot of health risk (r = -0.269, p < 0.01, having a job that is tasking (r = -0.206, p < 0.05) and having the belief that there are spiritual forces responsible for the challenges one is facing (r = -0.249, p < 0.05) accounted for decrease in MCS of respondents in non-Governmental sector.Conclusion: Occupational factors had more negative impact on the quality of life of respondents in non-Governmental sector than their counterparts in Governmental sector of the economy.Keywords: Quality of life, Occupation, Governmental sector, Non-governmental sector, Nigerian workers, Medical outcomes survey

Evaluation of Information Contained in Drug Advertisement and Promotion Materials in Nigeria

Purpose: To evaluate the physical characteristics (size, legibility or readability) and the completeness of information in drug package leaflets/inserts and drug promotional brochures in Nigeria.Methods: Three hundred materials (drug information leaflets and brochures) were collected from various community pharmacies, private and governmental clinics and from various pharmaceutical distributor or representatives from different states of Nigeria. Two independent panels sorted and evaluated the information found in them and differences were resolved by consensus.Results: This study revealed that 80.7 % of the materials evaluated were leaflets while brochures accounted for 18 %. The physical characteristics of the materials showed that 58.7, 31.3 and 89.0 % of the materials were sizeable, readable/legible and had adequate color contrast respectively. Most of the materials were written in English (78.7 %), English and French 17.3 %, English and Arabic accounted for only 4 %. Description of indications for which the drugs were used was mentioned in 30.3 % of materials. Other contents of the materials were mechanism of action (70.3 %), overdoses information (55.0 %), drug interaction (51.3 %), pharmacokinetics (36.3 %) and revision date of the information (21.0 %).Conclusion: This study reveals that advertising materials used in promoting drugs in Nigeria have incomplete information and the physical characteristics of the materials are not adequate. It seems that drug industries at present mainly aim at increasing sales rather than promoting health care. Information in some pharmaceutical brochures exaggerated the benefits of the drug and downplayed risks associated with the drugs.Keywords: Drug information, Drug leaflet, Drug promotion brochure, Nigeria, Advertizing material

Assessment of Community Pharmacist Role in the Management of type 2 Diabetic Patients: Enugu Urban Case Study

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