Evaluation of drug therapy problems among renal patients receiving care in some tertiary hospitals in Nigeria

Purpose: To determine the prevalence of drug therapy problems (DTPs), identify the types of DTPs and assess outcomes of DTP interventions among renal patients receiving care in three Nigerian tertiary hospitals.Methods: This prospective descriptive study was conducted in nephrology units of three tertiary hospitals in Nigeria, based on recommendations of working conference of the Pharmaceutical Care Network Europe, version 6.2 while the reviews,  classification of DTPs and principles of drug use in chronic kidney diseases (CKD) were based on evidence-based clinical guidelines and standards of practice (Kidney Disease: Improving Global Outcomes (KDIGO).Results: Out of 234 DTPs identified, 90 (38.46%) had drug choice problem, 86 (36.75%), had problems of drug interactions; 47(20.09%), had dosing problem, while 11 (4.70%) had drug use problem. Clinical interventions (459) were  undertaken at prescriber level (78; 16.99%); patient/carer level (211, 46.00 %) and drug level (170, 30.04 %). Pharmacists recommended 376 of the interventions for approval, out of which 310 (67.54%) were approved. Amongst the DTPs indentified, 47.86 % were successfully resolved.Conclusion: Drug therapy problems among renal patients were high. Inappropriate drug selection and drug interactions were the commonest drug therapy problems. The acceptance of pharmacists’ interventions by prescribers was appreciable.Keywords: Drug therapy problems, Renal patients, Therapy, Intervention, Outcome

Pregnancy outcome in booked and unbooked mothers in Southeastern Nigeria

Background: In order for individual health institutions in Nigeria to contribute towards the achievement of the Millennium Development Goals (MDG) with regards to maternal health, there is need for research on the local causes of and factors influencing adverse maternal outcomes. This would enable care providers and policy makers appreciate the burden of the problem and know where to focus as they distribute resources.Objectives: To compare the socio-demographical characteristics, obstetrical complications and foetal outcome in booked verses unbooked mothers who delivered at this hospital.Design: A hospital based retrospective study.Setting: The Abia State University Teaching Hospital (ABSUTH), Aba in South Eastern Nigeria.Subjects: Three thousand, seven hundred and thirty four mothers who delivered in the hospital between 1st January 2005 and 31st December 2007.Results: Unbooked mothers constituted 17.0% of the 3734 deliveries in the studied period. Compared to booked mothers, unbooked mothers were younger in age (28.2 ± 5.80 vs. 29.3 ± 6.04; p < 0.001) and had a lower educational status (

Health-related quality of life of HIV-infected patients taking different antiretroviral regimens at a tertiary healthcare facility in northern Nigeria

Purpose: To evaluate the health-related quality of life (HRQoL) of patients taking different antiretroviral regimens.Methods: A cross-sectional descriptive design was used to evaluate HRQoL of patients on Highly Active Antiretroviral Therapy (HAART) at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Data were collected using HIV/AIDS-Targeted Quality of Life instrument between May and November, 2015 from 872 adult outpatients who had been on their regimen for at least 6 months. Data were statistically analysed.Results: The overall HRQoL score of the patients was 59.40 ± 18.66. Among  patients on the first-line regimens, those on TDF + FTC + EFZ (60.52 ± 19.17) and those on TDF + 3TC + EFZ (64.41 ± 18.04) reported the best HRQoL scores. The difference between the scores of patients on the two most utilised regimens; AZT + 3TC + NVP (58.14 ± 18.53) and TDF + 3TC + EFZ (64.41 ± 18.04) was significant (p &lt; 0.05). Among patients on second-line regimens, those on TDF + FTC + LPVr (67.58 ± 14.80) reported the highest HRQoL score.Conclusion: Patients in this facility had a moderate HRQoL. TDF + 3TC + EFZ, TDF + FTC + EFZ and TDF + FTC + LPVr were the regimens with the best HRQoL  outcomes. The use of these regimens should be encouraged for better patient well-being.Keywords: HIV, Health-related quality of life, Antiretroviral therapy, First-line  antiretroviral regimen, Second-line antiretroviral regime

Health state utilities of a population of Nigerian hypertensive patients

<p>Abstract</p> <p>Background</p> <p>Establishment of the health impact of hypertension on quality of life of Nigerians is a step towards controlling the disease. The study aimed to provide a Nigerian specific reference list of utility scores of hypertensive patients with various interacting conditions.</p> <p>Findings</p> <p>An interviewer-based, cross-sectional study was conducted using hypertensive patients in two purposively selected tertiary hospitals located in South-Eastern Nigeria. Health Utility Index Mark 3 (HUI3) was used.</p> <p>A total of 384 participants with either hypertension alone or with hypertension-associated complications were interviewed in the two tertiary hospitals.</p> <p>The overall mean utility score was 0.35 +/- 0.42. Patients with hypertension alone had the highest overall mean utility score (0.57 +/- 0.29) while hypertensive patients with stroke had the lowest overall mean score (0.04 +/- 0.36). Being a male, increase in age and mean arterial blood pressure, emergency visit and loss of work due to illness were associated with significant decrease in overall utility scores.</p> <p>Conclusions</p> <p>This study presented a reference for health state utilities of a population of Nigerian hypertensive patients.</p

How Nigeria’s 2015 presidential election outcome was forecasted with geodemographics and public sentiment analytics

In 2015, Nigeria held one of the most fiercely contested presidential elections in the nation’s recent democratic history. The outcome of the election was expected to exert significant influence on democratic practices on the African continent. The stiffness of the contest also meant that it was difficult to predict the likely winner of the election. This paper summarizes how an empirical approach was used to forecast the outcome of the election by modeling public sentiment data-set using a geodemographic framework. Results indicate that the main electorates that determined the outcome of the election were situated in thirteen battleground states. Additionally, results showed that two years before the presidential election, Goodluck Jonathan’s public approval ratings on corruption, insecurity, and the economy (the main drivers of the 2015 election) had nose-dived across many of the battleground states. This eventually contributed toward his loss

A Comparative Study of Quinine and Artemether in the Treatment of Severe Malaria in Nigerian Children

Purpose: Nigeria has adopted quinine as the drug of first choice in the treatment of severe malaria and artemether as an alternative therapy. The purpose of this study was to ascertain whether artemether is a comparable alternative to quinine in the management of severe malaria in Nigerian children. Methods: We conducted a randomized prospective study comparing quinine and artemether therapies in 90 Nigerian children with severe malaria. Results: Mortality was lower in quinine group (13.0 %) than artemether (15.9 %), Odds Ratio (OR) = 0.446 (95 % Confidence Interval (CI), 0.124 to 1.603, p = 0.249 ). The parasitaemia clearance on day 3 by quinine and artemether was 96.8 and 99.0 % (p = 0.422), respectively, while on day 14 it was 100 % for both medicines. Fever clearance by quinine and artemether was 87.7 and 90 % (p = 0.753), respectively, on day 3 but it increased to 100 and 96.42 % (p = 0.072), respectively, on day 14. For the quinine group, 71.74 % of the patients spent less than one week in the hospital versus 61.76 % for the artemether group (p = 0.829, OR = 0.883, 95 %CI = 0.284 to 2.742). Conclusion: Artemether is a comparable alternative to quinine in the treatment of severe paediatric malaria

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