Assessment of patients knowledge and attitude towards diabetes and its relationship with glycemic control: a cross-sectional study in a Nigerian tertiary hospital

Background: It is postulated that increased knowledge of patients about diabetes as well as a positive attitude will lead to improved glycaemic control and better outcome. The aim of this study was to determine the knowledge and attitude of diabetic patients in a tertiary hospital in Enugu and the relationship with their glycaemic control.Methods: A cross-sectional study was done using a structured questionnaire to obtain socio-demographic data and assess knowledge and attitude to diabetes on consecutive patients attending the outpatient clinic in a tertiary hospital. Responses were scored with equal weighting. The fasting blood glucose of the patients was measured and recorded.Result: There were 51(60.7%) females and 33 (39.3%) males, with majority (63.1%) in the age range 41 -64 years and 32(38.1%) had only primary education. The mean knowledge score was 6.19 ± 2.08 and 33(39.3%) demonstrated good knowledge. Knowledge did not differ between males and females (p=0.34), but was highest in those with tertiary education (p = 0.02). Positive attitude to the condition was recorded in 63(75%) subjects. There was poor correlation between knowledge and attitude (r = -0.161, p= 0.14). Those with good knowledge scores were 2 times more likely to have good glycaemic control compared with those with poor knowledge; OR = 2.015, p = 0.02. There was no significant difference between the glycemic control of those with good attitude and those with poor attitude (p= 0.08).Conclusion: Although overall knowledge was poor, patients had a good attitude to their illness. Knowledge, but not attitude was significantly positively associated with glycemic control.Keywords: Diabetes mellitus, Knowledge, Attitude, Glycaemic contro

Adverse drug reactions : assessment and relevance to patient care in Nigeria

This review article defines and classifies adverse drug reaction (ADR). It then emphasizes the importance of Pharmacovigilance (PV) which is the practice of monitoring the effects of drugs after they have been already licensed for use especially in order to identify and evaluate previously unreported ADR. A general review of International and Nigerian PV is given. There is emphasis on assessment of PV to ensure it is related to patient care. Outcome measures to look out for in the practice of PV should include effect on mortality, effect on morbidity and quality of life and the potential return on public investment in detecting adverse drug effects. The characteristics and weaknesses associated with drug use and adverse reactions in Nigeria are outlined. This includes the few available experts trained in PV; lack of enabling environment for these experts to transmit their knowledge to other health care team to facilitate the achievement of the goals of PV; lack of general knowledge on PV, absence of equipped and functional PV clinics, inadequate funding of PV programme, substandard falsified medical products, adulteration of medicines, faulty drug distributions systems previously, inability to enact and enforce adequate laws to regulate the use of drugs in Nigeria and lack of political will to enforce the National drug use policy. In conclusion, some action points for a successful PV in Nigeria include establishment of PV clinics in all Teaching/Specialist hospitals as well as all General hospitals in the country, recruitment of all pharmaceutical manufacturing and or distributing companies, traditional herbal practitioners, the patent medicine dealers and all patients in the practice of PV in Nigeria