Patients\' Perception of the Benefits of Pharmaceutical Care Services in the Management of Hypertension in a Tertiary Health Care Facility in Benin City

Purpose: Measuring the perceptions of patients is essential in evaluating the success of therapy and needs of patients. The objective of this study was to investigate patients' perceptions of the benefits of regular participation in pharmaceutical care services in the management of hypertension. Method: In a cross sectional study, 285 systematically selected hypertensive patients attending consultant outpatient clinic in University of Benin Teaching Hospital, Benin City (UBTH) were interviewed on the benefits of pharmaceutical care services they received from pharmacists, susceptibility to health-related problems and threat reduction associated with regularly meeting with the pharmacists, using a validated structured interview format with reliability coefficient in the range of 0.79 to 0.87. Results: The patients rated medications supply and medication cost information provision as beneficial but rated patient education/counseling as fairly beneficial. However, patient monitoring, provision of nonmedication information and other specific information such as side effects, exercises, weight and blood pressure control were rated as "not beneficial". The services provided by the pharmacists in preventing/reducing health-related problems were poorly rated. While the perceived benefits and thread reduction were not associated with age, sex and education of the patients or the type of medication taken, patients perceived a significantly lower chance of developing health-related problem when they met with the pharmacists as compared to when they did not (P<0.001). Conclusion: Although the hypertensive patients studied perceived that pharmacists contribute to the reduction in hypertension-related problems, they do not currently benefit much from the level of services offered by the pharmacists. Therefore, pharmacists working in UBTH needs to develop and fully implement comprehensive pharmaceutical care and the Health Ministries should work in collaboration with the relevant professional bodies to ensure that there is effective pharmaceutical care services in all health care facilities

Patients' Perception of the Benefits of Pharmaceutical Care Services in the Management of Hypertension in a Tertiary Health Care Facility in Benin City

Purpose: Measuring the perceptions of patients is essential in evaluating the success of therapy and needs of patients. The objective of this study was to investigate patients' perceptions of the benefits of regular participation in pharmaceutical care services in the management of hypertension. Method: In a cross sectional study, 285 systematically selected hypertensive patients attending consultant outpatient clinic in University of Benin Teaching Hospital, Benin City (UBTH) were interviewed on the benefits of pharmaceutical care services they received from pharmacists, susceptibility to health-related problems and threat reduction associated with regularly meeting with the pharmacists, using a validated structured interview format with reliability coefficient in the range of 0.79 to 0.87. Results: The patients rated medications supply and medication cost information provision as beneficial but rated patient education/counseling as fairly beneficial. However, patient monitoring, provision of nonmedication information and other specific information such as side effects, exercises, weight and blood pressure control were rated as "not beneficial". The services provided by the pharmacists in preventing/reducing health-related problems were poorly rated. While the perceived benefits and thread reduction were not associated with age, sex and education of the patients or the type of medication taken, patients perceived a significantly lower chance of developing health-related problem when they met with the pharmacists as compared to when they did not (P<0.001). Conclusion: Although the hypertensive patients studied perceived that pharmacists contribute to the reduction in hypertension-related problems, they do not currently benefit much from the level of services offered by the pharmacists. Therefore, pharmacists working in UBTH needs to develop and fully implement comprehensive pharmaceutical care and the Health Ministries should work in collaboration with the relevant professional bodies to ensure that there is effective pharmaceutical care services in all health care facilities

Ion-pair high-performance liquid chromatographic assay method for the assessment of clarithromycin stability in aqueous solution and in gastric juice

A simple and selective ion-pair HPLC method has been developed for the analysis of clarithromycin in aqueous solutions and in gastric juice. A Hypersil ODS 5-mu m (150 x 4.6 mm I.D.) column was used with a mobile phase consisting of acetonitrile-aqueous 0.05 M phosphate buffer (pH 4.6) containing 5 mM 1-octanesulphonic acid (50:50, v/v). The column temperature was 50 degrees C and detection was by UV absorption (210 nm). The limits of detection of 50-mu l samples were 0.4 mu g/ml (aqueous) and 0.78 mu g/ml (0.5 ml gastric juice) or better. The assay was linear in the range of 1.56 to 100 pg/ml with r(2) values greater than 0.99. The recovery from the gastric juice samples was 98.5 +/- 2.9%. The method was applied successfully to determine the stability of clarithromycin in 0.01 M HCl and gastric juice

Reversed-phase high-performance liquid chromatographic assay methods for the analysis of a range of penicillins in in vitro permeation studies

Simple, rapid and selective HPLC methods have been developed for the analysis of amoxycillin, ampicillin, epicillin, mecillinam and propicillin. A Hypersil ODS 5 mu m (150x4.6 mm I.D.) column was used with mobile phases containing aqueous phosphate buffers, pH 3-4.6 and either methanol or acetonitrile as the organic modifier. Samples were detected by their optimal UV absorption (210-230 nm). The lower limits of quantitation of the compounds !(100 mu l injection volume) were 0.1 mu g/ml. The assays were linear in the range of 0.1-100 mu g/ml with r(2) values greater than 0.99. The methods have been applied successfully for the measurement of the Aux of the compounds across Caco-2 cells monolayers. (C) 1998 Elsevier Science B.V

Assessment of waiting time and satisfaction of patients with service delivery in an ambulatory pharmacy in Lagos University Teaching Hospital (LUTH)

Background: In the outpatient pharmacy setting, waiting time is the main indicator for assessing quality of service delivery. Long waiting times affect the efficiency of the pharmacy and cause patients' dissatisfaction.Method: The study employed a combination of work flow analysis and a survey involving administration of questionnaires to 123&nbsp; ambulatory patients in Family Medicine/General Outpatient department of LUTH.Results: The workflow analysis revealed a total patient waiting time of 79.24min with the process component accounting for 7.9 min (9.97%) and delay component responsible for 71.34 min (90.03%). The results of the survey indicated that more than half of therespondents felt that the queue in the pharmacy was long. In spite of this excessive delay, 80% of the respondents still felt satisfied with the services received.Conclusion: Significant reduction in waiting time can be made by facilitating service delivery at the prescription validation and&nbsp; assessment point. The excessive patient waiting time underscored the need to employ more pharmacists to improve on the&nbsp; performance. It was recommended that payment point be sited within the vicinity of the pharmacy unit and that patient waiting time be effectively managed by using the waiting area as an avenue to disseminate drug information and provide educational materials to the patients. Keywords - Ambulatory Pharmacy, Waiting time, Service Delivery, Patient Satisfactio

Prescription pattern and cost analysis of antipsychotics in a tertiary hospital in south- South Nigeria.

To promote rational drug use in developing countries, it is important to assess drug use pattern using the World Health Organisation (WHO) drug use indicators. Therefore the main objective of this study is to assess the prescription patterns and undertake drug cost analysis at the Federal Neuropsychiatric Hospital, Benin City using some of the WHO core drug use indicators. This is a retrospective, crosssectional survey and the sample was selected using systematic random sampling. The 540 patients encountered were reviewed from January 2014 – September 2014. The average number of the drugs prescribed per encounter was 2.3 with a range between 1 and 6. The percentage of encounters in which an antibiotic or injection was prescribed was 2.0% (n=11) and 40.9% (n=221) respectively. The percentage of drugs prescribed by generic name and from essential drug list was 92.5% (n=1165) and 70.0% (n=880) respectively. The oral antipsychotics prescribed (86%) included haloperidol, chlorpromazine, trifluoperazine, thioridazine, olanzapine and risperidone. The depot preparations (17%) were fluphenazine decanoate and flupenthixol decanoate. The cost of prescriptions ranged from N90-N18, 405. Our study revealed that the prescription patterns at the hospital studied were not in conformity with the WHO guidelines. Atypicals, are very expensive and unaffordable to the majority of patients in the study setting. This indicates the need for measures to reduce cost of newer psychotropic drugs, to increase their availability and use for enhanced quality of life of mentally ill patients in Nigeria.Keywords; :prescription pattern, antipsychotics, rational dru

The stability of amoxycillin, clarithromycin and metronidazole in gastric juice: Relevance to the treatment of Helicobacter pylori infection

Although omeprazole is an important component in anti-Helicobacter pylori therapeutic regimes using clarithromycin, amoxycillin and metronidazole, the mechanism by which it enhances antimicrobial action is unknown. One potential explanation for this effect is increased antibiotic chemical stability resulting from gastric pH changes induced by co-administration of omeprazole. The chemical stability of clarithromycin, amoxycillin and metronidazole was investigated in aqueous solutions and in human gastric juice collected before and after a 7-day course of omeprazole. Amoxycillin, clarithromycin and metronidazole were prepared in buffered aqueous solutions of pH 1.0 to 8.0 and in gastric juice of pH 2.0 and 7.0. The gastric juice samples were obtained from fasted H. pylori-negative volunteers before and after they had received a 7-day course of omeprazole. All the samples were incubated at 37°C and analysed at intervals by HPLC. Amoxycillin, clarithromycin and metronidazole were stable in aqueous solutions of pH 4.0-7.0, pH 5.0-8.0 and pH 2.0-7.0, respectively. At pH 2.0, the degradation half-lives were 19.0 ± 0.2 h, 1.3 ± 0.05 h and 2200 ± 1100 h, respectively. In gastric juice samples of pH 2.0, the degradation half-lives were 15.2 ± 0.3 h, 1.0 ± 0.04 h and ≤ 800 h, respectively. The half-lives of the drugs in the gastric juice samples of pH 7.0 were all > 68 h. The co-administration of omeprazole with amoxycillin or clarithromycin is likely to increase the chemical stability of amoxycillin and clarithromycin in gastric juice. Clarithromycin degrades rapidly at normal gastric pH (1.0-2.0) but amoxycillin and metronidazole are sufficiently stable at this pH to maintain an antibacterial concentration in the stomach

The effect of protein binding and lipophilicity of penicillins on their in-vitro flux across gastric mucosa

Delivery of amoxycillin across the human gastric mucosa to Helicobacter pylori is poor compared with that of metronidazole and clarithromycin, limiting the clinical effectiveness of this penicillin. To investigate the physicochemical properties of penicillins that influence their flux across gastric mucosa, the fluxes of metronidazole and eight penicillins were measured in vitro across rat gastric mucosa. The lipophilicity of these drugs was also measured using potentiometric titration. The mean fluxes of monobasic penicillins (range 0.66-0.89 nmol/cm(2)/h) were significantly lower than those of the aminopenicillins (range 1.94-2.80 nmol/cm(2)/h) (P < 0.005). Penicillin flux was not significantly correlated with lipophilicity as measured, but was significantly correlated with published protein binding data (r(s) = 0.9048, P < 0.002). Metronidazole flux was significantly higher than that of any penicillin at 22.6 (+/-0.9) nmol/cm(2)/h (P < 0.001). Therefore, the in-vitro gastric delivery of penicillins can be predicted from protein binding which may in turn predict activity against H. pylori in vivo