Prevalence and control of hypertension in a Niger Delta semi urban community, Nigeria

Background: Hypertension is a public health problem worldwide, but the prevalence in Amassoma, Southern Ijaw Local Government Area is not known. Objective: To investigate the prevalence of hypertension in the locality and the extent of control in diagnosed cases. Methods: It is a prospective study involving interviewing. Four hundred adults aged 20 years and above selected through stratified random sampling across the various compounds called “AMA”; a unit of settlement comprising extended families of common ancestors. A self-developed, validated and pretested interviewer-administered questionnaire on demographics, predisposing factors, and medication history was used. In addition, measurement of respondents’ blood pressure, weight and height was carried out. The Body Mass Index calculated and the data were appropriately analysed. Results: The response rate of questionnaire distribution was 100.0% being interviewer administered alongside weight, height and blood pressure measurement. Majority of respondents were female. Almost half of respondents (46.5%) had their BMI above normal, 15.3% (61) of which falls within the obese region (>30.0kg/m2). The mean (SD) systolic blood pressure among males was 133.3 (3.2) mmHg and that of females was 127.4 (3.0) while the mean (SD) diastolic blood pressures were 86.2 (1.7) and 83.9 (2.4) for males and females respectively. Crude prevalence rate of hypertension in the community was 15.0% (60) out of which 13.8 % (55) were previously diagnosed. The hypertension was that of Stage I in 11.5% (46) and Stage II in 3.5% (14). Hypertension prevalence was slightly higher in males (18.8%) than that of the females (12.5%) (p= 0.0889), Relative Risk (RR)=1.500 [95%CI 0.9422:2.388]. The prevalence rate among 40 years and above was 41.6% (42/101) who also constituted 70.0% (42/60) of participants with hypertension in the survey and 10.5% (42/400) of the total. Of the previously diagnosed cases of hypertension, only 31% (17/55) were taking their drugs during the survey and only 12.7% (07/55) had regular adherence to medication and adequate BP control was achieved in 7.3% (04/55). Majority of the patients on drugs (21.8%) (12/55) were either taking methydopa as monotherapy or in combination with amiloride and hydrochlorothiazide. Other drugs being taken by patients include lisinopril, propranolol, amlodipine, atenolol, nifedipine and low dose aspirin. Conclusion: The prevalence of hypertension in the semi urban community is 15.0% with a pre-hypertension in another 23.5%. There was poor control of blood pressure among previously hypertensive patients

Drug Therapy Problems in Patients on Antihypertensives and Antidiabetic Drugs in Two Tertiary Health Institutions in Niger Delta Region, Nigeria

Drug therapy problems (DTPs), with the associated risks inherent in antihypertensive and antidiabetic therapy require utmost attention. This present study was aimed at assessing the DTPs observed in the management of hypertension and diabetes mellitus (DM) in two tertiary health facilities in Niger Delta region. In this retrospective study, 531 randomly selected case notes of hypertensive and/or diabetic patients who attended the health facilities in 2011 and 2012 were evaluated for DTPs. The mean patients’ age was 55.70±12.23 years with the elderly patients constituting 70.2% of the population studied. Overall, average numbers of drugs per prescription in the first-month and the fourth–month of drug therapy considered were 4.91±1.96 and 4.92±1.70 (p>0.05), with associated mean DTP values of 1.54±1.08 and 1.46±1.20 (p>0.05) respectively. Using Beer’s/STOPP/START criteria, 21.5% and 22.8% of all DTPs at therapy initiation and last clinic visit were identified in older patients. Unnecessary drug therapy was the most observed DTP in the first month and fourth-month (23.6%, 29.4%) of drug therapy in all the patients and was closely followed by wrong drug therapy (23.4%, 22.9%), need for additional drug therapy (20.9%, 17.4%), non-adherence (15.4%, 13.8%), and drug interactions (12.9%, 9.6%). Other DTPs observed, though to lesser extents were dosage too low (1.5 %, 5.2 %), adverse drug reaction (1.4 %, 1.3 %) and dosage too high (0.9 %, 0.4 %) respectively. There was thus, high incidence of DTPs in the hypertensive and/or diabetic patients studied. Unnecessary drug therapy and wrong drug therapy were the most frequently observed DTPs.Keywords: Antidiabetic medications, antihypertensive medications, diabetes mellitus, drug therapy problem, hypertension, Niger Delta, Nigeri

Pharmacist’s Intervention in the Control of Blood Sugar Levels in Randomised Diabetes Patients at a Primary Health Care Setting in Benin City

Background: The extended roles of pharmacists in Nigeria in the improvement of quality of health care at the primary health care (PHC) level is currently poorly executed even though pharmacists have been proven to be involved in interventional activities in health care delivery.Objective: To evaluate pharmacists' intervention in the control of blood sugar levels of diabetes patients in a PHC setting in Benin City, Nigeria.Methods: At baseline, the fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), body mass index (BMI) and blood pressure (BP) of randomly selected 170 diabetic patients in a primary health care centre were evaluated. This was followed-up with intervention by the pharmacists through counselling on lifestyle modification, selfmedication and drug adherence on monthly basis for three consecutive months after which the FBS, HbA1c, BMI and BP were re-evaluated.Results: indicated significant reduction in BMI, HbAlc and FBS from 27.1±4.2 kg/m2, 8.1±3.0% and 10.0±4.2 mmol/l to 23.5±3.5 kg/m2, 7.1±1.8% and 8.5±2.1 mmol/l, respectively (p<0.001) was observed following the intervention by the pharmacists.Conclusion: Direct involvement of pharmacists in the care of diabetic patients in PHC settings can significantly improve the quality of life provided to these patients and hence reduce mortality resulting from the disease. Recruitment of reasonable number of pharmacists should always be considered in health policies for PHC settings in developing countries.Keywords: Diabetes mellitus, blood sugar levels, pharmacist intervention, primary health care