Patients’ Knowledge of Diabetes Mellitus in a Nigerian City

Purpose: To assess the knowledge of diabetes mellitus among diabetes patients and to identify knowledge deficits and patient specific characteristics that are associated with this knowledge.                              Methods: This was a descriptive cross sectional observational clinic study conducted among previously diagnosed patients with diabetes attending the Consultant Outpatient Departments (COPD) of the University of Benin Teaching Hospital (UBTH). The study employed the use of a 14-item Diabetes Knowledge Test (DKT), developed by the University of Michigan Diabetes Research and Training Centre (MDRTC) and a demographic questionnaire to assess patient’s knowledge and its association with some patient specific variables.Results: The overall mean knowledge score of the subjects was 5.54 ± 2.3 (39.5 % ± 16.7 %) range 7 - 79 %. There was no statistically significant difference in knowledge scores with respect to family history of the disease, recent training in DM, age and sex p > 0.05. Respondents without any formal education scored significantly higher in the DKT (7.0 ± 2.27) followed by those with post graduate and University education 6.67 ± 2.41 and 6.65 ± 2.41 respectively. Higher score on the DKT was significantly correlated with duration of disease awareness (r = 0.217; 95 %CI = 0.02 – 0.39, p < 0.05) but not associated with improved glucose control as measured by FBG levels. (r = -0.073; 95 %CI = -0.277 - 0.137, p > 0.05). Only 12 (13.5 %) of the respondents had FBG levels with the normal range of 5.6 – 6.9 mmole/L.Conclusion: Respondents’ knowledge of diabetes mellitus based on the DKT was very poor. There were knowledge deficits which relate to misconceptions in the diabetics diet and knowledge of blood glucose monitoring with glycosylated haemoglobin test. Longer duration of diabetes, irrespective of educational status, was associated with higher knowledge score.Keywords: Diabetes, knowledge, Patient’s characteristics

Knowledge of Diabetes Mellitus among Registered Nurses in Benin City

Purpose: To determine the level of diabetes knowledge and knowledge gaps among registered nurses. Methods: We conducted a cross sectional study among four major hospitals located in Benin City. Levels of knowledge were assessed using the 23-item University of Michigan Diabetes Research and Training Centre Knowledge Test questionnaire. Demographic characteristics of the respondents were also outlined. Association and differences between nurses’ knowledge scores and relevant demographic variables were carried out using Pearson correlation and Student t-tests as appropriate. Results: The 191 nurses who participated in the study had an average score of 61.9±14.24 on a 100 point scale. No nurse was able to correctly answer all questions. Nurses were able to recognise long term complications of diabetes with 86.9%, 86.4% of the respondents answering correctly questions on symptoms of numbness and tingling, cause of high blood glucose, and problems associated with diabetes respectively. Although, nurses knew that diet plays a great role in management of diabetes mellitus, they were not aware of the effect of “unsweetened” fruit juice on blood glucose (15.2%), a free food for a iabetic (20.9%), and the identification of a proper diabetes diet (42.9%). There was a statistical difference in the knowledge scores of nurses that had a family history of diabetes and those that did not (P < 0.05). Conclusion: The knowledge of the nurses sampled as regards diabetes mellitus was less than satisfactory; areas of knowledge deficits include diet and signs of acute complications of diabetes as well as proper foot care. We suggest regular appraisal of nurses’ knowledge requirement followed by educational training tailored to improve nurses’ level of knowledge.Keywords: Nurses, Health education, Understanding of diabetes

Attitude of Nursing Staff Towards Disbetes in a Secondary Health Facility

This study was designed to determine the attitude of nurses in Central Hospital Benin towards diabetes mellitus. The third version of the diabetes attitude scale (DAS-3) which is a reliable and valid measure of attitudes towards diabetes was used. This instrument consists of a 33 item questionnaire addressing attitudes towards diabetes on 5 domains using a 5 point Likert response scale (1=strongly disagree to 5=strongly agree). The domains include; the seriousness of type 2 diabetes, the need for nurses to undergo training, the value of tight control, the psychosocial impact of diabetes and the need for patient autonomy. A total of 145 questionnaires were distributed to practicing nurses in Central hospital Benin City and 114 were retrieved giving a response rate of 78.62%. Most respondents were females 98(86%), and midwives 30(26.3%). The mean age of the nurses was 35.74 years and they cut across all cadres of nursing. Overall, the nurses showed a positive attitude to all the 5 domains of the study. Mean positive response was 3.37 ± 0.8846 with the highest score being in the subscale of the need for special training (4.18 ± 0.580). However, there was a much lower positive attitude on the psychosocial impact of diabetes on the patients. Nurses in the study showed a good attitude towards diabetes but expressed a strong desire for special training in diabetes.Keywords: Attitude, diabetes, nursing careNigerian Journal of Pharmaceutical Research, Vol. 8 No 1 pp. 129 - 137 (September 2010

Identification of Drug Therapy Problems in Patients with Diabetes Treated in a Secondary Care Facility in Benin City

This study aims to identify the types and frequency of drug therapy problems (DTPs) as well as the treatment pattern of patients with diabetes admitted to the medical wards of the Central hospital Benin City. A prospective descriptive survey of 40 patients was undertaken during a 3 month period in the male and female medical wards of Central Hospital Benin City. Patient specific subjective and objective data were collected through interview, and review of medical records and prescriptions using pharmaceutical care forms. Data collection began on admission and ended on discharge in respect of each patient. The data were evaluated and identified. The number of male patients 27(67.5%) was twice that of the female. There were varying diagnosis and several co-morbidities and/or complications. The most commonly used oral antidiabetic was metformin (57.5%) followed by glibenclamide (45%). Soluble insulin was the most prescribed of the insulin preparations occurring in 23 (57.5%) patients. Of the patients with diabetes who had hypertension, 15 (37.5%) were on lisinopril while 5 (12.5%) were on amlodipine and nifedipine respectively. There was a statistically significant difference in the FBS, Systolic BP and Diastolic BP on admission and discharge, P < 0.01. All the diabetic patients experienced DTPs (potential or actual) which could have been easily identified by a clinically trained pharmacist. The mean rate of DTP was 4.05 ± 1.96. The most frequently encountered DTP was wrong drug 23.9% followed by adverse drug reaction 16.4%, needs additional drug therapy 14.5% and dosage too high 14.47%. Others include inappropriate compliance 13.8%, dosage too low 11.3% and unnecessary drug therapy 5.6%. The findings of this study suggest a high incidence of drug therapy problems in the health facility and this makes a case for the presence of a pharmacist who is trained in the pharmaceutical care of diabetes in our health care system to help identify, prevent and resolve DTPs.Nigerian Journal of Pharmaceutical Research, Vol. 9 No 1 pp. 72 - 81 (February 2011

Prescription patterns and utilisation of antihypertensive drugs in a specialist hospital in Port-Harcourt

The aim of the study is to investigate the prescribing pattern and drug use in the management of essential hypertension in a specialist hospital and its conformity to the JNC VII and WHO/ISH management guidelines. A total of 1572 prescriptions from 490 case files of hypertensive patients (> 18 years) attending the Out-patients Departments of a Specialist Hospital between May and October 2012, were retrospectively surveyed. The most prescribed antihypertensive drug class was calcium channel blockers (32.44%), followed by ACE Inhibitors, (18.06%), diuretics (13.93%), fixed dose combinations (10.75%) and anxiolytics and low dose Aspirin grouped as others (14.12%). Individually, amlodipine (26.53%) was the most prescribed drug followed by Lisinopril (13.36%), hydrochlorothiazide + amiloride (Moduretic) (12.02%), Lexotan (9.29%), hydrochlorothiazide + Valsatan (Co-Diovan)(6.42%), nifedipine (5.92%), and methyldopa (5.53%). Combination therapy (73.38%) was used more commonly than monotherapy (22.50%). Among the combination therapies, 2- drug therapy (28.97%) was more preferred while the 3-drug and 4-drug therapies of diuretic + 2 drugs and Fixed Dose Combination + 2 drugs (11.62% each) were most commonly used. The study also shows that, of the 680 numbers of encounters, there were a total of 1544 drugs and 28 non-drug interventions. The average number of drugs per encounter was 2.3. The percentage of drug prescribed by generic name is 31.2% (482), while the percentage of encounter with antibiotics and injections was 0.7% each. The pattern of antihypertensive utilization complied partially with the JNC 7 Guideline and WHO/ISH 1999 Guidelines but did not conform to the Essential Drug List Act of Nigeria.Keywords: Antihypertensives, prescription pattern, drug utilization, treatment guidelin

Compliance of a Secondary Health Facility to the Nigerian Antimalarial Treatment Policy

In Nigeria, the change from chloroquine and other antimalarial monotherapy treatment to artemisininbased combination therapy (ACT) was introduced in 2004 due to evidence-based national and international findings. This one-year retrospective study describes the level of compliance to the national antimalarial treatment policy in our health institutions using the Central Hospital, Sapele in Delta State as a case study. Records of antimalarial prescriptions as well as patient biodata were systematically collected using a data form. A total of two hundred and fifty prescriptions on case management of malaria from January to December 2005 were randomly selected such that the prescribing habit of a cross section of the clinicians was obtained. Artemisinin based combination drugs were the most frequent antimalarials prescribed, they accounted for 73(28.2%) of the total antimalarial prescription. This was closely followed by artemisinin monotherapy 66(25.4%), others were chloroquine 56(21.6%), quinine 46(17.7%), sulphadoxine/pyrimethamine (SP) 14(5.4%) and halofantrine 7(2.7%). Chloroquine and quinine were still the drugs of choice in treating malaria in pregnancy. The level of compliance of the doctors in this health facility to the national anti-malarial treatment policy was quite low and various antimalarial monotherapies including chloroquine were still being used as first line drugs for malaria treatment.Keywords: Antimalarials, guidelines, treatment policyNigerian Journal of Pharmaceutical Research, Vol. 8 No 1 pp. 72 - 77 (September 2010

Prevalence of Overweight and Obesity among Pharmacy Students in a University in Benin City, Nigeria

Purpose: To identify the prevalence as well as determine gender differences in overweight and obesity among undergraduate pharmacy students of the University of Benin, Benin City, Nigeria.Methods: Undergraduate pharmacy students (n = 172) of University of Benin, aged 18 years and above, were recruited for the study. Body mass index, (BMI), waist circumference (WC) and waist/hip ratio (WHR) were measured using standard methods. Blood pressure (BP), and fasting blood glucose (FBG) levels were also measured.Results: The prevalence of overweight and obesity in the sample based on the three anthropometric indices yielded different rates as follows: BMI (10.5 and 1.2 %), WHR (8.1 and 2.3 %), WC (6.9 and 1.7 %), respectively. WHR and WC, but not BMI, reported higher prevalence of overweight among females than males. Only 4 (2.3 %) and 1 (0.58 %) of the subjects had high BP (. 140/90 mm Hg) and FBG (> 126 mg/dl).Conclusion: The prevalence of overweight and obesity as well as  hypertension and diabetes among pharmacy students sampled is low. Among the overweight and obese, there was no gender difference with regard to BMI. However, WHR and WC revealed that more females compared to males were overweight or obese.Keywords: Overweight, Obesity, Body mass index, Waist-hip-ratio, Anthropometric index, Hypertension, Diabete

Prevalence of some risk factors associated with hypertension among residents of a north central Nigerian state

Hypertension is fast becoming a public health problem and has been associated with certain risk factors that have been found to contribute to the increasing rates of cardiovascular diseases (CVD) in Sub Saharan Africa. The objective of this study was to determine the prevalence of some risk factors associated with hypertension among residents of Ilorin West Local Government Area (LGA) of Kwara State, Nigeria. It was a descriptive study conducted among 270 residents in the LGA selected using multistage sampling technique. About 51.5% of respondents had body mass index (BMI) within normal range, while 44.5% were either overweight or obese. Respondents’ mean BMI was 24.97 ±4.56 kg/m2. Using Waist to Hip Ratio (WHR), 7.1% of male, 78.5% of female and 45.2% of total respondents had abdominal obesity. Also, average waist circumference among male and female respondents was 82.24 ±11.30 cm and 88.99 ±13.01 cm respectively. Prevalence of familial history of hypertension was found to be 21% among respondents with 50% of them being traced to the father and/or mother. Prevalence of alcohol consumption, tobacco consumption and caffeine intake were 14.1%, 5.9% and 68.5% respectively. Only 5% of respondents consumed copious amounts of salt, while 2% took no salt. Majority (83.3%) of respondents claimed they engage in one form of exercise or the other, everyday and 43% get stressed up performing their daily activities. In conclusion, obesity and stress were the most predominant risk factors associated with hypertension among respondents.Keywords: Prevalence, Risk factors, hypertension, obesity, salt intake

Impact of nutrition education on diabetes knowledge and attitudes of adults with type 2 diabetes living in a resource-limited setting in South Africa: a randomised controlled trial

OBJECTIVE : To evaluate the effect of a nutrition education (NE) programme on diabetes knowledge and attitudes of adults with type 2 diabetes mellitus (T2DM). METHODS : Eighty-two adults (40–70 years) with poorly controlled T2DM (HbA1c ≥ 8%) and attending two community health centres in Moretele, North West Province (South Africa) participated in a one-year randomised controlled trial. Participants were randomised to the intervention group (n = 41; 8 weekly group education (2–2.5 hours); follow-up meetings and education materials) or control group (education materials only). Diabetes Knowledge Form B assessed knowledge about diabetes. Diabetes Attitudes Scale-III assessed the attitudes towards diabetes and treatment. Assessments were done at 6 and 12 months. Analysis of co-variance compared the groups (baseline, age, gender and clinic adjustments). An intention-to-treat analysis was employed. RESULTS : The intervention group had higher mean diabetes knowledge scores + 0.95 (p = 0.033) and + 2.05 (p < 0.001) at 6 and 12 months respectively. However, the scores were below 50%. Patient autonomy for diabetes attitudes was the only score significantly higher in the intervention group + 0.27 (p = 0.028) at 12 months. CONCLUSION : NE significantly improved diabetes knowledge in the intervention group, though not satisfactorily, but had limited effects on the attitudes towards diabetes.The Nestlè Nutrition Institute Africa and the South African Sugar Association [grant number 212].http://www.jemdsa.co.zaindex.php/JEMDSAam2016Human NutritionInternal Medicin