Toward pharmacy-based smoking cessation services in Nigeria: Knowledge, perception and practice of community pharmacists

Introduction: Worldwide, tobacco smoking is one of the leading causes of avoidable deaths. In Nigeria, there is currently no clinical guidelines for tobacco dependence treatment. However, globally, pharmacy-based smoking cessation intervention has been associated with improved cessation rates and quality of life. This study aims at assessing the knowledge and perception of community pharmacists about smoking cessation and tobacco harm reduction as well as barriers to the practice of pharmacy based smoking cessation intervention. Methods: A cross-sectional survey was carried out among 104 community pharmacists, between August and December 2019, using a self-administered paper questionnaire. Data entering, cleansing, and analysis were done using IBM SPSS (version 23). Descriptive statistics including frequencies and percentages were used to summarize the data. Results: Thirteen pharmacists (12.5%) were providing smoking cessation services. One-tenth (10.6%) of the pharmacists were aware of tobacco harm reduction. The majority (89.4%) were willing to attend smoking cessation training. Among the respondents, 65 (62.5%) had poor knowledge regarding smoking cessation and tobacco harm reduction. Lack of knowledge and skills were reported by all (100%) as a barrier to providing the service. However, 101 (97.1%) community pharmacists agreed that smoking cessation treatment is an important role of pharmacists. Conclusions: A suboptimal level of knowledge of smoking cessation and tobacco harm reduction was noted among the community pharmacists. However, they believed smoking cessation intervention is an important role of pharmacists. It is advocated that smoking cessation training should be included as part of the Pharmacists’ Council of Nigeria Mandatory Continuing Professional Development Training. Thus, it is imperative to establish basic national smoking cessation guidelines that can be functional towards reducing mortality and morbidity associated with tobacco smoking in Nigeria

The impact of COVID-19 pandemic on medicine security in Africa: Nigeria as a case study

COVID-19 is an unprecedented pandemic posing major threat to global public health. In the past decades of years or so, one could have heard of how dangerous it is to be virtually reliant on medicine supply from other countries. Nonetheless, no action was taken because it seemed to many that the global trade system was operational and Nigerians as well as citizens of African countries appear to have sufficient supply of the medications required at quite appealing cost. Currently in 2020, this apprehension has revolved from an imaginary problem to an actual challenge that might have consequences for millions nationwide due to COVID-19 pandemic. Now, African countries can realize that putting all our eggs in one basket was not such a good idea. In Nigeria, over 70% of the prescribed medications are produced from active ingredients (API) primarily sourced from firms in China and India. Access to medicine is an integral part of healthcare systems, uninterrupted access to medicine is much needed and essential for the well-being of the population. We are now approaching the conclusion that it is more reasonable to probably invest a little more to resuscitate a domestic pharmaceutical synthesis and herbal medicine research capacity in Nigeria and across African countries to improve public health

Treatment of malaria in pregnancy: Knowledge of community pharmacists in Ibadan, Nigeria

Purpose: To evaluate the knowledge of community pharmacists in the management of malaria in pregnancy and their adherence to the World Health Organisation (WHO) treatment guidelines. Methods: Questionnaires were administered to obtain information on knowledge and adherence to WHO guidelines. Respondents’ scores on a 12-item knowledge question on the management of malaria in pregnancy were categorized as good knowledge if ≥ 10, and poor knowledge if < 10. Descriptive statistics were used to summarise the data. Chi-square test was used to explore the association between sociodemographic characteristics and knowledge. Results: Pharmacists qualified within 10 years of the study period were 29 (48.3 %). Only 25 (31.3 %) of the pharmacists possessed an additional qualification to Bachelor of Pharmacy degree. Rapid diagnostic test kits (RDT) and light microscopy test (LMT) have been used by 51 (76.2 %) and 17 (28.8 %), respectively, to diagnose malaria. About three-quarters (71.3 %) had poor knowledge of the medication for the treatment of malaria in pregnancy. Knowledge score was neither significantly associated with the pharmacists’ years of qualification (p = 0.174) nor with possession of additional qualification (p = 0.334). Conclusions: There is a substantial gap in pharmacists’ knowledge on the management of malaria in pregnancy, revealing an urgent need for training and adherence of community pharmacists to World Health Organisation treatment guidelines to ensure the safety of pregnant women and the unborn baby

Potential inappropriate prescribing among ambulatory elderly patients in a geriatric centre in southwestern Nigeria: Beers criteria versus STOPP/START criteria

Purpose: To identify potentially inappropriate prescribing in ambulatory elderly patients and compare the appropriateness of guidelines; Beers' and Screening Tool of Older Person’s Prescription (STOPP)/Screening Tool to Alert Right Treatment (START) criteria to detect potentially  inappropriate prescribing among the elderly.Methods: A retrospective study was conducted using case files of 335 elderly patients aged ≥ 60 years between 1st January and 31st December  2016, using a data extraction sheet. The 2015 American Geriatrics Society (AGS)-Beers Criteria, and version 2 of the STOPP and START were  subsequently used to identify the Potentially Inappropriate Prescribing (PIP) and Potential Prescribing Omissions (PPOs).Results: Mean age of patients was 69 ± 0.4 years (range 60 - 85 years) and 219 (65.4 %) were females. An average of 4.2 medications per patient prescription was found. The Beers criteria identified 26.5 % PIP, while STOPP criteria identified 57.1 % PIP. START detected 29 PPOs in 15 (4.4 %) of the patient’s prescription. The most prevalent disease conditions were hypertension 235 (70.1 %) and osteoarthritis 64 (19.3 %). Polypharmacy was significantly associated with PIP in both Beers (p = 0.002) and STOPP (p = 0.001) criteria.Conclusion: The prevalence of PIP is high among elderly patients. The STOPP/START criteria identified a higher proportion of PIP among elderly patients compared with Beers criteria. The frequency of PIP should stimulate efforts to curtail potentially inappropriate prescribing and may require the need for advocating for a national criterion to be adopted by health care professionals in Nigeria. Keywords: Potential inappropriate prescribing, Beers’ criteria, STOPP/START criteria, Elderl

COVID-19 in Nigeria: Is the pharmaceutical sector spared?

No abstract available

When it is available, will we take it? Public perception of hypothetical COVID-19 vaccine in Nigeria

Introduction COVID-19 pandemic is a global public health threat facing mankind. There is no specific antiviral treatment for COVID-19, and no vaccine is currently available. This study aimed to understand the perception of the public towards a hypothetical COVID-19 vaccine in Nigeria. Method We conducted a cross-sectional survey in August 2020 across the 36 states of Nigeria using an online questionnaire. The questionnaire includes sections on the demographic characteristics of the respondents and their perception regarding a hypothetical COVID-19 vaccine. A total of 517 respondents completed and returned the informed consent along with the questionnaire electronically. Data were coded and abstracted into the Microsoft Excel spreadsheet and loaded into the STATA 14 software for final analysis. Results The results showed that more than half of the respondents were male 294 (56.9%). Most of the respondents (385, 74.5%) intend to take the COVID-19 vaccine when it becomes available. Among the 132 respondents that would not take the COVID-19 vaccine, the major reason for non-acceptance was unreliability of the clinical trials 49 (37.1%), followed by the belief that their immune system was sufficient to combat the virus 36 (27.3%). There were significant association between the age of the respondents and the COVID-19 vaccine acceptance (P-value=0.00) as well as geographical location and COVID-19 vaccine acceptance (P-value=0.02). Conclusion It was observed that most of the respondents were willing to take the COVID-19 vaccine. Our findings reiterate the need to reassure the public that any vaccine that becomes available will be safe and effective. In addition, there is a need for the national health authorities to ensure the public trust is earned and all communities, including the marginalized populations, are engaged properly to ensure an optimal COVID-19 vaccine acceptance

When it is available, will we take it? Social media users' perception of hypothetical COVID-19 vaccine in Nigeria

INTRODUCTION: COVID-19 pandemic is a global public health threat facing mankind. There is no specific antiviral treatment for COVID-19, and many vaccine candidates are currently under clinical trials. This study aimed to understand the perception of social media users regarding a hypothetical COVID-19 vaccine in Nigeria. METHODS: we conducted a cross-sectional survey among social media users in Nigeria in August 2020 using an online questionnaire. The questionnaire includes sections on the demographic characteristics of the respondents and their perception regarding a hypothetical COVID-19 vaccine. A total of 517 respondents completed and returned the informed consent along with the questionnaire electronically. Data were coded and abstracted into Microsoft Excel spreadsheet and loaded into the STATA 14 software for final analysis. RESULTS: the results showed that more than half of the respondents were male 294 (56.9%). Most of the respondents 385 (74.5%) intend to take the COVID-19 vaccine when it becomes available. Among the 132 respondents that would not take the COVID-19 vaccine, the major reason for non-acceptance was unreliability of the clinical trials 49 (37.1%), followed by the belief that their immune system is sufficient to combat the virus 36 (27.3%). We found a significant association between the age of the respondents and the COVID-19 vaccine acceptance (P-value=0.00) as well as geographical location and COVID-19 vaccine acceptance (P-value=0.02). CONCLUSION: it was observed that most of the respondents were willing to take the COVID-19 vaccine. Our findings also reiterate the need to reassure the public the benefits an effective and safe COVID-19 vaccine can reap for public health. There is a need for national health authorities in Nigeria to ensure public trust is earned and all communities, including the marginalized populations, are properly engaged to ensure an optimal COVID-19 vaccine acceptance

Diabetes mortality and trends before 25 years of age : an analysis of the Global Burden of Disease Study 2019

Background: Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods: We used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990–2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals. Findings: In 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73·7% (68·3 to 77·4) were classified as due to type 1 diabetes. The age-standardised death rate was 0·50 (0·44 to 0·58) per 100 000 population, and 15 900 (97·5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0·13 (0·12 to 0·14) per 100 000 population in the high SDI quintile, 0·60 (0·51 to 0·70) per 100 000 population in the low-middle SDI quintile, and 0·71 (0·60 to 0·86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r2=0·62). From 1990 to 2019, age-standardised death rates decreased globally by 17·0% (−28·4 to −2·9) for all diabetes, and by 21·0% (–33·0 to −5·9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (−13·6% [–28·4 to 3·4]) and for type 1 diabetes (−13·6% [–29·3 to 8·9]). Interpretation: Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding: Bill & Melinda Gates Foundation.publishedVersionPeer reviewe

Self-medication with over-the-counter drugs among consumers: a cross-sectional survey in a Southwestern State in Nigeria

Objectives This study set out to assess the knowledge, perception and practices of consumers regarding self-medication with over-the-counter (OTC) drugs, the prevalence of risky practices and their associated factors in pharmacy outlets in Ibadan, Southwestern Nigeria.Setting A cross-sectional study was conducted using an interviewer administered questionnaire. Descriptive statistics and multivariate analysis were performed by using SPSS V.23 with statistical significance set at p<0.05.Participants 658 adult consumers aged 18 years and above.Primary and secondary outcome measures The primary outcome was self-medication, measured using the following question: A positive answer indicates a self-medicated participant. Do you practise self-medication?Results Respondents who had practised self-medication with OTC drugs were 562 (85.4%), of which over 95% were involved in risky practice. Consumers agreed (73.4%) that OTC drugs can be recommended by pharmacists and perceived (60.4%) that OTC drugs are harmless regardless of how they are used. Reasons for practising self-medication with OTC drugs include: if it is a minor condition, I can take the initiative (90.9%), visiting a hospital wastes my time (75.5%) and ease accessibility of the pharmacy (88.9%). Overall, (83.7%) respondents had good practices of handling and use of OTC drugs, while (56.1%) had good knowledge of OTC drugs and identification of OTC drugs. Factors associated with consumer handling and use of OTC drugs in self-medication were older participants (p=0.01), those with postsecondary education (p=0.02), and who possessed good knowledge (0.02), were more likely to practise self-medication with OTC drugs.Conclusion The study revealed a high prevalence of self-medication, good practices towards handling and use of OTC drugs, and moderate knowledge of OTC drugs by the consumers. This underscores the need for policy-makers to introduce measures to enforce consumer education by community pharmacists to minimise the risks of inappropriate self-medication with OTC drugs

Antimicrobial stewardship: community pharmacists’ antibiotic dispensing practices, knowledge, and perception regarding antibiotics and antibiotic resistance

Objectives: Antimicrobial resistance is a major global health threat, and the inappropriate use of antibiotics is a key driver of this phenomenon. Community pharmacists play a crucial role in the responsible use of antibiotics and in promoting antimicrobial stewardship. This study assessed the knowledge and perception of community pharmacists regarding antibiotics and antibiotic resistance as well as their antibiotic dispensing practices. Methods: This was a cross-sectional survey conducted among 126 community pharmacists in Ibadan, with the use of a self-administered paper questionnaire. The questionnaire contained Likert-type 8-item knowledge, 5-item perception, and 18-item dispensing practice scales. The scaled score was graded as adequate and inadequate knowledge, and good or poor dispensing practices. Data were analysed using SPSS (version 25) and results are presented using descriptive statistics. Key findings: Adequate knowledge of antibiotics and antibiotic resistance was demonstrated by 89 (70.6%) of the community pharmacists. However, 60 (47.6%) reported that antibiotics were not classified as prescription-only medications in Nigeria and that there were no regulations governing their sale and dispensing. Majority, 118 (93.7%), agreed that it is important to conduct culture and sensitivity tests before prescribing antibiotics to patients. Only 21 (16.7%) of the respondents agreed that pharmacists should always dispense antibiotics only when a prescription is presented. In all, 115 (91.3%) community pharmacists had poor antibiotic dispensing practices. Conclusion: Most of the community pharmacists possess adequate knowledge of antibiotics and antibiotic resistance; nonetheless, a significant portion of them exhibits poor antibiotic dispensing practices