Knowledge, Perception and Practice of Medication Use Review among Community Pharmacists in Southwestern Nigeria

Background: Medication use review (MUR) is an emerging concept in medicine management that has recorded success in many developed countries.Purpose: To evaluate knowledge, perception and practice of MUR among community pharmacists (CP) in southwestern Nigeria.Method: A cross-sectional study was carried out among 100 CP recruited from Oyo and Osun states between January and March, 2015, using a pre-tested questionnaire. Demographic information and CP's knowledge, perception and current practice of MUR were evaluated using open-ended, closed-ended and Likert-scale questions. Respondents' scores for 6-item knowledge test questions and description of specific component of MUR services were categorised as score>3 (good knowledge) and score≤3 (poor knowledge). Descriptive statistics were used to summarize data. Ranked variables were evaluated using Kruskal-Wallis test at p<0.05.Results: Fifty-nine (59.0%) CP from Oyo and 41(41.0%) from Osun state participated. Sixty-five (70.7%) had score>3 indicating "good" knowledge of MUR, while 27 (29.3%) had score≤3 suggesting "poor" knowledge. Forty-two (42.0%) claimed to provide MUR service; of this, 14 (33.3%) had scores>3 indicating those who gave correct description of specific component of MUR. Lack of adequate time for counselling (49; 49.5%) and lack of specialized training for pharmacists (45;45.5%) were cited as barriers to MUR practice. Majority (51; 51.5%) agreed that MUR service should be incorporated into community pharmacy practice.Conclusion: Knowledge of MUR concept among community pharmacists in Oyo and Osun states is considerable, but description of specific component of MUR services by respondents was poor. There is therefore a need for continuous training on emerging concepts among pharmacists, so as to stimulate interest in patient-oriented service

An Overview of Pharmacotherapy-Induced Ototoxicity

This article provides an overview of ototoxic medication; as well as different pharmacological and audiological monitoring strategies. Although ototoxic medications play an important role in modern medicine; they also have the capacity to do great harm and lead to significant morbidity. Physicians have to be aware of the potential effects of medication in order to identify patients who are at increased risk of developing ototoxicity. Precaution should be taken to prevent any auditory impairment that might occur through appropriate administration and monitoring. Although some otoprotective substances have been used successfully in certain studies; further trials must be performed to assess their clinical utility. The clinical pharmacist and audiologist form an important part of the ototoxicity management healthcare team

Focus Group Discussion with Private Sector Doctors in the eThekwini Metro of KwaZulu-Natal on the Management of HIV/AIDS Patients

Background: Highly active antiretroviral treatment (HAART) is essential in the treatment of HIV/AIDS; however; a holistic approach to HIV/AIDS management is important. This study was done to confirm the findings of two studies done previously in the eThekwini Metro of KwaZulu-Natal on private sector doctors' management of HIV-infected patients and to obtain morein in depth information about their nonpharmacological management of HIV-infected patients. Methods: Two focus group discussions were conducted amongst private sector doctors in the eThekwini Metro; after obtaining their consent. The focus group sessions were scripted; audio-taped and transcribed verbatim. Prevalent themes were identified and reported. Results: Eight doctors participated. Of the total patient population seen annually by the majority of the doctors; an average of 43.8 was HIV infected. Doctors in this study managed their patients both pharmacologically and nonpharmacologically. Seventy-five per cent of doctors indicated that the taste of medicine played an important role in nonadherence to treatment; but all agreed that cultural beliefs also influenced the patient's adherence to medication. Theft of medicines and the outof-stock situation prevented antiretroviral drug access; which impacted negatively on adherence. Five doctors mentioned that depressed patients abused alcohol; resulting in nonadherence. One doctor reported that he used the biopsychosocial approach to improve adherence in his patients. Doctors indicated that the disability grant given by the South African Government caused patients not to adhere to treatment in order to maintain a CD4 count of 200 or less so as to qualify for the grant. Conclusions: The study confirmed the previous study findings in that it showed that private sector doctors manage their HIV-infected patients both pharmacologically and nonpharmacologically. It further provided new and interesting information with regard to the nonpharmacological methods employed in HIV/AIDS management; that is the incorporation of cultural beliefs in the management of HIV-infected patients to improve adherence to treatment; and the role of the disability grant and pharmaceutical formulations in contributing to nonadherence by HIV-infected patients

Management of asthma in sub-Saharan Africa: the Nigerian perspective

Asthma is a very common respiratory disorder with rising prevalence rates worldwide. The advances in our understanding of its pathogenesis and introduction of new medications in its management have not been of much benefit to most patients in Africa. This is due to various complex and interrelated reasons such as lack of proven diagnostic and monitoring facilities; inadequate knowledge of current management of asthma by doctors; poor compliance by patients; use of traditional medicines of unproven efficacy; fake/ substandard drugs; and lack of locally designed guidelines based on local resources. The solutions to these problems require the full participation of all. Governments need to provide the appropriate environment for the care-givers and patients; on the other hand the care-givers need to update themselves on the current management of asthma; while the patients need to take the treatment of their illness seriously and also develop a strong management partnership with their care-givers