ABSTRACT
Aims: To explore the pattern of unmet medicine information needs of hypertensive patients on long term therapy and their attitude to use of SMS (mobile phone short message service) for medicine information exchange with hospital pharmacists. Sample: 117 hypertensive patients on long term therapy who had been accessing care for at least one year. Study Design: An exploratory medicine information exchange programme followed by a cross-sectional survey. Place and Duration of Study: Outpatient Clinic of Department of Cardiology at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between October, 2010and May, 2011. Methods: Patients were prompted with SMS twice weekly for 5-8 months for use of their medication with advice to send their medicine information needs to the hospital pharmacist. Received messages were subjected to content analysis to identify their themes. A semi-structured questionnaire was used to explore patient attitude to the use of SMS. The 17-item questionnaire was designed on a 5-point Likert scale for responses with weights of 0-4. Data obtained were analysed using both descriptive and inferential statistics. These include frequencies and mean of weighted averages (MWA); tests of relationships, associations and of differences in means. Results: A total of 63 SMS texts were received from the respondents and 44% of the messages expressed medicine information needs. Majority of the enquiries were related to indications and adverse effects. The patients’ attitude to the use of SMS for medicine information exchange with pharmacists was generally positive (MWA=3.13) with no significant demographic effects. Some (46%) of the patients called for institutionalisation of the medicine information exchange programme. Conclusion: The unmet medicine information needs of chronic hypertensive patients in the study were related mainly to indications and side effects of prescribed and nonprescribed medications and the patients clamoured for use of SMS in redressing the anomaly.
ABSTRACT
Aims: Misuse of antimicrobial medicines is a major contributory factor to development of resistant strains of micro-organisms, therapeutic failure and increased healthcare costs in many countries. To identify pattern of antimicrobial use among undergraduate students of the University of Sierra Leone and to determine possible gaps in their understanding of appropriate use of these therapeutic agents. Study Design: A cross-sectional survey of the students using a structured questionnaire and a stratified random sampling method to obtain the respective number of students from each college. Place and Duration of Study: Registered undergraduates in the three Colleges of the University of Sierra Leone, between March and June 2012. Methodology: A 25-item structured questionnaire was administered on a random sample of four hundred and eighteen (418) undergraduates of the University. The instrument explored respondents’ pattern of self-medication with antimicrobials, knowledge of the indications for use and sources of supply. Results: Most students reported having self-medicated with antimicrobials at various times and there were gaps in their understanding of the medicines; with about 67% having some knowledge of correct indications for use. Majority of them (70%) obtained the medicines on demand from open drug markets without prescriptions and the medicines were used for such ailments as common colds and diarrhea. Previous experiences of treating similar symptoms ranked highest as the factor affecting demand and penicillins topped the list of commonly used antimicrobials. Most of the students did not complete full regimen of the medication for reasons of cost, long duration of treatment and side effects. Conclusion: There were knowledge gaps in the proper use of antimicrobial medicines and unrestricted access to prescription drugs was a major factor of misuse. The existing drug laws in the country should be strengthened to control indiscriminate sale and distribution. Basic courses on rational medicine use may need to be incorporated in the general studies programme of the University; with emphasis on the consequences of indiscriminate use of antimicrobial medicines.
ABSTRACT
Background: Chronic kidney disease (CKD) is a global public health problem, with a greater burden and prohibitive cost of care particularly in developing countries. This study determined the prevalence of chronic kidney disease and identified its associated risk factors in patients attending the Family Practice Clinic, Wesley Guild Hospital, Ilesa, Nigeria. Method: Consecutive newly-registered patients who attended the Family Practice Clinic of Wesley Guild Hospital, Ilesa from August 2005 to January 2006 were recruited and studied. Relevant data were collected by using an interviewer-administered questionnaire, and determining the spot urinary ACR (albumin-creatinine ratio) of the subjects by using Microalbustix⢠reagent strips and using their serum creatinine concentration. The glomerular filtration rate (GFR) of each subject was estimated using the Modification of Diet in Renal Disease (MDRD) formula. A repeat urine test was done three months after the initial screening to identify subjects with persistent microalbuminuria. Results: The age of the study subjects ranged from 20 to 74 years, with a mean age of 50.52 + 13.03 years. There were 68 males and 182 females in the sample population, showing a male to female ratio of 1:2.7. One hundred and thirteen of the 250 subjects (45.2%) were found to have pathologic albuminuria at the initial screening, while 31 (12.4%) had persistent albuminuria three months later. Also, 51 subjects (20.4%) had estimated low GFR at the initial screening and 26 (10.4%) had persistent low GFR three months later. Significant risk factors for CKD in the study subjects were increasing age, elevated blood pressure, history of diabetes mellitus (DM), habitual intake of analgesics and herbs, and an abnormal waist to hip ratio(p < 0.05). The association between persistent abnormal ACR and low GFR did not reach statistical significance (p = 0.053). Habitual analgesic intake (p = 0.002) and age group (p = 0.0027) were true predictors of CKD among the study subjects. Conclusions: The prevalence of CKD in the study population was high and its association with modifiable risk factors was demonstrated. Family physicians have a unique opportunity to identify and address these factors in their patients. Routine screening for CKD in family practice clinics is indicated to reduce the burden of renal disease in the population