Comparative assessment of medication knowledge among ambulatory patients: A cross-sectional study in Nigeria.

Background: Patient knowledge on medication is considered a critical aspect of medication self-management by the patient. Medication education and counseling is an important component of pharmaceutical care services. Objective: This study was aimed at evaluating the impact of medication education and counseling services offered to ambulatory patients receiving care in a typical Nigerian healthcare setting on the patients' knowledge of their medication. Methods: A cross sectional prospective study conducted at the outpatient pharmacy unit of University of Uyo Teaching Hospital, Nigeria. The patient population was divided into two arms: those who were yet to receive medication education/counseling - Arm 1, and those who had received medication education/counseling from the clinical pharmacist - Arm 2. A patient medication knowledge assessment questionnaire was used to assess patients' knowledge of their prescribed medication. Data obtained were analyzed using the IBM SPSS computer package version 25.0. Results: Three hundred and ninety-one outpatients (196 in Arm-1 and 195 in Arm-2) participated in the study. There was a statistically significant difference in the mean medication knowledge score between patients in Arm-1 and those in Arm-2. Patients in Arm-2 had a statistically significant higher mean medication knowledge score than those in Arm-1 (5.228 versus 3.191; t = 10.152; P = 0.000). Conclusion: Outpatients who received medication education and counseling from clinical pharmacists had better knowledge of their prescribed medications than those who were yet to receive this pharmaceutical intervention.

Improving antiepileptic drug tolerability among patients living with epilepsy: the impact of pharmaceutical care services.

Therapeutic management of epilepsy is usually long term; thus, patient tolerability of prescribed antiepileptic drugs should be a major consideration as it affects compliance to therapy. The aim of this study was to determine the impact of pharmaceutical care services on antiepileptic drug tolerability among patients living with epilepsy. This study was an open, randomized, controlled, longitudinal and two-arm parallel prospective study with a 6-month patient follow-up period. Patients were recruited from the neurology and medical out-patient clinics of two selected epilepsy referral centres. Recruited patients were randomized into one of the two study groups: pharmaceutical care (PC) or usual care (UC) groups. Patients in the UC group received the usual care provided in the hospitals, while patients in the PC group received PC services in addition to the usual care provided in the hospitals. The impact of PC on patient tolerability of antiepileptic drugs was evaluated using a patient judged antiepileptic drug tolerabiltity scale. The evaluation was done at baseline (pre-intervention), 3 months and 6 months post-intervention. Patients in the PC group had a significantly lower antiepileptic drug tolerability score than those of the UC group at 3 months and 6 months - (Pre-intervention: 0.97 versus 1.13; t = -1.081; p = 0.281), (3 months: 1.13 versus 0.71; t = 3.084; p = 0.001), (6 months: 1.00 versus 0.60; t = 3.083; p = 0.001), indicating a significant improvement in the tolerability of antiepileptic drugs among those in the PC group over time. Pharmaceutical care interventions that included education and counseling services significantly improved tolerability of antiepileptic drugs among patients living with epilepsy.

Patients' perceived quality of the care provided during the management of HIV/AIDS in a tertiary care setting in Nigeria.

Background: The provision of patient-centred care by clinicians is believed to improve patient satisfaction with care as well as the outcome of treatment. Objective: To assess the quality of personalized care provided to people living with HIV/AIDS in a typical Nigerian health care setting and its association with patients' knowledge and attitude towards HIV/AIDS and patients' knowledge and attitude towards antiretroviral therapy. Methods: The study was a cross sectional study carried out in the HIV/AIDS clinic of the University of Uyo Teaching Hospital, Nigeria. Data on the demographic and clinical details of the patients were obtained from patients' case notes using a suitably designed, pre-piloted data collection instrument. Furthermore, data on the quality of patient-centred care, patients' knowledge and attitude towards HIV/AIDS, and patients' knowledge and attitude towards antiretroviral therapy was obtained using 'Patient Assessment of Quality of Individualized care for Chronic Illness Scale', 'Patient knowledge and attitude towards HIV/AIDS questionnaire; and 'Patient knowledge and attitude towards antiretroviral therapy questionnaire', respectively.Quantitative data were analysed using Statistical Program and Service Solutions (SPSS) version 25.0 computer package. Descriptive statistics were used to summarize data, while inferential statistics were used where applicable with statistical significance set at p<0.05. Results: The overall mean patients' satisfaction with individualized care score was 3.54 (SD = ±0.86; Max. = 5). The mean scores of the patients' knowledge and attitude towards HIV/AIDS were 6.80 (SD = ± 1.079; Max. = 8) and 5.5 (SD = ± 0.924; Max. = 7) respectively, while the mean scores of the patients' knowledge and attitude toward antiretroviral therapy were 5.7 (SD = ± 1.103; Max. = 10) and 4.2 (SD = ± 0.874; Max. = 6). Multivariate linear regression revealed that the quality of patient centred care was a predictor of knowledge and attitude towards antiretroviral therapy (B=0.511; CI = 95%, p = 0.024). Conclusion: The quality of patient-centred care provided to persons living with HIV/AIDS in the facility is satisfactory. Patients perceived quality of care appear to be a predictor of knowledge and attitude towards antiretroviral therapy.

Evaluating the impact of pharmaceutical care services on the clinical outcomes of epilepsy: a randomised controlled trial.

BACKGROUND: The involvement of pharmacists in the provision of specialised care to patients with epilepsy is poor. OBJECTIVE: To evaluate the impact of pharmaceutical care services on the clinical outcomes of epilepsy. SETTING: Two selected major referral epilepsy treatment centres in southern Nigeria were used for the study. Patients were recruited from the Neurology and Medical out-patient clinics of the hospitals. METHOD: An open randomised controlled study was carried out on epilepsy patients receiving clinical care at the selected hospitals. Patients in the intervention group were offered pharmaceutical care services. The impact of the pharmaceutical care services on the clinical outcomes of epilepsy (seizure frequency and severity) was evaluated. MAIN OUTCOME MEASURE: The effect of pharmaceutical care services on seizure frequency and severity in patients with epilepsy. RESULTS: There was a statistically significant difference between the usual care (UC) and the pharmaceutical care (PC) group on the clinical outcomes of epilepsy post-PC intervention. Comparison between the groups (UC versus PC) revealed that patients in the PC group had a significantly lower seizure frequency score than those in the UC group at 3 months and 6 months-(pre-intervention: 3.09 versus 3.34; t = -1.685; p = 0.094) (3 months 2.45 versus 1.68; t = 4.494; p = 0.001), (6 months: 1.97 versus 0.92; t = -3.137; p = 0.001). Also, comparisons between the groups (UC versus PC) showed that patients in the PC group had a significantly lower seizure severity score than those in the UC group at 3 months and 6 months-(pre-intervention 18.46 versus 20.38; t = -3.102; p = 0.01) (3 months: 17.51 versus 14.79; t = 4.202; p = 0.001) (6 months 16.41 versus 11.66; t = 8.930; p = 0.001). CONCLUSION: Pharmaceutical care interventions may significantly reduce seizure frequency and severity in patients with epilepsy. IMPACT OF FINDINGS ON PRACTICE: These findings provide justification for the integration of pharmaceutical care services with other elements of health care for epilepsy patients.

Impact of a pharmacist-led education and counseling interventions on quality of life in epilepsy: A randomized controlled trial.

BACKGROUND: The impact of epilepsy on the quality of life of the patient can be considerably high with far-reaching and life-long consequences. The goal of patient counseling and education is to achieve positive clinical outcomes and optimize the patient's health-related quality of life. OBJECTIVE: To evaluate the impact of a pharmacist-led education and counselling interventions on the health-related quality of life of patients living with epilepsy. METHODS: A randomized controlled trial was carried out on epilepsy patients attending the neurology/medical out-patient clinics of two tertiary hospitals. Patients in the intervention group were offered education and counselling services. The impact of the interventions on the patients' quality of life in epilepsy was evaluated using the QOLIE-10P questionnaire. The research protocol was approved by the Health Research Ethics Committees of the University of Uyo Teaching Hospital and University of Calabar Teaching Hospital (Reference numbers: UUTH/AD/S/96/VOL.XIV/571 & UCTH/HREC/33/454). RESULTS: There was a statistically significant difference between the usual care (UC) and the pharmaceutical care (PC) group on the quality of life in epilepsy scores post-intervention. Comparisons between groups (UC versus PC) revealed that patients in the PC group had a significantly higher QOLIE score than those in the UC group at 3 months and 6 months - (Pre-intervention: 8.73 versus 7.91; t = 0.619; p = 0.537), (3 months: 9.74 versus 15.37; t = -3.34; p = 0.01), (6 months: 11.59 versus 17.01; t = -3.137; p = 0.01). CONCLUSION: Pharmacist-led education and counselling interventions may significantly improve the quality of life of patients with epilepsy.

Infrequent Monitoring of the Effects of Valproate and Carbamazepine Therapy in Patients With Epilepsy in Nigeria.

BACKGROUND: Carbamazepine and valproate are widely used in the treatment of epileptic seizures. However, these agents exhibit certain adverse effects including hematopoietic disorders (carbamazepine) and severe hepatotoxicity (valproate). PURPOSE: To determine the extent of monitoring of the hematologic effects of carbamazepine as well as the extent of monitoring of the hepatic effects of valproate in patients with epilepsy receiving treatment with these agents. METHOD: A cross-sectional antiepileptic drug use study using case notes of patients with epilepsy managed at the neurologic clinics of 2 tertiary medical facilities in Nigeria between January and December 2017. RESULTS: Carbamazepine was the most frequently prescribed antiepileptic drug (48.24%), followed by valproate (29.34%) and levetiracetam (9.24%). Pretreatment monitoring of hematologic effect was carried out in only 61.11% of patients placed on carbamazepine therapy while follow-up monitoring was done in 3.7% of these patients. Also, in patients placed on valproate therapy, pretreatment and follow-up monitoring of the hepatic effect was done in only 33.71% and 19.0% of the patients, respectively. CONCLUSIONS: The extent of monitoring of the hematologic effects of carbamazepine, as well as the hepatic effects of valproate in the cohort studied, is poor.