Utilization of telepharmacy in the management of hypertension.

BACKGROUND: Deaths due to cardiovascular diseases is on the rise, with hypertension as its most important risk factor. Effective management of hypertension, however, remains a challenge. Globally, only one in five adults with hypertension have it under control. The situation is worse in sub-Saharan Africa where hypertension prevalence is highest. Telepharmacy presents a great opportunity to enhance the way we address hypertension management. OBJECTIVES: This study sought to determine the effectiveness of pharmaceutical care interventions implemented through telepharmacy on medication adherence, practice of therapeutic lifestyles and overall blood pressure control among patients with hypertension. METHODS: This was a randomized control trial conducted among individuals with hypertension recruited from two Ghanaian hospitals from May 2022 to December 2022. Patients with confirmed diagnosis of hypertension were recruited and assigned into a control or intervention group. Both groups were followed for six months with the intervention group receiving telepharmacy services in addition to standard clinical care. Outcome measures included changes in blood pressure, medication adherence, lifestyle modifications, identification and resolution of pharmaceutical care issues. RESULTS: One hundred and eighteen (118) patients with hypertension were involved in the study. There was a statistically significant reduction in mean blood pressures for the intervention group after six months (Systolic-148.1 + 23.6, to 134.8 + 13.7, Diastolic- 85.8 + 9.8, to 79.5 + 8.7) (p < 0.05). The proportion of patients with adequately controlled blood pressure increased from 39.0% to 66.1%. There was also an increase in the mean adherence score (p < 0.05). The number of participants who adopted lifestyle modifications such as reducing salt consumption (89.5%) and exercising (77.2%) increased. The majority (87%) of all pharmaceutical care issues were identified and resolved over the six-month period. CONCLUSION: Telepharmacy service provided via phone calls was effective in improving the control of blood pressure. It also promoted the practice of therapeutic lifestyle modifications, medication adherence and identification of pharmaceutical care issues among patients with hypertension.

Evaluation of workplace hypertension preventative and detection service in a Ghanaian University.

OBJECTIVES: This study sought to evaluate the effectiveness of a pharmacist-led hypertension screening, preventative and detection services at the workplace. METHODS: This was a prospective study conducted among staff at the Kwame Nkrumah University of Science and Technology from September 2019 to September 2020. Staff were screened for hypertension and interviewed via a structured questionnaire to gather data on their lifestyle practices and risk of hypertension. Prehypertensive individuals were educated and followed up for 6 months and all participants who had blood pressure consistently above 140/90 mmHg (hypertension) were referred to the University Hospital. KEY FINDINGS: Out of 162 participants screened, 19 (11.7%) were classified as stage 1 hypertensive, 5 (3.1%) as stage 2 hypertensive and 74 (45.7%) as prehypertensive. The commonest modifiable risk factor identified was body mass index > 25 kg/m2 (99, 61.1%) and physical inactivity (97, 59.9%). Eleven (61%) out of 18 participants referred to the physician were confirmed hypertensive and prescribed medications. After a 6 month follow-up, there was a reduction in the mean systolic and diastolic blood pressures (P < 0.05); and 47 (63.5%) out of 74 initially classified as prehypertensive had their blood pressures within the normal range. CONCLUSION: Workplace preventative and detection services can effectively lead to the identification of risk factors, promotion of lifestyle changes and detection of hypertension. Such services should be integrated into workplace systems to aid the prevention and detection of chronic conditions such as hypertension.

Disposal of leftover and expired medicines by community pharmacies and their clients in Ghana.

Improper and unsafe disposal of expired and unwanted medicines could cause harm to both people and the environment and therefore it is of public health importance. The objective of the study was to determine the methods employed by community pharmacist and their clients in the disposal of unwanted and expired medicines. Furthermore, the role of the pharmacists in the assessment of clients left over medicines was also explored. A cross sectional study design was employed with a sample of 120 pharmacy staff and 200 clients. Semi structured questionnaires were developed and administered to the two groups. Ethical approval was obtained. Data collected were analyzed using the Statistical Package for Social Sciences (SPSS v.24). Two hundred and eighty medicines were assessed from 131 respondents (65.5%) who brought their unused or left-over medicines to the pharmacy. These included analgesics 102(36.4%), antibiotics 50 (17.9%) and antacids 22 (7.9%). Disposal of expired and left-over medicines cited by respondents were the general-purpose bin 58(77.0%) and down the sink 11(14.3%). The majority 99(82.9%) of community pharmacies also disposed of solid dosage forms through the general-purpose bin. In addition, 90(75%) community pharmacies disposed of liquid waste in general purpose bin. Lack of enforcement of legislation was cited by community pharmacy staff as a barrier to the proper disposal of pharmaceutical waste. The predominant method of disposal of expired/unwanted medicines by community pharmacies and their clients was via the general-purpose bin. Implementation of interventions such as take back programmes that will enhance proper disposal of expired and left over medicines should be initiated.

Blood Pressure Control, Accessibility, and Adherence to Antihypertensive Medications: Patients Seeking Care in Two Hospitals in the Ashanti Region of Ghana.

Hypertension is the second leading cause of death in Ghana, partly accounting for two-thirds of all medical admissions and more than 50% of deaths. This study aimed to comparatively evaluate adherence and accessibility to antihypertensive medications at two different levels of healthcare facilities in Kumasi, Ghana, and determine factors associated with medicine accessibility and adherence. A cross-sectional study involving outpatient department (OPD) hypertensive patients, 143 at KNUST Hospital (UHS) and 342 at Komfo Anokye Teaching Hospital (KATH), was conducted using a semistructured questionnaire. Correlations were drawn to evaluate the effect of accessibility and adherence on blood pressure control. A face-to-face interview was also conducted with relevant stakeholders involved in procurement of medicines. Blood pressure was uncontrolled in 50.4% (n = 72) of participants at UHS and 52.9% (n = 181) at KATH. With respect to medicine accessibility, 98.8% (n = 338) and 42.9% (n = 61) received at least one medication from the hospital pharmacy of KATH and UHS, respectively. Using MARS-10, 49.2% (n = 70) and 52.9% (n = 181) were nonadherent in UHS and KATH, respectively. There was a significant association between adherence and BP control at both UHS (p=0.038) and KATH (p=0.043). At UHS, there was a significant association between accessibility to medicines at the hospital and BP control (p=0.031), whilst at KATH, no significant association was observed (p=0.198). Supply chain practices and delays in payment by the NHIA affected accessibility to antihypertensive medications. Blood pressure control was inadequate among participants in both facilities. Accessibility to medicines was better at the tertiary facility compared to the secondary facility. Increased accessibility and adherence to antihypertensives were related to blood pressure control in both facilities. Good supply chain practices and prompt payment by the National Health Insurance Authority would enhance accessibility to antihypertensive medications.

Global health research partnerships in the context of the Sustainable Development Goals (SDGs).

This themed issue on global health research has come at an opportune time in the middle of the ongoing global public health crisis arising from the coronavirus disease (COVID-19) pandemic which has claimed nearly 756,000 lives in 210 countries and territories around the world as of August 15, 2020. The public health crisis underscores the importance of global health research partnerships and collaborations to develop and evaluate the requisite health technologies to assist in containing COVID-19, other diseases, and health-related concerns that defy national borders. The 17 Sustainable Development Goals (SDGs), adopted by the member countries of the United Nations in September 2015, provide a framework for global development efforts including global health research. SDG3, which promotes health and well-being for the world populations across the age spectrum, highlights disease areas for special focus which can be adapted in specific global health research programs to serve local health needs. SDG17 promotes partnerships between high income (HIC) and low and middle-income countries (LMIC) for sustainable and equitable global development. However, given the wide disparities in fiscal and overall capacity for research between researchers in HIC and their counterparts in LMIC as well as the greater vulnerabilities of the LMIC communities when serving as research locations, a spotlight on the nature of such global health research partnerships in the context of the SDGs is desirable. This is to ensure that they are meaningful and mutually-beneficial partnerships which address local health concerns and promote long-term value for the communities involved. The objective of this commentary is, therefore, to provide a brief overview of the SDGs by way of context; explore the power differences at play when researchers from HIC are seeking research opportunities in LMIC; examine the social determinants of health and the disproportionate burden of global diseases carried by populations in LMIC to establish their vulnerability; discuss global research partnerships; and attempt to make a case for why community-based participatory research may be the preferred type of global health research partnership in the context of the SDGs.

Using community pharmacies to expand access to screening for noncommunicable diseases in suburban Ghana-A facility-based survey on client needs and acceptability.

BACKGROUND: Many of the 28 million deaths from noncommunicable diseases (NCDs) in low- and middle-income countries each year could be prevented through early detection and intervention. The introduction of screening for NCDs in community pharmacies (CPs) in Ghana could enhance access to early detection. METHODS: We surveyed clients in three districts in suburban Ghana to assess perceived need for screening, willingness to be screened in CPs, and willingness to receive NCD health promotion information through text messages (NCD m-Health). We performed regression analysis to identify predictors of NCD m-Health acceptability. RESULTS: We interviewed 330 clients in six CPs, 134 (42.3%) of whom were females. The median age was 34 years (interquartile range, 27-43). Fifty-four (16.4%) had no formal education. Although most respondents knew obesity (74.9%), smoking (81.9%), and excessive dietary salt (91.7%) were risk factors for NCDs, only 27.0% knew family history carried similar risk. Most respondents, 61.6% and 70.6%, respectively, had not had their weight and blood pressure (BP) checked for more than 12 months. These included about a third of respondents who were known hypertensives. Similarly, 71.3% of 80 participants with a family history of hypertension had not had their BPs checked. Screening for NCDs in CPs and the sending of NCD m-Health messages was deemed acceptable to 98.5% and 83.1% of the participants, respectively. Formal education beyond junior high school (Grade 9) was the strongest independent predictor of NCD m-Health acceptance (OR = 4.77; 95% CI, 1.72-13.18; P value < 0.01). One hundred and twenty-five (39.4%) participants indicated they would consider unsolicited NCD m-Health messages an invasion of their privacy. CONCLUSION: An urgent need exists to promote access to NCD screening in these communities. Its introduction into CPs is acceptable to nearly all the clients surveyed. The introduction of NCD m-Health as an accompaniment requires consideration for the privacy of clients.

Exploring the extended role of the community pharmacist in improving blood pressure control among hypertensive patients in a developing setting.

BACKGROUND: In most developing countries including Ghana, there is scant literature on the involvement of the community pharmacist in the care of patients with chronic conditions such as hypertension and blood pressure control. The objective of the study was to evaluate the effect of a pharmaceutical care model on blood pressure control and adherence among hypertensive patients. METHODS: This was a quasi experimental design and the primary outcome measure was a change in systolic and diastolic blood pressure. One hundred and eighty hypertensive patients were recruited for the study: 90 in the intervention group and 90 in the control group. The intervention, consisting of health education, adherence counselling and medicine use review; was offered monthly for six months. RESULTS: At baseline there was no significant difference in demographic and clinical characteristics between the intervention and control group. Pharmaceutical care issues identified among the intervention group during the 6 months period were non effectiveness of therapy (n = 23), experience of side effects (n = 20) and nonadherence to therapy (n = 40). The mean diastolic blood pressure difference between the intervention group and the control group was statistically significant (p = 0.001). The mean adherence difference between the two groups was also statistically significant at the end of the study. (p = 0.001). CONCLUSIONS: The pharmaceutical care intervention offered by the pharmacist led to the resolution of some pharmaceutical care issues, improvement in diastolic blood pressure and adherence among hypertensive patients. Guidelines and polices to streamline these services are needed if they are to be made available in community pharmacies in developing countries.

Evaluation of a pharmacist-led hypertension preventative and detection service in the Ghanaian community pharmacy: an exploratory study.

OBJECTIVES: The objective of the study was to explore the feasibility and acceptability of a pharmacist-led hypertension preventative service in the community pharmacy. METHODS: This was an exploratory uncontrolled pre-post intervention study conducted from February 2012 - March 2013 in three community pharmacies in Ghana. Clients at risk for hypertension were identified and screened by the Medicine Counter Assistant (MCA). Those whose blood pressure was above 140/90 (stage 1 and 2 hypertension) were referred to the pharmacist for further assessment and referral to the physician as necessary. Participant awareness of risk and changes in the lifestyle was assessed at baseline and 6-month follow-up respectively. KEY FINDINGS: Out of 250 clients approached, 170 agreed to be screened. Forty three (25%) were pre-hypertensive, 42 (25%) had stage 1 hypertension and 13 (8%) had stage 2 hypertension. The most frequent modifiable risk factors identified were lack of exercise 107 (63%), poor diet (42%) and obesity (21%). Lifestyle changes reported at 6 months by participants with pre-hypertension were weight reduction and reduced alcohol intake. Of the 34 participants who were referred to the physician, 10 (29%) were diagnosed with hypertension and an antihypertensive was prescribed. CONCLUSIONS: Hypertension preventative services offered in the Ghanaian community pharmacy are acceptable to clients. The findings suggest that pharmacists can detect hypertension and promote some lifestyle changes among clients with pre-hypertension. A larger controlled study is needed to confirm these findings. Ultimately guidelines and polices to streamline these services would be needed if such services were made routinely available in community pharmacies in Ghana.

A psychosocial perspective of medication side effects, experiences, coping approaches and implications for adherence in hypertension management.

INTRODUCTION: This study examined whether psychosocial variables influenced patients' perception and experience of side effects of their medicines, how they coped with these experiences and the impact on medication adherence behaviour. METHODS: A hospital-based mixed methods study using quantitative and qualitative approaches was conducted with hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms and coping mechanisms with the aid of standard questionnaires and an interview guide. RESULTS: The experiences of side effects-such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion-were categorized as no/low (39.75 %), moderate (53.0 %) and high (7.25 %). Significant relationships between depression (x (2) = 24.21, p < 0.0001), anxiety (x (2) = 42.33, p < 0.0001), stress (x (2) = 39.73, p < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association is reported-depression [OR = 1.9 (1.03-3.57), p = 0.04], anxiety [OR = 1.5 (1.22-1.77), p ≤ 0.001] and stress [OR = 1.3 (1.02-1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95 % CI 1.07-1.85), p = 0.04] with social factors, media influences and attitudes of primary care givers further explaining this relationship. Personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments and interventions made by clinicians were the main forms of coping with side effects. DISCUSSION: Results from this study show that, in addition to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The results offer more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care.

Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence.

BACKGROUND: Patients with chronic conditions like hypertension may experience many negative emotions which increase their risk for the development of mental health disorders particularly anxiety and depression. For Ghanaian patients with hypertension, the interaction between hypertension and symptoms of anxiety, depression and stress remains largely unexplored. To fill this knowledge gap, the study sought to ascertain the prevalence and role of these negative emotions on anti-hypertensive medication adherence while taking into account patients' belief systems. METHODS: The hospital-based cross-sectional study involving 400 hypertensive patients was conducted in two tertiary hospitals in Ghana. Data were gathered on patient's socio-demographic characteristics, anxiety, depression and stress symptoms, spiritual beliefs, and medication adherence. RESULTS: Hypertensive patients experienced symptoms of anxiety (56%), stress (20%) and depression (4%). As a coping mechanism, a significant relation was observed between spiritual beliefs and anxiety (x (2) = 13.352, p = 0.010), depression (x (2) = 6.205, p = 0.045) and stress (x (2) = 14.833, p = 0.001). Stress among patients increased their likelihood of medication non-adherence [odds ratio (OR) = 2.42 (95% CI 1.06 - 5.5), p = 0.035]. CONCLUSION: The study has demonstrated the need for clinicians to pay attention to negative emotions and their role in medication non-adherence. The recommendation is that attention should be directed toward the use of spirituality as a possible mechanism by which negative emotions could be managed among hypertensive patients.

Locus of control and anti-hypertensive medication adherence in Ghana.

INTRODUCTION: Medication non-adherence is a major public health problem in Ghana. Locus of control (LoC) may influence adherence to medication. In this study we examine the association between locus orientation and adherence to hypertensive medication among adult patients. We also take into account the role of medication side effects. METHODS: We conducted a hospital-based cross-sectional study involving two tertiary hospitals in southern and northern Ghana. Data were collected from 400 hypertensive patients using a structured questionnaire. We gathered information on patient's sociodemographic characteristics, health LoC, side effects of anti-hypertensive medication and adherence to anti-hypertensive medication. RESULTS: Participants exhibited features of mixed LoC (both internal and external) usually referred to as bi-local expectancy. However, orientation was skewed towards external LoC. Females were marginally more likely than males to have an internal LoC. Education was associated with a greater likelihood of internal LoC. While most patients (93.3%) poorly adhered to antihypertensive medications, logistic regression model revealed that non-adherence was significantly associated with low internal LoC, medication side effects and the combined effect of medication side effects and external LoC. CONCLUSION: Medication non-adherence, experiences of medication side effects and LoC are associated. Multifaceted intervention programmes highlighting personality characteristics like LoC may improve anti-hypertensive medication adherence.

Patterns and determinants of the use of complementary and alternative medicine: a cross-sectional study of hypertensive patients in Ghana.

BACKGROUND: The use of complementary and alternative medicine (CAM) is widespread and high utilization rates are associated with people who have chronic conditions like hypertension which management requires adherence to conventional treatment. Often however, the use of alternative medicines has been linked to negative health outcomes. The purpose of the study therefore was to evaluate the pattern, determinants and the association between CAM use and the adherence behaviour of hypertensive patients in Ghana. METHODS: A cross-sectional study was conducted using 400 hypertensive patients attending Korle-bu and Komfo Anokye Teaching Hospitals in Ghana from May to July, 2012. Information was gathered on the socio-demographic characteristics of patients, CAM use, and adherence using the 8-item Morisky Medication Adherence Scale (MMAS). RESULTS: Out of the 400 study participants, 78 (19.5%) reported using CAM with the majority (65.38%) utilizing biological based therapies. About 70% of CAM users had not disclosed their CAM use to their healthcare professionals citing fear and the lack of inquiry by these health professionals as the main reasons for non-disclosure. Males were 2.86 more likely to use CAM than females [odds ratio (OR) = 2.86 (95% CI 1.48-5.52), p = 0.002]. Participants who could not afford their medications had 3.85 times likelihood of CAM use than those who could afford their medicines [OR = 3.85 (1.15-12.5), p = 0.029]. In addition, a significant relationship between CAM use and experiences of anti-hypertensive side effects was observed, X2 = 25.378, p < 0.0001. CAM users were 2.22 times more likely to be non-adherent than participants who did not use CAM [OR = 2.22 (0.70-7.14), p = 0.176]. CONCLUSION: Hypertensive patients in Ghana have shown utilization for CAM. It is important that healthcare providers understand the patterns and determinants of CAM use among their patients. Intervention programmes can then be incorporated to enhance the desired health outcomes of patients.

Patient knowledge of medicines dispensed from Ghanaian community pharmacies.

BACKGROUND: One vital requirement for patient adherence to medicines is good patient knowledge of the medicines dispensed and this will invariably be linked to good labelling and counselling. OBJECTIVE: The aim of this study was to evaluate the quality of labelling of medicines and determine patient knowledge of the administration of medicines dispensed from a community pharmacy in Ghana. METHODS: From 6th to 29th January, 2010, dispensed prescriptions of 280 clients were purposely sampled to evaluate the quality of labelling. These clients were also interviewed about their knowledge of the last medicine received immediately after dispensing. A scoring system was employed by awarding a point for each attribute written on the package and each attribute stated by the patient. The dispensing attributes noted were name, dosage, frequency, duration, quantity and route of administration. RESULTS: Of the 280 patients interviewed, 157 (56%) were males. Thirty one (11%) had no education and 99(35%) were secondary school graduates. Antimalarials comprised 17.9% and analgesics, 15.4% of medicines dispensed. The name, quantity, dosage, frequency, duration of therapy and route of administration were written on the label in 98%, 99%, 55%, 54%, 6% and 2% respectively of the dispensed medicines. The mean labelling score was 3.096 (SD=1.05) out of 6. The corresponding patient knowledge values were 63%, 80%, 80%, 75%, 57% and 86%. The mean knowledge score was 4.375 (SD; 1.38) out of 6. The chi square test p-value for the effect of demographic characteristics (sex, educational background, location) on patient knowledge of medicines dispensed were p=0.454; p=0.000, and p=0.138 respectively. CONCLUSIONS: Patient knowledge of the administration of dispensed medicines was rated good; and this largely corresponded with the quality of labelling, except that the duration of therapy and route of administration was not frequently written and so labelling was rated just above average.

Spiritual and religious beliefs: do they matter in the medication adherence behaviour of hypertensive patients?

BACKGROUND: Medication non-adherence is often a predominant problem in the management of hypertension and other chronic conditions. In explaining health behaviours, social determinants like spirituality and religiosity are increasingly identified to impact health and treatment. Although a number of researchers have found spirituality and religiosity to be primary resources among persons dealing with chronic disability and illness, studies relating this specifically to medication adherence have been limited. METHODS: Our study sought to examine the interrelationship between spirituality/ religiosity and medication adherence among 400 hypertensive patients 18 years old and above. Spiritual Perspective Scale, Duke Religion Index, and the Morisky Medication Adherence Scale were used to determine spirituality, religiosity and medication adherence respectively. RESULTS: The majority (93.25%) of patients poorly adhered to their medications. While high spiritual and religious beliefs formed core components of the lifestyles of patients, spirituality (p = 0.018) and not religiosity (p = 0.474) related directly with medication non-adherence. Likewise, after controlling for demography and other medical co-morbidities, patients with high spirituality were 2.68 times more likely to be poorly adherent than patients who place lower emphasis on the association between spirituality and health. CONCLUSION: Our study suggests that while spirituality/ religiosity was dominant among hypertensive patients, these spiritual attachments of patients with a supreme being potentially increased their trust in the expectation of divine healing instead of adhering adequately with their anti-hypertensive medications.

Patient knowledge of medicines dispensed from Ghanaian community pharmacies / Conocimiento de los pacientes sobre medicamentos dispensados en las farmacias comunitarias de Ghana

Background: One vital requirement for patient adherence to medicines is good patient knowledge of the medicines dispensed and this will invariably be linked to good labelling and counselling. Objective: The aim of this study was to evaluate the quality of labelling of medicines and determine patient knowledge of the administration of medicines dispensed from a community pharmacy in Ghana. Methods: From 6th to 29th January, 2010, dispensed prescriptions of 280 clients were purposely sampled to evaluate the quality of labelling. These clients were also interviewed about their knowledge of the last medicine received immediately after dispensing. A scoring system was employed by awarding a point for each attribute written on the package and each attribute stated by the patient. The dispensing attributes noted were name, dosage, frequency, duration, quantity and route of administration. Results: Of the 280 patients interviewed, 157 (56%) were males. Thirty one (11%) had no education and 99(35%) were secondary school graduates. Antimalarials comprised 17.9% and analgesics, 15.4% of medicines dispensed. The name, quantity, dosage, frequency, duration of therapy and route of administration were written on the label in 98%, 99%, 55%, 54%, 6% and 2% respectively of the dispensed medicines. The mean labelling score was 3.096 (SD=1.05) out of 6. The corresponding patient knowledge values were 63%, 80%, 80%, 75%, 57% and 86%. The mean knowledge score was 4.375 (SD; 1.38) out of 6. The chi square test p-value for the effect of demographic characteristics (sex, educational background, location) on patient knowledge of medicines dispensed were p=0.454; p=0.000, and p=0.138 respectively Conclusion: Patient knowledge of the administration of dispensed medicines was rated good; and this largely corresponded with the quality of labelling, except that the duration of therapy and route of administration was not frequently written and so labelling was rated just above average (AU)

Antecedentes: Un requisito básico pata la adherencia del paciente a la medicación es el buen conocimiento de los medicamentos dispensados, lo que estará invariablemente ligado a un buen etiquetado y asesoramiento. Objetivo: El objetivo de este estudio fue evaluar la calidad del etiquetado de los medicamentos y determinar el conocimiento de los pacientes sobre la administración de os medicamentos dispensados en farmacia comunitaria en Ghana. Métodos: Para evaluar la calidad del etiquetado, entre 6 y 29 de enero de 2010, se muestrearon propositivamente los medicamentos dispensados. También se entrevistó a estos clientes sobre su conocimiento de la última medicina recibida en la dispensación. Se utilizó un sistema de puntuación que asignaba un punto a cada atributo que aparecía escrito en el embalaje y a cada atributo respondido por el paciente. Estos atributos eran; nombre, dosis, frecuencia, duración, cantidad y vía de administración. esultados: De los 280 pacientes entrevistados, 157 (56%) eran hombres. 31 (11%) no tenía educación y 99 (35%) eran graduados en escuela secundaria. Los antimaláricos supusieron el 17,9% de las medicinas dispensadas y los analgésicos el 15,4%. El nombre, cantidad, dosis, frecuencia, duración del tratamiento y vía de administración estaban escritos en el 98%, 99%, 55%, 54%, 6% y 2% de los medicamentos dispensados. La media de la puntuación del etiquetado fue de 3,096 (SD=1.05) sobre 6. Los valores equivalentes del conocimiento de los pacientes fueron 63%, 80%, 80%, 75%, 57% y 86%. La puntuación promedio del conocimiento fue de 4,375 (SD=1,38) sobre 6. El valor de los p en la prueba chi-cuadrado para el efecto de las características demográficas (sexo, educación, localidad) sobre el conocimiento del paciente fueron p=0.454; p=0.000, and p=0.138 respectivamente. Conclusión: El conocimiento de los pacientes sobre los medicamentos dispensados fue calificado de bueno, y se corresponde con la calidad del etiquetado, excepto para la duración del tratamiento y vía de administración, que no estaban escritas normalmente, lo que provocó que el etiquetado fuese calificado solo como sobre la media (AU)

The contribution of Ghanaian pharmacists to mental healthcare: current practice and barriers.

BACKGROUND: There is scant knowledge of the involvement of developing country pharmacists in mental healthcare. The objectives of this study were: to examine the existing role of Ghanaian community and hospital pharmacists in the management of mental illness, and to determine the barriers that hinder pharmacists' involvement in mental healthcare in Ghana. METHOD: A respondent self-completion questionnaire was randomly distributed to 120 superintendent community pharmacists out of an estimated 240 pharmacists in Kumasi, Ashanti Region of Ghana. A purposive sampling method was utilized in selecting two public psychiatric hospital pharmacists in Accra, the capital city of Ghana for a face-to-face interview. A semi-structured interview guide was employed. RESULTS: A 91.7% response rate was obtained for the community pharmacists' questionnaire survey. Approximately 65% of community pharmacists were not involved in mental health provision. Of the 35% who were, 57% counseled psychiatric patients and 44% of these dispensed medicines for mental illness. Perceived barriers that hindered community pharmacists' involvement in the management of mental health included inadequate education in mental health (cited by 81% of respondents) and a low level of encounter with patients (72%). The psychiatric hospital pharmacists were mostly involved in the dispensing of medicines from the hospital pharmacy. CONCLUSION: Both community and hospital pharmacists in Ghana were marginally involved in the provision of mental healthcare. The greatest barrier cited was inadequate knowledge in mental health.

Ghanaian pharmacists' perception of people living with HIV and AIDS (PLWHIV).

To determine Ghanaian pharmacists' perception of persons living with HIV (PLWHIV), pharmacists and other health care personnel in Ghana completed self-administered questionnaires in 3 separate studies from November 2003 to January 2005. Two of the studies (studies 2 and 3) incorporated 4 simple questions that are generally administered to determine, hypothetically, the degree of discrimination against PLWHIV. Responses to these questions were also analyzed in the 2003 Ghana Demographic and Health Survey (GDHS). A nondiscriminatory response to all the indicators reflected an accepting attitude, and a discriminatory response, in at least one indicator, reflected a negative attitude. In study 1, 35% of pharmacists indicated an accepting attitude toward PLWHIV. In study 2, only 17% of the pharmacists sampled indicated an accepting attitude toward PLWHIV. In study 3, none of the 10 pharmacists sampled indicated an accepting attitude toward PLWHIV. However, 19% of the totality of health workers did so. Compared to Ghanaians of similar socioeconomic backgrounds, pharmacists tended to report a more perceived discriminatory attitude toward PLWHIV.

Addressing the workforce crisis: the professional aspirations of pharmacy students in Ghana.

OBJECTIVE: A lack of skilled health professionals, and net migration from developing to more developed countries, are widely recognised as barriers to the delivery of effective health care. However, few studies have investigated this issue from the perspective of pharmacists, although they are increasingly viewed as a potentially valuable and underexploited health care resource. The objectives of this study were to examine the professional aspirations and perceived opportunities of final year pharmacy students in a developing country; and consider what developments may encourage them to remain in, and contribute to, health care in their home country. METHOD: Final year pharmacy students from the Faculty of Pharmacy, KNUST, Kumasi, Ghana, were randomly selected and invited to participate in in-depth interviews. These were audio-recorded (with permission of respondents) and transcribed verbatim to enable a qualitative analysis. MAIN OUTCOME MEASURE: professional aspirations, and perceived opportunities and barriers to their achievement in Ghana and abroad. Results Participants viewed themselves, and wished to be viewed by others, as health professionals. They described a commitment to applying their clinical knowledge and to education beyond their first degree. However, they identified significant barriers to the achievement of professional aspirations in Ghana, which would diminish their opportunities to contribute to health care. Whilst most students expressed the expectation or desire to travel at some point, usually early, in their career, they all demonstrated a commitment to their country and stated a wish to return. CONCLUSION: Overall the study highlighted prospective pharmacists in Ghana as ambitious, committed potential health professionals. The study indicates that a lack of attention by policy makers and professional bodies to ways of exploiting the contribution of pharmacists to public health, may represent a lost potential human resource for health in developing countries.