Cross-sectional survey data on the socio-demographic characteristics associated with substance use among internal displaced persons in Maiduguri, Nigeria.

Regression analysis was carried out to examine the association between certain socio-demographic characteristics and substance use among internally displaced persons (IDPs). Using an adapted version of the Drug Use Disorder Identification Test (DUDIT) instrument, cross-sectional survey data were obtained from 520 IDPs living in three camps located in Maiduguri, Borno state of Nigeria. The data were analyzed using Statistical Package for Social Sciences software version 21.0. Specifically, this article provides data about the participants' demographic characteristics, the types of substances they use, reasons for using such substances, and the prevalence of substance use. This dataset can offer valuable multivariate information for future research agendas in similar, or closely related study populations. This cross-sectional dataset is also valuable for policymakers who are seeking ways to intervene in the substance use problem, as well as other associated social vices, affecting the vulnerable population of IDPs.

Student's perspectives, satisfaction and experiences with online and classroom learning during the COVID-19 pandemic: Findings and implications on blended learning.

Objectives: The coronavirus disease 2019 (COVID-19) pandemic disrupted classroom-based learning, necessitating the adoption of online learning in most universities. However, there has been a lack of information on university students' perspectives regarding online learning during the COVID-19 pandemic. This study assessed the perspectives, satisfaction and experiences with online and classroom learning among human health students at the University of Zambia. Methods: This cross-sectional study was conducted among 737 students at the University of Zambia from October 2022 to April 2023. Data were analysed using Stata version 16.1. Results: Of the 737 participants, 51.6% were female and 56.5% agreed that blended learning should continue even after the COVID-19 pandemic. However, 78.4% of the students believed that group discussions were more suitable in the classroom than online learning. Most students (67.1%) disagreed that they preferred online learning to classroom learning. Furthermore, 77.6% of the students disagreed that online learning gave more satisfaction than classroom learning. Conclusions: This study found that most students recommended the continuation of blended learning after the pandemic. However, they believed that follow-up tutorials and assessments were better undertaken in physical classrooms than online learning. These findings are important in sensitising stakeholders in the education sector and governments to consider blended learning as a teaching strategy in the future. There is a need to develop and implement curricula that offer blended learning to students as well as ensure the students have the necessary facilities and equipment to support such learning.

Primary health care roles of community pharmacists in low- and middle-income countries: A protocol for a mixed methods systematic review.

BACKGROUND: The roles of community pharmacists in primary health care cannot be overemphasized, these professionals have evolved from the traditional dispensing to providing health promotion, vaccination services, and medication therapy management as well as other areas of patient care needs. The objectives of this review are to explore evidence of the provision of primary health care services by community pharmacists in low- and middle-income countries (LMICs) and identify barriers to these services and how these barriers can be mitigated. METHOD: A systematic search will be conducted in Medline, CINAHL, Google scholar, Global Index Medicus, LILACS, and CENTRAL to identify potentially relevant primary literature for inclusion. Also, ProQuest Dissertations and Theses will be search to identify relevant gray literature. The review will be guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist for systematic reviews. All primary research articles regardless of study design exploring or reporting on community pharmacists' involvement in primary health care in LMICs will be considered for possible inclusion. A summary of the included studies will be provided and a quality assessment will be conducted using the 2018 version of the mixed methods analytical tool. EXPECTED RESULTS: Findings from this review will add to the evidence in the literature and cause the need for policy change to empower the community pharmacy practice by providing a friendlier legal framework for delivering services in tandem with international best practices. PROSPERO registration ID: CRD42023357312.

Older adults' exposure to anticholinergic medications: Implications for pharmaceutical care for Nigerian older adults.

Introduction: Anticholinergic medications which are commonly prescribed to older adults can produce more pronounced adverse effects compared to the younger population. Objectives: To investigate the prevalence of polypharmacy, describe the prescription patterns of anticholinergic medications, determine the prevalence of exposure to high-risk anticholinergic cognitive burden (ACB) medications, and identify the potential predictors of exposure to high-risk ACB medications in older adults in a Nigerian secondary hospital. Methods: This cross-sectional study that included older adults prescribed at least one anticholinergic medication was conducted at a secondary care hospital in Nigeria. The study data were initially summarized using descriptive statistics, whereas multivariable logistic regression analysis was used to identify the potential predictors of exposure to high-risk ACB medications. In this study, the cumulative ACB scores were dichotomized into low risk (score 1-2) and high risk (score ⩾ 3). A p value less than 0.05 was considered to be statistically significant. Results: A total of 256 older adults were included in this study; 113 (44.1%) had polypharmacy, whereas 26.6% (188/256) were exposed to high-risk ACB medications. Of a total of 391 anticholinergic medications used by the population, furosemide (36.57%) was the most commonly prescribed. The adjusted multivariable logistic regression analysis indicated that patients who had acute diseases were 2.5 times (adjusted odds ratio (AOR) = 2.49, 95% confidence interval (CI): 1.40-4.45) more likely to be exposed to high-risk ACB medications than those with chronic diseases. Conclusion: The study demonstrates a high prevalence of polypharmacy and exposure to high-risk ACB medications suggesting the need for pharmaceutical care in this high-risk population. Older adults' exposure to high-risk ACB medications was significantly associated with prescriptions for acute diseases.

Assessment of the impact of COVID-19 pandemic on the mental health and wellbeing of pharmacists: A nationwide survey.

OBJECTIVES: To explore the impact of the COVID-19 pandemic and work on the mental health and wellbeing of pharmacists in Nigeria and investigate the risk of exhaustion, disengagement, burnout, and their associated factors. METHODS: This was an online cross-sectional study among pharmacists that involved the use of mental health and wellbeing questionnaire including a 16-item OLBI questionnaire. Descriptive statistical analyses were performed to determine the study distribution. Chi-square test was used to compare categorical variables, while independent sample t-test and one-way ANOVA were used to compare the mean values of two and three groups, respectively. Tukey posthoc test was used to compare various practice settings based on significant factors, while a two-sided Dunnett t-test was used to compare between groups for other significant factors. A p-value less than 0.05 was considered statistically significant. RESULTS: Of the 612 pharmacists invited to participate in the survey, 426 completed and submitted the questionnaire giving a response rate of 69.6%. The Cronbach's alpha for wellness and mental health survey instrument in our study population is 0.74, while the average Cronbach's alpha for a 16-item OLBI questionnaire is 0.62 in our study population. The high risk of exhaustion and disengagement were met by 75.6% and 77.2% of the respondents, respectively. Eighty-three respondents (19.5%) met thresholds for either high risk of exhaustion or disengagement, while 66.2% had both a high risk of exhaustion and disengagement (burnout). Significant proportions of respondents with undergraduate pharmacy degree as the highest qualification obtained (70.6%, p < 0.001), in the hospital practice setting (62.8%, p < 0.001), and in full-time employment type (68.1%, p = 0.004) had the higher risk of burnout compared to their counterparts. CONCLUSION: The COVID-19 pandemic and work significantly impacted the mental health and wellbeing of a considerable proportion of the respondents. Burnout affects the majority of pharmacists in Nigeria and is linked to undergraduate pharmacy degrees as the highest qualification obtained, hospital practice settings, and full-time employment. Thus, mitigating strategies from employees, government, and organizations are recommended to help improve working conditions and promote the well-being of pharmacists in Nigeria.

Psychological impact of coronavirus disease (COVID-19) on health professions students at the University of Zambia: a cross-sectional study.

Introduction: the coronavirus disease 2019 (COVID-19) has negatively impacted the mental health of students across the globe. In Zambia, little is known about the psychological impacts of COVID-19 on healthcare students. This study assessed the psychological impact of COVID-19 on health professions students at the University of Zambia. Methods: this cross-sectional study was conducted from August 2021 to October 2021. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). The multivariable logistic regression model was used to identify the factors associated with anxiety and depression among the participants. Data were analysed using Stata 16.1. Results: of the 452 students, 57.5% were female, with the majority aged between 19 and 24 years. Overall, 65% (95% CI: 60.5-69.4) experienced anxiety, while 86% (95% CI: 82.7-89.3) experienced depression. Participants whose income was affected were more likely to experience anxiety (aOR; 2.09, 95% CI: 1.29-3.37) and depression (aOR; 2.87, 95% CI: 1.53-5.38). Anxiety was associated with difficulty in observing the COVID-19 preventive measures (aOR; 1.84, 95% CI: 1.21-2.81). Being depressed was associated with having a chronic condition (aOR; 3.98, 95% CI: 1.67-9.50) or a relative or friend who died from COVID-19 (aOR: 1.98, 95% CI: 1.06-3.70). Conclusion: many students experienced anxiety and depression during the COVID-19 third wave of infections. This calls for mitigation measures because continued anxiety and depression can affect the academic performance of students. Fortunately, most of the associated factors are modifiable and can easily be targeted when formulating interventions to reduce anxiety and depression among students.

Assessment of health-related quality of life and its determinants in the pre-dialysis patients with chronic kidney disease.

PURPOSE: Health-related quality of life (HRQoL) is increasingly being considered as a critical parameter to measure how the disease affects patients' health status, especially for long-term ailments like chronic kidney disease (CKD). This study aimed to assess the HRQoL and its determinants in pre-dialysis patients with CKD. METHODS: This cross-sectional study recruited patients with CKD stages one to four. Data were collected using the HRQoL Questionnaire (15D). Descriptive statistics were used to summarize patients' characteristics. Chi-square test or Fisher's exact test was used to explore the association between independent variables and the HRQoL. Multivariate logistic regression analyses were employed to investigate the determinants of HRQoL. A P value of less than 0.05 was considered statistically significant. RESULTS: Two hundred and twenty patients were enrolled in the study (average age 52.7 ± 12.4 years, 61.8% females, and 69.1% with CKD stage 4). The average multidimensional utility score of the study population was 0.82 ± 0.13, while the single-attribute utility scores ranged from 0.73 to 0.89. The speech, and discomfort and symptoms dimensions had the highest (0.89) and lowest (0.73) single-attribute utility scores, respectively. The patients who were uneducated [Adjusted Odds Ratio (AOR) 0.34, 95% CI (0.12-0.97)] were significantly less likely to have poor HRQoL compared to those with tertiary education level. Additionally, unemployed [AOR 4.69, 95% CI (1.69-13.02)], and self-employed patients [AOR 4.25, 95% CI (1.26-14.38)] were significantly more likely to have poor HRQoL compared to the retirees CONCLUSIONS: This study shows that the overall HRQoL of the participants was high, though a considerable proportion of them had poor HRQoL, while the discomfort and symptoms dimension was the most impacted. Being educated, unemployed, and self-employed were significantly and independently associated with poor overall HRQoL.

Knowledge, attitudes, and practices of pharmacists toward biosimilar medicines in Nigeria.

BACKGROUND: Biopharmaceutical medicines have transformed the treatment of various long-term diseases, despite their high cost and limited availability. Due to their cost saving potentials, biosimilar medicines represent a new wave of therapy for several diseases in the next few years. Thus, pharmacists are uniquely placed to promote and enhance their uptake. OBJECTIVES: The objectives of this study were to assess Nigerian pharmacists' biosimilar medicine knowledge, attitudes, and practices. METHODS: This was a cross-sectional, national online survey of conveniently sampled pharmacists in Nigeria. Data were collected with a validated 31-item biosimilar medicine knowledge, attitude, and practice questionnaire. The Pearson correlation (r) analysis was conducted to investigate the association among knowledge, attitude, and practice. A P value of < 0.05 was considered statistically significant. RESULTS: Of the 600 pharmacists who were invited to participate in the survey, 411 completed the questionnaire giving a response rate of 68.5%. The mean knowledge score was 6.2 ± 3.0 out of a maximum score of 14. Most of the participants (n = 268, 65.2%) had overall knowledge scores of 1 to 7. The mean attitude score was 35.0 ± 8.8 out of a maximum score of 55, whereas that of practice was 18.7 ± 5.3 out of a maximum score of 30. Knowledge was significantly positively correlated with practice (r = 0.360). CONCLUSION: Most of the surveyed pharmacists had poor knowledge of biosimilar medicines, while their reported fair attitude did not translate to good practice.

Awareness and acceptance of COVID-19 vaccines and associated factors among pharmacy students in Zambia.

Aim: This study aimed to assess the awareness and acceptance of COVID-19 vaccines and associated factors among pharmacy students in Zambia. Materials and Methods: We conducted a cross-sectional study among 326 undergraduate pharmacy students in Lusaka, Zambia, from February to April 2021. Data were analysed using Stata version 16.1. Multivariable logistic regression was used to determine key factors influencing vaccine acceptance. Results: Of the 326 participants, 98.8% were aware of the COVID-19 vaccines, but only 24.5% would accept vaccination. Compared to other religions, being of Christian faith was associated with reduced odds of awareness of the COVID-19 vaccine (aOR=0.01, 95% CI: 0.01-0.20). Conversely, factors associated with vaccine acceptance were being male, single and unemployed. Compared to females, male respondents were 86% more likely to accept the vaccine if it was made available (aOR=1.86, 95% CI: 1.10-3.14). In addition, unmarried respondents were 2.65 times as likely to accept vaccination than married respondents (aOR=2.65, 95% CI: 1.06-6.63). Conversely, unemployed respondents were less likely to accept vaccination than their employed counterparts (aOR=0.32, 95% CI: 0.16-0.46). Barriers to the acceptability of the vaccine were possible side effects (78.5%) and scepticism about its effectiveness (10.2%). Conclusion: There was significant vaccine hesitancy toward COVID-19 vaccines among Zambian pharmacy students despite their awareness of the vaccines. Health authorities must work collaboratively with training institutions to mitigate vaccine hesitancy, especially with healthcare students being a key part of the future healthcare workforce overseeing disease prevention strategies.

Assessment of proton-pump inhibitor use at a tertiary teaching hospital in Nigeria.

Background: Proton-pump inhibitor (PPI) is a widely used medication class globally. Because of its good safety profile, there is a huge likelihood of inappropriate use. Objectives: To determine the prevalence of PPI use and indications, describe its pattern of usage, and identify factors associated with inappropriate prescriptions at a federal tertiary teaching hospital in Maiduguri, Nigeria. Methods: PPI prescriptions were retrospectively assessed in the General Outpatients' Department (GOPD) and Gastroenterology Unit (GITU) of a teaching hospital. Relevant data for the study were extracted from the patients' medical records. Chi-square or Fisher's exact tests where appropriate were used to identify factors associated with inappropriate PPI prescriptions. A p < 0.05 was considered to be significant. Results: PPIs were prescribed to 73.3% (220/300) of patients, while inappropriate prescriptions were noted in 91.4% (201/220) of these patients. Epigastric pain (49.5%) was the most common PPI indication, while omeprazole was the highest prescribed (53.4%). Nearly all inpatients (98.2%), those with epigastric pain (95.7%), and patients who were prescribed intravenous PPIs had more inappropriate PPI prescriptions compared to others. Conclusion: This study revealed a high prevalence of PPI use and inappropriate prescriptions at the study hospital. As a result, these findings highlight the importance PPI-based stewardship program at the study hospital.

COVID-19 pandemic: The role of community pharmacists in chronic kidney disease management supportive care.

The COVID-19 pandemic is putting enormous pressure on healthcare systems worldwide and various countries are struggling to flatten the curve to prevent their healthcare system from becoming overwhelmed. Studies have shown that people with chronic kidney disease (CKD) are at increased risk of COVID-19 infection and mortality. However, the interruption of routine care and support due to the current challenges with healthcare providers, facilities, and essential medicines due to this pandemic is adversely affecting people with CKD. This is because poor management of this disease leads to negative health outcomes. In order to maintain good health, this vulnerable group of patients rely heavily on the extended role of the community pharmacists in chronic disease management. This paper highlights the extended role of the community pharmacists in CKD management supportive care during the COVID-19 pandemic.

Community pharmacists on the frontline in the chronic disease management: The need for primary healthcare policy reforms in low and middle income countries.

In low- and middle-income countries (LMICs), over 12 million people die yearly from chronic diseases and this number is expected to increase if concerted actions are not taken. The purpose of this paper is to highlight the roles and impact of community pharmacists in chronic disease management support and the need for policymakers in LMICs to reposition community pharmacists appropriately for this extended role. Recent findings have shown that community pharmacists are the most accessible healthcare providers to the members of the community. Published evidence have demonstrated that community pharmacists' interventions in chronic diseases significantly improve economic, clinical, and humanistic outcomes. However, they are not officially recognized as primary healthcare providers in LMICs. Therefore, there is need for policy reforms that will encourage strategic use of the clinical skills of community pharmacists as part of the primary healthcare team in LMICs.

Biosimilar medicines uptake: The role of the clinical pharmacist.

The introduction of biological medicines has revolutionized the management of chronic diseases. Due to the high cost of biological medicine coupled with the fact that patents of many of these medicines are on the verge of expiration, manufacturers are exploring the production of biosimilars. The introduction of biosimilars has the capacity to increase competition among manufacturers, reduce prices, and improve patient access to these medicines. Therefore, a biosimilar is a new wave in therapy and treatment for the next few years. Despite the growing number of biosimilars approved for patient care, physicians' comfort in prescribing reference products against biosimilars and patient reluctance to switch from a reference product to a biosimilar are the major barriers for biosimilar increasing use. This paper aims to highlight the role of the clinical pharmacist (CP) in the utilization of biosimilars and the need for a pharmacy specialty regarding biosimilars. Of all the healthcare providers, CP has the most holistic view of the biosimilar products' clinical profile, and logistical and supply chain considerations. Thus, CPs are uniquely positioned to better educate all biosimilar medicine key stakeholders in an effort to increase access and rational use.

Assessment of public hospital drug supply financing through the public-private partnership: pharmacists' perspectives

In Nigeria, drug financing by the public has been challenged by financial constraints through public fund due to a limited fund available to the government to meet all its demands. The objectives of this study were to determine the variability of the hospital patient prices of same drugs under the PublicPrivate Partnership (PPP) and in Private Retail Community Pharmacy (PRCP), and to investigate the perceived efficiency and effectiveness of the PPP by comparing it with the Drug Revolving Fund (DRF) model in drug supply financing. This study was conducted in Nigeria utilizing a mixed method. Mann-Whitney U test analysis was used to compare the median drug price of the two facilities. The majority (76.19%) of the drugs were sold at a cheaper rate in the hospital than what was obtained in the PRCP with no significance difference (p > 0.05). Dominant responses from the focused group discussions supported the PPP model. This study shows that the median patient price of the basket of matched pairs of same drugs in the hospital under the PPP and in the PRCP was identical. Overall, the participants were of the opinion that the PPP model was more efficient and effective than DRFin the financing drug supply

Quality of life of pharmacy students in Northern Nigeria.

OBJECTIVES: To assess the quality of life (QoL) of Nigerian pharmacy students and to investigate its predictors. METHODS: This cross-sectional descriptive study randomly sampled one pharmacy school from each of the three geopolitical zones of northern Nigeria We collected data with the WHOQOL-BREF questionnaire. Independent-samples t-test and one-way analysis of variance were used to compare groups. The predictors of QoL were identified using multiple linear regression analysis. P < 0.05 was considered statistically significant. KEY FINDINGS: The overall response rate was 81.2%. The overall QoL mean score of pharmacy students in the region was 76.94 ± 17.65. There was a lower environment domain mean score (56.06 ± 14.60) compared to other domains. Multivariate analyses revealed that being a Christian, in the 5th year of study, and having a current illness/problem negatively affected overall QoL (P < 0.05). Having a current illness/problem negatively affected physical health (P < 0.05). Being in the 5th year of study and having a current illness/problem negatively affected psychological health, whereas schooling in the state of residence, active involvement with student organizations/clubs and having a current illness/problem negatively affected the environment domain (P < 0.05). CONCLUSION: This study showed that pharmacy students had a fair overall QoL and poor well-being in all four domains. Religion, state of residence, year of study, organizations/clubs and current illness/problem were the significant predictors of QoL. Therefore, these findings will be useful in reviewing the training of pharmacy students with a view to improving their well-being and quality of pharmacy education.

Evaluation of medication adherence and predictors of sub-optimal adherence among pre-dialysis patients with chronic kidney disease.

Background: Multiple medications are required to effectively manage chronic kidney disease (CKD) and associated complications, posing the risk of poor medication adherence. Objectives: To measure medication adherence levels and to investigate the potential predictors of sub-optimal medication adherence in pre-dialysis patients with CKD. Methods: A prospective study was conducted in the medical and nephrology outpatients' clinics in Maiduguri. Non-dialysis patients with CKD stages 1-4 aged 18 years and above were recruited through their physicians. The level of medication adherence was determined using Morisky Medication Adherence Scale. Descriptive statistics were used to summarize patients' background characteristics. Multivariate binary logistic regression analyses were performed to investigate the significantly potential predictors of sub-optimal medication adherence at a p < 0.05. Results: There were 107 participants (48.6%) who had high medication adherence, while 97 (44.1%), and 16 (7.3%) of them had moderate adherence, and low adherence, respectively. The univariate analysis revealed that medication adherence level differed significantly with the number of medications taken daily by patients (p < 0.05). Multivariate logistic regression analyses did not reveal a significant independent predictor of sub-optimal medication adherence. Conclusion: A majority of the participants reported sub-optimal medication adherence. The independent variables considered did not significantly predict sub-optimal medication adherence in the study population. Nevertheless, the study findings highlight the importance of clinical pharmacists' CKD management supportive care to help improve medication adherence.

Kidney Disease Knowledge and Its Determinants Among Patients With Chronic Kidney Disease.

The alarming rise in the incidence of end-stage renal disease in Nigeria is likely to continue if patients with chronic kidney disease (CKD) lack knowledge of this disease, its management, and practices to support effective self-management. The study aimed to assess CKD knowledge and to investigate its predictors. A cross-sectional survey was conducted using a paper-based questionnaire at the medical and nephrology outpatients' clinics of a secondary and tertiary hospital in Maiduguri. The study enrolled 220 patients with CKD stages 1 to 4. Sixty-five percent of the participants had poor CKD knowledge. The patients who had a tertiary level of education were significantly more likely to have higher CKD knowledge compared to those with no formal education (adjusted odds ratio: 2.62, 95% CI: 1.20-5.72). The study shows that the majority of the participants had poor CKD knowledge. Tertiary educational level was the only significant independent predictor of higher CKD knowledge. Therefore, targeted educational interventions are needed among patients with no or low formal education to be able to support them with self-management behaviors.

Comparative Analysis of Private Retail Community Pharmacies' Participation in the National Health Insurance Scheme of Nigeria and Ghana: Implications for Access to Essential Medicines.

BACKGROUND: Frequent stock-out of drugs in the public hospitals causes National Health Insurance Scheme (NHIS) enrollees to purchase most of their medicines out-of-pocket in community pharmacies, thereby imposing financial constraints on them against the main objective of the scheme. The objectives of this study were to determine and compare the level of participation of private retail community pharmacies (PRCPs) in the NHIS of Nigeria and Ghana, to describe their spatial distribution, and to highlight from literature major factors that would influence the participation of these pharmacies in the scheme. METHODS: PRCPs data were collected from the Nigerian NHIS active secondary healthcare providers list of 1st July 2017 and the Ghanaian NHIS active providers online list of 2018. PRCPs densities at the national levels were calculated from last published national coverage data for each country. RESULTS: The total number of PRCP accredited by NHIS of both Nigeria and Ghana is 964(639[66.3% versus 325[33.7%]). NHIS accredited PRCPs densities for Nigeria and Ghana were 1 PRCP per 9, 390 enrollees and 1 PRCP per 33, 108 enrollees respectively. Across the Nigerian States, it was noted that Lagos State has the highest proportion (21.4%, n = 137) of community pharmacy participation in the scheme whereas, in Ghan, Greater Accra Region has the highest participation (34.2%, n = 111). CONCLUSION: This study revealed low participation of PRCPs and skewed spatial distribution between urban and rural areas of both countries, although there was higher participation of these pharmacies in Nigeria due to Nigerian lower NHIS coverage data compared to Ghana.