FACULTY OF PHARMACY
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Item Pharmacy students’ knowledge of psychotropic medicines and their attitude towards providing pharmaceutical care to patients with anxiety in Nigeria(Nigeria Association of Pharmacists in Academia (NAPA), 2022) Akande-Sholabi, W.|| || ||; Bakare, O. E.; Adebisi, A. Y.; Odeku, O.Background: Healthcare professionals, such as pharmacists, play critical roles in the management of mental disorders by assessing the potential for adverse reactions, providing medication counseling, and medication review optimize treatment regimens. Objectives: This study aims to assess the knowledge of pharmacy students in a Nigerian university regarding psychotropic medicines and their attitude towards providing pharmaceutical care to patients with anxiety. Method: A cross-sectional web-based survey was conducted in May 2021 among fourth- and fifth-year pharmacy students in a Nigerian university. The data were summarized using descriptive statistics, such as frequencies and percentages. Chi square was utilized to examine the association between the demographic characteristics and the respondents' overall knowledge and attitude. Results: The response rate was 85%, as 126 responses were received. About half of the respondents 69 (54.8%) reported that they have received training on psychotropic medicines and 9 (9.1%) have been previously diagnosed with anxiety disorders. Only 53 (42.1%) and 71 (56.3%) of our respondents knew that escitalopram and alprazolam are categorized as anxiolytics respectively. Most respondents would like to talk to patients with anxiety about their medications 110 (87.3%), attend training on pharmaceutical care for patients with anxiety 103 (81.7%), and obtain a medication history for people with anxiety 113 (89.7%). Ninety-four (74.6%) pharmacy students would like to suggest prescription medication for a patient with anxiety and only 88 (69.8%) would like to correct any errors in prescription in any anxiety cases. Our findings also revealed that there is a significant association between the students’ attitude and year of study (p=0.038) and previous training on psychotropic medicines (p=0.004). Conclusion: Findings from this study suggested that participants require improved knowledge and training of psychotropic medicines.Item Therapeutic lifestyle strategies taught in Nigerian pharmacy schools(West African Postgraduate College of Pharmacists (WAPCP), 2022) Akande-Sholabi, W.; Adebisi, A. Y.; Odeku O.Background: Therapeutic lifestyle modifications are the basis of treatment and prevention of numerous chronic diseases. Objectives: To describe the therapeutic lifestyle modifications taught in Nigerian pharmacy schools. METHODS: A short self-administered online questionnaire (using Google Form), to ascertain the curricular coverage of therapeutic lifestyle modification in undergraduate pharmacy training programs was sent to the Deans of all accredited schools of pharmacy in Nigeria (n = 20). The collected data were summarized using descriptive statistics. RESULTS: Thirteen schools of pharmacy participated in the study. All the schools taught at least one of the 10 specified therapeutic lifestyle strategies. Less than a third taught smoking cessation (2.0, 15.4%), lifestyle modifications for pregnant women (2.0, 15.4%) and patients with mental health issues (1.0, 7.7%). CONCLUSIONS: There are variations in the content of teaching of therapeutic lifestyle approaches in Nigerian pharmacy schools. To enhance therapeutic lifestyles, it is essential to improve the content and teaching of therapeutic lifestyle strategies in Nigerian pharmacy schools. All schools should do more to ensure that they are providing adequate training to enable students to be prepared for delivering support to all patients (including pregnant women and mental health patients) on therapeutic lifestyles.Item Promoting Cessation and a Tobacco Free Future: Knowledge and Attitude of Pharmacy Students Regarding Smoking Cessation in a Nigerian University(Universiti Sains Malaysia (USM), 2022) Akande-Sholabi, W.; Adebisi, A. Y.Tobacco smoking is a global public health threat and the largest single driver of health inequalities. Currently, there are over a billion smokers worldwide with approximately 80% of the smokers living in low-and-middle-income countries like Nigeria. Knowledge gaps on smoking cessation among pharmacy students might impact the quality of service these future pharmacists would provide in practice. Therefore, this study aimed to evaluate the knowledge and attitude of pharmacy students regarding smoking cessation in a Nigerian university. A University-based cross-sectional study was conducted among 277 pharmacy students of a Nigerian university using a pretested self-administered questionnaire between August and December 2019. Data were summarised descriptively using IBM SPSS (version 23). Most of the pharmacy students 203 (73.2%) agreed it is the pharmacists’ responsibility to support patients with smoking cessation. The majority of our respondents 226 (81.6%) reported pharmacy students need more training on smoking cessation. Thirty-three (11.9%) pharmacy students knew nicotine does not cause cancer. Less than one-tenth 27 (9.7%) of the pharmacy students were aware of smoking cessation products. Overall, 203 (73.2%) respondents had poor knowledge (score < 60%) and an average positive attitude about smoking cessation. Pharmacy students have suboptimal knowledge about smoking cessation. However, they revealed a positive attitude towards smoking cessation. Therefore, there is a need for educational interventions to address the deficit in smoking cessation knowledge, as well as equip future healthcare providers. Thus, improving the quality of public health especially among smokers in Nigeria.Item Toward pharmacy-based smoking cessation services in Nigeria: Knowledge, perception and practice of community pharmacists(European Publishing, 2021) Akande-Sholabi, W.; Adebisi, A. Y.Introduction Worldwide, tobacco smoking is one of the leading causes of avoidable deaths. In Nigeria, there is currently no clinical guidelines for tobacco dependence treatment. However, globally, pharmacy-based smoking cessation intervention has been associated with improved cessation rates and quality of life. This study aims at assessing the knowledge and perception of community pharmacists about smoking cessation and tobacco harm reduction as well as barriers to the practice of pharmacy-based smoking cessation intervention. METHODS A cross-sectional survey was carried out among 104 community pharmacists, between August and December 2019, using a self-administered paper questionnaire. Data entering, cleansing, and analysis were done using IBM SPSS (version 23). Descriptive statistics including frequencies and percentages were used to summarize the data. RESULTS Thirteen pharmacists (12.5%) were providing smoking cessation services. One-tenth (10.6%) of the pharmacists were aware of tobacco harm reduction. The majority (89.4%) were willing to attend smoking cessation training. Among the respondents, 65 (62.5%) had poor knowledge regarding smoking cessation and tobacco harm reduction. Lack of knowledge and skills were reported by all (100%) as a barrier to providing the service. However, 101 (97.1%) community pharmacists agreed that smoking cessation treatment is an important role of pharmacists. CONCLUSIONS A suboptimal level of knowledge of smoking cessation and tobacco harm reduction was noted among the community pharmacists. However, they believed smoking cessation intervention is an important role of pharmacists. It is advocated that smoking cessation training should be included as part of the Pharmacists’ Council of Nigeria Mandatory Continuing Professional Development Training. Thus, it is imperative to establish basic national smoking cessation guidelines that can be functional towards reducing mortality and morbidity associated with tobacco smoking in Nigeria.Item Medications and the risk of falls among older people in a geriatric centre in Nigeria: a cross-sectional study(Springer Nature, 2021) Akande-Sholabi, W.; Ogundipe, F.; Adebusoye, LBackground Falls are a major cause of morbidity and hospitalization in older people. Many drugs have been shown to increase the risk of falls in this population. Few empirical data exist on the use of fall-risk-increasing drugs among older people of sub-Saharan Africa countries. Objective This study aimed to assess the prevalence and predictors of falls, and the association between FRIDs, drugs causing orthostatic hypotension and falls. Setting Geriatric center, University College Hospital, Ibadan, Nigeria. Methods A cross-sectional study of 400 older patients aged ≥ 60 years selected consecutively at the geriatric centre, between September and November 2019, were interviewed using a semi-structured questionnaire. Socio-demographic information, medication utilization, and history of falls were obtained. Bivariate and multivariate analyses were carried out using SPSS 23. Alpha was set at 0.05. Main outcome measure Prevalence and predictors of falls among ambulatory older patients. Results The mean age of the older patients was 72.4 ± 7.3 years and 255 (63.7%) were females. The total number of FRIDs and ODs used by older patients was 578 (35.2%). The prevalence of fall was 181 (45.3%) which was significantly higher among the females compared with the males (51.8% vs 33.8%) p = 0.01. Classes of medications such as anti-Parkinson’s (p = 0.027), sedatives (p = 0.033), antipsychotics (p = 0.011) and anticholinergic (p = 0.027) were significantly associated with fall. Predictive factors for falls on logistic regression were female [OR = 2.375; 95% CI 0.274–3.704, p = 0.001] and use of antipsychotics [OR = 5.132; 95% CI 1.352–19.480, p = 0.016]. Conclusion The prevalence of falls was high and being a woman ≥ 60 years is a major risk factor for falling. Interventions to decrease falls in older patients by drug modification and deprescribing of FRIDs and ODs might reduce fall-related injuries. Thus, a multidisciplinary approach is essential for intervention to reduce the risk of falls and improve therapeutic outcomes among older patients.Item The impact of COVID-19 pandemic on medicine security in Africa: Nigeria as a case study(Pan African Medical Center for Public Information and Research, 2020) Akande-Sholabi, W.; Adebisi, A. Y.COVID-19 is an unprecedented pandemic posing major threat to global public health. In the past decades of years or so, one could have heard of how dangerous it is to be virtually reliant on medicine supply from other countries. Nonetheless, no action was taken because it seemed to many that the global trade system was operational and Nigerians as well as citizens of African countries appear to have sufficient supply of the medications required at quite appealing cost. Currently in 2020, this apprehension has revolved from an imaginary problem to an actual challenge that might have consequences for millions nationwide due to COVID-19 pandemic. Now, African countries can realize that putting all our eggs in one basket was not such a good idea. In Nigeria, over 70% of the prescribed medications are produced from active ingredients (API) primarily sourced from firms in China and India. Access to medicine is an integral part of healthcare systems, uninterrupted access to medicine is much needed and essential for the well-being of the population. We are now approaching the conclusion that it is more reasonable to probably invest a little more to resuscitate a domestic pharmaceutical synthesis and herbal medicine research capacity in Nigeria and across African countries to improve public health.Item Prescribing Pattern of Antihypertensive Medications in a Geriatric Center In Southwestern Nigeria(Nigeria Association of Pharmacists in Academia (NAPA), 2019) Akande-Sholabi, W.; Adebusoye, L.Background: Hypertension is a prominent public health problem, with considerable health consequences. Recommended guidelines encourage use of antihypertensive medications with the best evidence of reducing cardiovascular risk. Data on antihypertensive medications use among older Nigerians is limited. Objective: This study evaluated the antihypertensive medication use among older persons with hypertension in compliance with the Eighth Joint National Committee guidelines (JNC 8). Method: A retrospective cross-sectional study, of older patients diagnosed with hypertension between the 1st January 2017 and 31st December 2017 at the geriatric center, University College Hospital, Ibadan. Results: The mean age was 70.2 ± 7.2 years and 62% were female. The mean number of medications used by the patient was 4.5 ± 1.4. Of the patients, 56% were receiving combination therapy, 42% two drugs and 14% three drugs. Most patients were receiving calcium channel blockers (33.8%), followed by diuretics (29.6%), angiotensin receptor blockers (23.4%) and angiotensin-converting enzyme inhibitors (10.8%). Commonest combination therapy was calcium channel blockers and thiazide diuretics (28.3%), while the commonest multi-morbidities were osteoarthritis (32.7%), diabetes (17.3%) and dyslipidemia (8.7%). Conclusion: This study showed that more than half of older persons with hypertension were on combination therapy, and the most frequently used class of antihypertensive drugs were calcium channel blockers, followed by diuretics. The guidelines and data for black ≥60 years indicate that lower doses of combination therapy are more effective in achieving blood pressure target. Despite the numerous advantages of ACEIs, they remain underutilized.Item Potentially Inappropriate Medication Use Among Older Patients Attending a Geriatric Centre in South-West Nigeria(Sage, 2018) Akande-Sholabi, W.; Olowookere, O.; Adebusoye, L.Objectives: To determine the prevalence and describe factors associated with the use of potentially inappropriate medication (PIM) among older patients. Methods: Cross sectional study of 400 older patients selected systematically at the geriatric centre, University College Hospital, Ibadan between July and September 2016. With the aid of semi-structured questionnaires, information on the socio-demographic characteristics, lifestyle habits, healthcare utilisation and morbidities was obtained. The Beer’s criteria 2015 update was used to identify the PIMs. Predictors of PIMs were determined using multivariate analyses at alpha 0.05. Results: Age was 70.2 (SD=5.9) years and 240 (60%) were females. General prescription pattern showed antihypertensives (34.7%) as the commonest medications used. The point prevalence of PIMs use was 31%. In all, 10 PIMs were used by the respondents. The majority (81.5%) were using one PIM, while (17.7%) used two PIMs and (0.8%) 3 PIMs. NSAIDs (72.6%) were the commonest PIMs identified, followed by the benzodiazepines (24.2%). Respondents had an average of 1.9 morbidities, and mulitmorbidity found in 60.5%. Logistic regression analysis showed self-rated health assessed as better compared with age-mates [OR =1.718 (1.080–2.725)] and being physically active [OR =1.879 (1.026–3.436)] as the most significantly associated with PIMs use. Conclusions: The use of PIMs among older patients in our setting was high with NSAIDs being the most frequently used medications. An interdisciplinary approach, of medication review by pharmacists’, working with physicians may improve prescribing practices among older persons. Therefore, it is necessary to create public health awareness on the use of PIMs among older persons.Item Polypharmacy and Factors Associated with their Prevalence Among Older Patients Attending a Geriatric Centre in South-West Nigeria(West African Postgraduate College of Pharmacists (WAPCP), 2018) Akande-Sholabi, W.; Olowookere, O.; Adebusoye, L.Background: Polypharmacy among older people in Nigeria are prominent issues of public health dimension. Polypharmacy especially in older people with multiple diseases often results in poor health status and outcomes. Objectives: To determine the prevalence and factors associated with polypharmacy among older patients attending the geriatric clinic. Methods: Cross sectional study of 400 elderly patients aged 60 years and above who presented at geriatric clinic, UCH, Ibadan. Polypharmacy was taken as concurrent consumption of =5 medications. Socio-demographic characteristics, lifestyle habits, attitudinal factors on medication understanding, medication pattern and intake were assessed through a questionnaire. Bivariate and multivariate analyses were carried out using SPSS 20 and alpha was set at 0.05. Results: Mean age of the respondents was 70.2 ± 5.9 years and 240 (60.0%) were females. The point prevalence of polypharmacy was 23.8%. The average medications consumed were 4 without sex difference. Logistic regression analysis showed that taking too many prescription medications (OR = 2.188; 95% CI =1.014 – 4.808, p = 0.05), intentionally skipping my medications because they are too many (OR = 3.756; 95% CI = 1.354 – 10.424, p = 0.01) and receiving prescriptions from more than one physicians on regular basis (OR= 2.336; 95% CI = 1.058 – 5.155, p = 0.04) were the most significant factors associated with polypharmacy. Conclusion: Polypharmacy is common among older people in this setting. Healthcare workers should address the attitudinal, social and health related factors, which could lead to polypharmacy.Item Faecal antibiotic resistome of Nigerian chimpanzees from a wildlife sanctuary in Cross-River State, Nigeria(Faecal antibiotic resistome of Nigerian chimpanzees from a wildlife sanctuary in Cross-River State, Nigeria, 2021-06) George, U. E.; Arowolo, O. A.; Olayinka, O. A.; Ifeorah, I. M.; Faleye, T. O. C.; Oluremi, B.; Oragwa, A. O.; Omoruyi, E. C.; Udoh, E. E.; Osasona, O. G.; Donbraye, E.; Adeniji, O. P.; Adewumi, O. M.; Adeniji, J. A.Out of prescription, indiscriminate use, misuse and abuse of antibiotic administration and/or usage in both humans and farm animals have led to a consistent interference and contamination of biomes and ecobiomes. These resultantly give platforms for positive selection of resistant pathogens and high levels of Antibiotic Resistance Genes (ARGs). We examined Nigerian Chimpanzees in Boki Afi Mountain Wildlife Sanctuary, Cross-River State, Nigeria, to detect ARGs. Faecal samples from 15 Chimpanzees in pristine enclosures of Non-Human Primates in the Wildlife Sanctuary were analyzed. All faecal samples were pooled, then resuspended in phosphate-buffered saline. Subsequently, nucleic acid was extracted from the suspension and Illumina sequencing performed. ARGs in the raw reads were determined and assembled using the KmerResistance tool v2.2. From the 2,763,954 reads generated, 14 ARGs with statistically significant reads were identified. Precisely, 90.5% (12/14) of the ARGs detected target drugs that inhibit translation, of which 66.6% (8/12) were tetracycline resistance (TC-r) genes, while remaining 9.5% (2/14) inhibit cell wall synthesis (cfxA3_1 and cfxA6_1). Eight (aph(3’)-III_1, cfxA3_1, cfxA6_1, erm(B)_10, tet(Q)_1, tet(Q)_2, tet(Q)_4, tet(W)_5) of the ARGs detected were predicted to be plasmid-borne. We report using a cultivation-independent approach the presence of ARGs in Nigerian Chimpanzees. Findings suggest Nigerian Chimpanzees may constitute a hitherto overlooked source of antibiotic resistance in the environment. These ARGs may have been exchanged with handlers and rural dwellers around the Sanctuary. Surveillance of sympatric human faecal and environmental microbiota and their resistomes at the Wildlife Sanctuary are merited to inform public health interventions and decrease ARGs dissemination.
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