THE IMPACT OF MEDICATION COUNSELLING PRACTICE IN COMMUNITY PHARMACIES IN LAGOS STATE, NIGERIA

THE IMPACT OF MEDICATION COUNSELLING PRACTICE IN COMMUNITY PHARMACIES IN LAGOS STATE, NIGERIA

ABSTRACT

Community pharmacies are major sources of medicines in most communities in Nigeria. Clients visit community pharmacies to seek help in medication therapy from community pharmacist,who has a professional responsibility to protect the public from the dangers of self medication through provision of adequate medication counselling. It is however not known to what extent community pharmacists fulfil this roles. The aim of this study was to  examine the nature, extent and adequacy of medication counselling practice in community pharmacies and the factors influencing counselling practice.

A cross sectional survey of community pharmacies using simulated clients visit (Observational study) and cross sectional survey of community pharmacists using self administered questionnaire were carried out. Documents containing policy statements, laws and regulations were also reviewed. Educational intervention involving training of pharmacists in a workshop and on-site practical demonstration was carried out.

A total of 185 community pharmacies  had complete data for inclusion in the analysis, representing 89.9% response rate.  Pharmacist in 65 % of the pharmacies provided counselling. None of the pharmacist asked more than two questions, Information on dosage and frequency were the most (48%) frequently mentioned medication information items and information on adherence to medication least mentioned (3.6%). Only 10% pharmacies provided adequate medication counselling. Workload in the pharmacy (number of clients seen daily), and time of the day in which the pharmacy was accessed were found to be predictors of the amount of counselling offered by pharmacy staff (R= -0.268 & -0.329 ; p= 0.01 & 0.002 respectively).  Weak regulatory framework on counselling practice, inadequate knowledge of medication counselling among many (72.3%) community pharmacists and lack of medication counselling guide/aids were also identified as potential factors influencing counselling practice.

Medication counselling practice in community pharmacies in Lagos State is grossly inadequate. Workload in the pharmacy, inadequate knowledge of pharmacists and weak regulatory framework should be targeted as intervention by various pharmacy and public health stakeholders in order to improve the practice.

 

1.0  INTRODUCTION

 1.1. BACKGROUND TO THE STUDY

 Medicines are the most commonly used form of healthcare treatment. They provide relief from everyday ailments to life-saving interventions for acute illness as well as support for illnesses (Quick et al., 2011). However, medicines must be used appropriately to maximize their potential benefits. Appropriate use of medicines requires careful instructions tailored to a patient‟s level of health literacy and comprehension (Murray, 2007). Insufficient medication information carries a risk of harm to the patient. Patient who lacks adequate information about their medications are more likely to experience treatment failures due to poor adherence, medication errors, and adverse events (Murray, 2007). Gandhi et  al (2003) conducted a prospective cohort study of 661 outpatients responding to a survey to determine the rates, severity, and preventability of adverse drug events. Of the 661 participants, 25% (162) experienced adverse drug events, of which 13 % were serious and 39 % could have been made less severe or entirely prevented. Provider-patient communication was identified as a major factor responsible for many of these adverse events. Some studies have also found non- adherence rate of 50% even in life threatening situations (Quick et al., 2011). Causes of these adverse events include inappropriate attitudes and poor communication skills of providers, inadequate consulting time, and lack of access to printed information in simple language, such as patient leaflets or adequate labels.

THE IMPACT OF MEDICATION COUNSELLING PRACTICE IN COMMUNITY PHARMACIES IN LAGOS STATE, NIGERIA

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