Research
KNOWLEDGE OF DISEASE AND ADHERENCE TO DRUG THERAPY IN PERSONS WITH TYPE 2 DIABETES AND HYPERTENSION
This study was carried out to determine the level of knowledge of disease and adherence to drug therapy among patients with Type 2 diabetes and Hypertension. One hundred and seventy-seven (177) patients attending cardiology and endocrinology clinics at University College Hospital (UCH) Ibadan, in Nigeria participated in the study. Sociodemographic characteristics, patients’ knowledge of diabetes and hypertension and adherence to drug therapy were determined with the use of pre-tested questionnaires. Anthropometric measurements and blood pressure were taken with fasting blood glucose. Exactly 45.2% of the study population were males and 54.8% were females. Patients who had Type 2 diabetes alone were 23.0% and 20.3% had hypertension alone while 55.9% had type 2 diabetes with hypertension combined. The mean age was 63.2 ± 10.7 years. Exactly 64.0% of the study population had good knowledge of diabetes and hypertension while 58.8% were adherent to drug therapy by self-reported methods. Blood pressure control was poor among patients who had hypertension as only 42.9% of hypertensives had a systolic blood pressure of less than 140mmHg and diastolic blood pressure of less than 90mmHg. In patients with Type 2 diabetes combined with hypertension, blood pressure control was poor as only 41.9% had a systolic blood pressure of < 140mmHg and a diastolic blood pressure of < 90mmHg. Exactly 36.0% of patients with Type 2 diabetes alone and 40% of patients with type 2 diabetes with hypertension combined had good glycemic control. Descriptive statistics, Chi-square tests and Pearson correlation were used in evaluating the data obtained. Knowledge of diabetes and hypertension among these patients was above average however adherence to drug therapy was poor. This calls for increase in awareness the importance of adherence to drug therapy among patients with type 2 diabetes complicated with hypertension which will involve a concerted effort by all members of the healthcare team.
A Ten Year Study of Management of Ischemic Heart Disease in a Tertiary Hospital in South West Nigeria
The Pharmacotherapy of drugs used in the management of ischemic heart disease at the University College Hospital (UCH) in Ibadan between June 1998 and May 2007, was studied retrospectively. The objective was to assess the rational use of the prescribed drugs and to determine the tolerability and benefits of using nitrates, betablockers, calcium channel blockers and acetylsalicylic acid (aspirin). A total of 52 case files of patients with ischemic heart disease were randomly selected from the central medical record department and used for the study. Information extracted includes demographic data, the prescribed drugs and side effects. Results showed that males 27(51.9%) were more affected with ischemic heart disease than females 25(48.1%). Age range between 51- 60 years were 15(28.8%) and constituted the highest percentage with mean 54.1 years. Nitrates 36 (30.5%) were the highest prescribed drugs followed by acetylsalicylic acid 29 (24.5%), angiotensin converting enzyme inhibitors 14 (11.9%), beta blockers 13(10.9%), sedatives 11(9.3%), calcium channel blockers 8 (6.7%), morphine sulphate 4 (3.3%) and dopamine 3 (2.5%). Side effects documented were headache 8(19.2%), dizziness 5(12.2%), flushing 5(12.2%), tachycardia 4(9.7%), bronchoconstriction 2(4.8%), and depression 7(17.0%). There is a need for proper education of patients on dietary pattern, smoking ceasation, moderate exercise and drug compliance.
A Study Of Rational Prescriptions Of Penicillin And Cephalosporin Antibiotics In A Secodary Health Care Facility In South West Nigeria
The purpose of this study is to assess the prescriptions pattern of penicillin and cephalosporin antibiotics among physicians at Sacred Heart Hospital Lantoro Abeokuta and determine their conformity with standard guidelines and principles of antibiotic use. It was a retrospective study involving data obtained from outpatient case notes that were prescribed with cephalosporin and penicillin antibiotics during the 6 months period of January to June 2010. A total of six hundred and fourteen (614) case notes were randomly selected and used for the study. One hundred and sixty seven (167) (27%) patients were of the age group 0 - 9 years, 31(5%) patients were aged 10 – 19 years and 226 (37%) patients were of age group 20 – 29 years . Four hundred and forty (440) (71.7%) patients were males while 174 (28.3%) patients were females. Among diagnosis studied were upper respiratory tract infection (URTI) 238 (38.8%) and lower respiratory tract infection (LRTI) (21.0%) (p = 0.00393) (p<0.05). There was no definite diagnosis (NDD) made in 37 (6.02%) cases.
Assessment Of The Rational Use Of Anti Diabetics In Type 2 Diabetes Mellitus Using Case Notes Of Patients At A Tertiary Health Care Centre In South West Nigeria
This study was a prospective study of cases at the University College Hospital, Ibadan. A total of four in-patients comprising of two male and two female adults of the Endocrinology unit were monitored for the study. Patients’ case notes and drug administration charts were used to obtain necessary drug information in addition to information obtained directly from the patients. The age group distribution of the patients was found to be between 34-64 years. The mean age was 47.5 years. The drug regimen showed that Patients A, B, C and D received a total of 8, 10, 11 and 7 drugs respectively. These included Metformin, Insulin, Glibenclamide and Glimepiride as antidiabetic agents. Other drugs prescribed for coexisting diseases included: Nifedipine, Lisinopril, Alpha-methyldopa and Hydrochlorothiazide as Antihypertensives, Atorvastatin as Lipid-Lowering agents and Ceftriaxone, Lxime, Metronidazole, Ciprofloxacin as Antibiotics. Analgesics such as paracetamol and Hematinics such as ferrous sulphate were also prescribed as needed. Co-morbidities studied include hyperglycemic coma, peripheral neuropathy, Diabetic foot disease, Diabetic ketoacidosis, Hypertension and Hyperlipidemia. The results were documented and analysed using charts and tables.
A Study of Cost Effectiveness of Artemisinine Combination Therapy (Act) Among Paediatric Patients at a Tertiary Medical Centre in South West Nigeria
This retrospective study was to compare the cost effectiveness of oral ACT as a first line of treatment of malaria with non-oral ACTs in paediatric patients aged 5 years and below. The study was carried out at Children Outpatients Clinic of Federal Medical Centre, Abeokuta Ogun State in Nigeria between April and September 2005. Clinical case notes of paediatric patients aged 5 years and below were used. Three hundred and fifty (350) patients were randomly selected with only 328 patients meeting the inclusion criteria. The number consisted of 153 (46.6%) males and 175 (53.4%) females. The mean age of patients was 2.3 years (SD 1.4). Oral Chloroquine/Sulphadoxine and Pyrimethamine (CQ/SP) was administered to 127 (38.7%) patients, 113 (34.5%) patients had Quinine/Sulphadoxine and Pyrimethamine (QSP) while 88 (26.8% ) patients had Arthemisine/ Sulphadoxine, Pyrimethamine (ASP). The cure rate for CQ/SP, Quinine/SP and Arthemisine/SP were (11.0%), (22.1%) and (97.7%) respectively. It was only Artemisinine/SP that met the 7.5% efficacy rate recommended by WHO. Data on the therapeutic efficacy of the treatment given to the patients were collected and analyzed using descriptive statistics of frequency distribution and percentages with statistical package Microsoft SPSS 10.0 window version
