Research
Adherence and generic substitution among hypertensive patients in a Specialist Hospital
Hypertension is the commonest non-communicable disease in Nigeria with a prevalence of about 20-25 per cent in adult Nigerians. This research work examined generic drug substitution and its impact on drug adherence among hypertensive patients attending the Consultant Out-Patient Department of Sobi Specialist Hospital, Ilorin, Nigeria. Self-report adherence, personal interview, structured questionnaires and patients’ prescriptions were used to determine drug adherence and treatment outcomes of 167 hypertensive patients on antihypertensive drugs. Adults between the ages of 40 and 80 years were mostly affected, and women were more vulnerable to the disease. The clinical signs and symptoms mostly reported by the patients include severe headache, chest pain, numbness of extremities and general body weakness. The widely utilized generic antihypertensive agents in the studied hospital include Amlodipine, Methyldopa, Nifedipine, Lisinopril, and constituted 91.6% of all the prescriptions. The high rate of generic drug prescriptions in this hospital coupled with the consistent drug counselling offered to the patients by the pharmacist had greatly improved adherence rate to 67.7%. Generic drug substitution should be encouraged in all tiers of healthcare system to improve drug adherence and stem the tide of hypertension in this society. Also, public enlightenment and education should be strengthened to increase population awareness on the symptoms, risk factors, lifestyle modifications and complications of this silent killer disease.
HIV/AIDS patientsa adherence to antiretroviral therapy in Sobi specialist hospital, Ilorin, Nigeria
Nigeria currently accounts for about 10 percent of the global HIV burden, therefore tackling this devastating pandemic is very imperative. This study was conducted to assess the level of patients’ adherence to antiretroviral therapy and identify the factors responsible for non adherence in a major HIV/AIDS specialist hospital, Sobi, Ilorin, Nigeria. Adherence among 213 HIV infected patients on highly active antiretroviral therapy was assessed using self-reporting and pill counting methods for 20 months of therapy. Structured questionnaire, personal interview and patients’ hospital records were used to evaluate access to medicines and patients’ factors responsible for treatment adherence. Though, the level of patients’ adherence to antiretroviral drugs was low (73.3%) compared with the standard (95%), there was significant improvement compared with the earlier reported in the sub-Saharan African countries including Nigeria. Low level of education of patients, adverse antiretroviral drug effects and stigmatization were the main factors given for non adherence. Thus, Nigeria government and non-governmental organizations should intensify efforts by improving the standard of education of the citizenry, increasing the level of awareness and encouragement on HIV/AIDS status as well as continuing funding to the rural communities to stem the tide of the menace.
