ObjectiveTo assess the knowledge of self-care practices, as well as factors responsible for such knowledge among type 2 diabetes patients in two states of Nigeria.MethodsDescriptive, cross sectional survey research design was employed. The study was conducted on type 2 diabetes out-patients attending Endocrinology Clinic at the University of Uyo Teaching Hospital (UUTH) and University of Calabar Teaching Hospital (UCTH) between June 2012 and February 2013. The Diabetes Self-care Knowledge (DSCK-30) was used in evaluating knowledge of self-care practices. Socio-demographic information and respondents’ opinion on the possible barrier(s) to knowledge of self-care were also obtained. Data were analysed using Microsoft Excel and SPSS version 14.0. Statistical significance for all analyses was defined as a p value less than 0.05.ResultsA total of 303 out of 380 questionnaires distributed were completed and returned (response rate =79.7%). The majority of the study sample (79.5%) had 70% or more overall knowledge level about self-care. Self-care knowledge was associated with level of education (p<0.001), monthly income (p<0.001) and duration of diabetes (p=0.008). Negative attitude to disease condition was the only factor associated with knowledge (chi-square value at one degree of freedom =6.215; p=0.013).ConclusionDiabetes self-care knowledge was generally high among the population studied. Educational status, monthly income, duration of diabetes and negative attitude to disease condition predicted knowledge level.
Medication adherence was generally poor among the cohorts studied.
Objectives To evaluate the effects of pharmaceutical care (PC) interventions on humanistic outcomes in HIV-positive patients with hypertension. Methods This prospective, open-label, parallel randomized controlled trial was conducted in the HIV clinic of the University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria, from August 2018 to October 2019. Eligible patients were randomized sequentially and equally into two study arms: the control arm (CA), where participants received the traditional care and the intervention arm (IA), where participants received PC by the research pharmacist. The patient’s HIV knowledge questionnaire, the Hypertension Knowledge-Level Scale, the Medical Outcome Study-HIV Health Survey and the Patient Satisfaction with Pharmaceutical Service questionnaire were used to assess participants’ HIV-related knowledge, hypertension-related knowledge, health-related quality of life (HRQoL) and satisfaction with PC, respectively. These were self-completed at baseline, 6 months and 12 months. Data were analysed using SPSS (IBM version 25.0). Key findings Out of the 206 participants randomized, 182 completed the 12-month follow-up. After 12 months, there was a significant improvement in HIV-related knowledge (∆ = 11.28%, t(180) = 4.41, P < 0.001) and hypertension-related knowledge (∆ = 5.94%, t(180) = 3.25, P = 0.001) in the IA over and above those observed in the CA. Similarly, PC interventions led to significant improvements in HRQoL (∆ = 6.5%, t(180) = 5.50, P < 0.001) and satisfaction with PC in the IA (∆ = 18.12%, t(180) = 11.85, P < 0.001) at the end of the study. Conclusions PC significantly improved humanistic outcomes in HIV-positive patients with hypertension after a 12-month intervention.
What is known and objective Pharmaceutical care (PC) has been shown to improve clinical outcomes in hypertensive patients as well as in people living with HIV (PLWHV). The objective of this study was to evaluate the impact of PC on blood pressure (BP) control, viral load and adherence to medications in hypertensive PLWHV. Methods This was a prospective, randomized controlled study conducted in the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria. Eligible ambulatory patients were randomized equally to two study arms. The control arm (CA) received the traditional care offered at the HIV clinic; the intervention arm (IA) received the traditional care in addition to PC by the research pharmacist, which included structured education/counselling. BP and self‐reported medication adherence were measured at baseline, 6 months and 12 months. Viral load was obtained at baseline and after 12 months. Data were analysed with spss, version 25.0. Results and discussion Of the 206 participants initially randomized, 182 (91 in each study arm) completed the 12‐month follow‐up. No significant differences existed in both arms concerning socio‐demographic/clinical characteristics of participants at baseline (p > 0.05). After 12 months, BP control was significantly higher in the IA (53.4% vs. 25.2%; p < 0.001, adjusted odds ratio, aOR = 3.20 (95% CI 1.59–6.44). Systolic BP reduced by 0.9 mmHg from baseline in the CA (p = 0.668) and by 16.67 mmHg from baseline value in the IA (p < 0.001). Diastolic BP increased by 1.9 mmHg in the CA (p = 0.444), but reduced by 7.0 mmHg in the IA (p < 0.001). No significant differences were observed in the change from baseline in the proportion with undetectable plasma viral load (UPVL) in both groups (p > 0.05). PC led to an increase in mean adherence to antiretroviral drugs (Δ = 0.55; p = 0.015), and an increase in mean adherence to antihypertensive drugs (Δ = 2.32; p < 0.001) in the IA. What is new and conclusion To our knowledge, this is the first prospective randomized controlled study evaluating the impacts of PC on clinical outcomes in hypertensive PLWHV with a 12‐month follow‐up. Our results show that PC significantly improved BP control and adherence to antiretroviral and antihypertensive medications, but had no significant effect on viral load in HIV positive patients with hypertension. Providers of care for PLWHV should leverage the established HIV treatment successes for promoting adherence to treatment for common comorbidities like hypertension in PLWHV in order to improve clinical outcomes.
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