Clinical pharmacy services provided in public sector hospitals in Nigeria: a national survey

Abstract

Objectives Studies show that clinical pharmacy services are effective in optimizing medicines use and patients' outcomes. This study aimed to determine the clinical pharmacy services provided in public sector hospitals in Nigeria. Methods This was an online survey of 296 primary, secondary and tertiary care hospitals sampled purposively across the 36 States and Federal Capital Territory in Nigeria. Data analysis was conducted descriptively via χ 2 test and multivariate analysis of variance (MANOVA). Key findings Responses were obtained from 272 hospitals in the country with a survey completion rate of 88%. This included 55 tertiary, 72 secondary and 145 primary healthcare centres (PHCs). Pharmacists provided pharmaceutical care services in all the tertiary care hospitals, 94% of the secondary and in only 6% of the PHCs surveyed. Most of the secondary and tertiary care hospitals provided medicines information, patient education and counselling, and in-patient dispensing services [n = 97 (79%), 116 (94%), 88 (72%)], respectively. However, fewer than a third reported involvement in multidisciplinary ward rounds, medication chart review and antibiotic stewardship programmes [n = 18 (15%), 33 (27%), 22 (18%), respectively]. Furthermore, medication error reporting and pharmacovigilance services were each routinely provided in only about half of the secondary and tertiary care hospitals [n = 62 (50%)], and this was not associated with the level of care (P > 0.05). Conclusions The findings of this study demonstrate disparity in clinical pharmacy service availability across the various levels of care in Nigeria and emphasize the need to prioritize their integration within the primary care sector.

The Role of Pharmacists in Strengthening the Health System in Nigeria

“…Evidence gotten from countries such as South Africa indicated that pharmacist-led care interventions were highly effective in long-term disease prevention, medication therapy management, and improvement in drug-related patient outcomes. [31][32][33] There were also lower potentials for medication errors and non-adherence to long term disease therapies when pharmaceutical care services were provided by pharmacists which further emphasize the roles pharmacist play in strengthening a nation's health care system. 31,34,35 Pharmacists would continue to play an important role in strengthening the health care system.…”

Enhancing care transition performance of community pharmacies in Nigeria

“…Typically, CPs and hospitals work in isolation, and this disconnect extends to the relationship between the practitioners in these two facilities, thereby negatively affecting collaboration and smooth TOC 16 . Anecdotal evidence suggests that many private hospitals in Nigeria lack significant pharmacist engagement in their operations 23 . Similarly, some community pharmacists have been implicated in overreaching practices, such as offering prescription‐only medications to patients without a physician's input 24 .…”

“…16 Anecdotal evidence suggests that many private hospitals in Nigeria lack significant pharmacist engagement in their operations. 23 Similarly, some community pharmacists have been implicated in overreaching practices, such as offering prescription‐only medications to patients without a physician's input. 24 As such, professional silos created by a lack of trust and unhealthy competitive behaviors between care providers may deny patients quality care, where one provider hesitates to refer when due or does so as a mere “handover” devoid of feedback, follow‐up or consideration of patients' needs.…”

Pharmaceutical Care in Mental Health: Pharmacists’ Barriers, Collaborations, Attitudes, and Perceptions

“…[20][21][22] Low availability of mental health experts and poor involvement of pharmacists in clinical care of patients is also a notable challenge in Nigeria. 17,23 Poor institutionalization of collaborative care with pharmacists in Nigerian hospitals is a significant barrier to healthcare delivery in the country. 24 These situations reduce access to optimal mental healthcare, and prevents the utilization of the pharmacists' clinical skills thereby interfering with potential benefits for the patients.…”