Assessment of pharmacist's knowledge on use of non-steroidal anti-inflammatory drugs in hypertensive patients with co-morbid arthritis and pharmaceutical services rendered in Ibadan, Nigeria.
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Abstract
Background: hypertension and arthritis are two co-morbid diseases that require pharmaceutical care (PC) services. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for treatment of arthritis.
Objectives: The study evaluated the knowledge of pharmacist on the use of NSAIDs in this set of patients and the PC services rendered to them.
Methods: structured tested questionnaires were distributed to pharmacists working in public hospitals and community pharmacies in Ibadan metropolis. The questionnaire elicited information on the demographics of respondents, identification of drug related problems and ways of resolving them, knowledge on pharmacotherapy of arthritis and hypertension. Data was analysed with descriptive analysis using statistical package for the social sciences (SPSS) version 16 for windows.
Results: a total of 165 questionnaires were distributed with 124 properly filled and returned giving a response rate of 75.2%. Majority (64.5%) were females, the mean year of graduation of the respondents was 9.12years and 50.8% practice as Community pharmacists. Common PC activities include; counseling (84.4%), monitoring of patients B.P (53.3%), blood glucose measurement (53.3%), monitoring patient's using available laboratory results (44.3%). Majority (85.5%) resolved side effects complaint from patients by reassuring the patients that side effect will subside as therapy continues while 77.4% took full medication history and 65.3% consulted physician for a change of medication. Majority (88.7%) agreed that they encountered prescriptions containing NSAIDs for arthritis in their practice. Good numbers of the respondents had no idea of what measure to take when a patient diagnosed of arthritis and hypertension was prescribed NSAIDs if the blood pressure was control or when it was uncontrolled. Few 16.9% and 8.9% indicated they monitored B.P of such patients with controlled or uncontrolled B.P, while more than half (55.6%) of the respondent indicated that COX2 inhibitor are safer in hypertension as compared to COX1 and that NSAIDs effects on hypertension is dose dependent. Most (77.4%) of them indicated that NASIDs can exacerbate hypertension while 55.6% indicated that NSAIDs can induce hypertension.
Conclusion: Respondents' knowledge of the pharmacotherapy with antihypertensives and NSAIDs use in patients with hypertension co-morbid arthritis need to be improved. Good and well established pharmacistphysician relationship, refresher courses and remuneration of pharmacist for the PC services will also improve services provided by the pharmacist.
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References
Hepler CD and Strand, LM (1990). Opportunities and Responsibilities in Pharmaceutical Care. American Journal of Hospital Pharmacy 47: 533-43.
Westerlund T and B jork HT (2006). Pharmaceutical Care in Community Pharmacies: Practice and Research in Sweden. The Annals of Pharmacotherapy 40(6):1162-1169.
Roughhead L, Semple S and Vitry A (1990). The value of pharmacist professional services in the community setting: a systematic review of the literature of 1990-2002. Pg: 2002-507. www.guild.org.au/public/researchdocs/reportvalueservices. Accessed 9th October, 2015.
Boyden LM, Choi M, Choate KA, Nelson-Williams CJ, Farhi A, Toka HR, et al. (2012). Mutations in kelch-like 3 and cullin 3 cause hypertension and electrolyte abnormalities. Nature 482 (7383):98-102.
Albishri J (2013). NSAIDs and hypertension. Anaesthesia Pain & Intensive Care 17(2):171-173
Crofford LJ (2013). Use of NSAIDs in treating patients with arthritis. Arthritis Research & Therapy 15(Suppl 3):S2. 1-10. http://arthritisresearch.com/content/15/S3/S2.
Darell H and Melissa L (2008). Drug-Induced Hyper tension. U.S. Pharmacist; 33(9): Hs11-HS20.
Hamzat TK and Ajala, AO (2010). Interaction between anti-hypertensive and non-steroidal antiinflammatory drugs: implications in
management of osteoarthritis and opinion on a compromise therapy. Internet Journal of Medical Update (1):42-47.
http://www.akspublication.com/ijmu. Assessed on 4th February, 2015.
Meek IL, Van de Laar MAF and Vonkeman HE 2010. Nonsteroidal Anti-inflammatory drugs: an overview of cardio vascular risks. Pharmaceuticals 3: 2146-2162. www.mdpi.com/journal/pharmaceuticals.
Armstrong EP and Malone DC (2003). The Impact of Nonsteroidal Anti-inflammatory drugs on blood pressure, with an emphasis on Newer
Agents. Clinical Therapeutics 25:1-18
DeMaria AN and Weir MR (2003). Coxibs-beyond the GI tract: Renal and Cardiovascular issues. Journal of Pain Symptom Manage 25(2): S41-S49.
Stollberger C and Finsterer J (2004). Side Effects of Conventional Nonsteroidal Anti-inflammatory Drugs and Celecoxib: more similarities than differences. South Medical Journal 97:209-219.
Fournier JP, Sommet A, Bourrel R, Ousric S, Pathak A, Lapeyre- Mestre M, Montastruc JL (2012). Non-steriodal anti-inflammatory drugs (NSAIDs) and hypertension treatment intensification: A population-based cohort study. European Journal of Clinical Pharmacology 68 (11): 1533-1540.
Savenkov MP, Ivanov SN, Brodskaia SA (2001). Antihypertensive effect of enalapril and lisinopril administered in combination with nonsteroid anti-inflammatory agents. Terapevticheskii Arkhiv 73:27-31.
Polonia J (1997). Interaction of antihypertensive drugs with anti-inflammatory drugs. Cardiology 88:47-51.
Erah PO and Nwazuoke JC (2002). Identification of Standards for Pharmaceutical Care in Benin City. Tropical Journal of Pharmaceutical Research 1 (2): 55-66
Nwaozuzu EE, Okonta JM and Aguwa CN(2013). Attitude of hospital pharmacists in Nigeria towards pharmaceutical care. International
Journal of Development and Sustainability 2 (2): 1377-1385. Online ISSN: 2168-8662 –www.isdsnet.com/ijds
Awodele O, Fadipe A, Adekoya M and Adeyemi O (2014). Prescribing Pattern of Non-Steroidal Antiinflammatory Drugs at the Out-Patient Pharmacy Department of a University Teaching Hospital in Nigeria. Ghana Medical Journal 49 (1):25-29.
Singh G, Miller JD, Huse DM, Pettitt D, D'Agostino RB and Russell MW. (2003). Consequences of increased systolic blood pressure in patients with osteoarthritis and rheumatoid arthritis. Journal of Rheumatology 30(4):714-9.
www.raosoft.com/samplesize.html assessed 15/05/2015.
Rigby D (2010). Collaboration between doctors and pharmacists in community. Australian Prescriber 33:191-193.
Eniojukan JF, Giwa A and Kola-Korolo BA (2001). The Impact of the clinical pharmacist on patient care in Lagos state. Pharmacy Practice and Continuing Education 4 (1):13-19.
Chua SS, Kok CL, Yusof FA, Tang GH, Lee WSH, Efendie B and Paraidathathu T (2012). Pharmaceutical care issues identified by pharmacists in patients with diabetes, hypertension or hyperlipidaemia in primary care settings. BMC Health Services Research 12:388 http://www.biomedcentral.com /1472-6963/12/388
Mackenzie SI & MacDonald TM (2010). Treatment of osteoarthritis in hypertensive patients. Expert Opinion Pharmacotherapy 11(3):393-403.
Hochberg MC, Altman RD, April TK, Benkhalti M, Guyatt G, MCGowan J, Towheed T, Welch V, Wells G and Tugwell P (2012). American College of Rheumatology Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee.