ABSTRACT
The study was carried out to determine the role of pharmacists in diabetes management in Nigeria.
Diabetes, a widespread health challenge intensifying global prevalence, has become a significant and formidable challenge for the current human population. The surge in diabetes cases observed across most regions worldwide corresponds to rapid economic growth, urbanization, and the adoption of modern lifestyle habits (Blas and Kurup, 2010).
According to the World Health Organization (2023), the number of individuals affected by diabetes increased from 108 million in 1980 to 422 million in 2014. The prevalence of diabetes has been rising at a faster pace in low- and middle-income countries compared to high-income countries. In 2019, it was estimated that approximately 463 million adults aged 20-79 years had diabetes, representing approximately 9.3percent of the worldwide adult populace. Projections indicate that by 2030, this number is expected to rise to 578 million, encompassing 10.2% of the worldwide adult populace.
The study was conducted among Pharmacists in Oshodi LGA, Lagos. The study adopted quantitative pilot survey that will be conducted by the researcher among Pharmacists in Oshodi LGA, Lagos. The Pharmacists used for the study include those that have practices for 1-20yrs. A quantitative research method through structured questionnaire will be employed for data collection and analysis. The sample population for the study was all the Pharmacists in Lagos. Simple random sampling technique will be used to select 100 Pharmacists in Oshodi LGA, Lagos. Data collected were presented in tables and the corresponding values expressed in percentages. Hypotheses were tested using chi-square statistical approach.
Findings from the study reveal that a Pharmacist can provide people at risk with more information about a healthy lifestyle and what steps can be taken to keep diabetes under control.
Pharmacists serve as members of diabetes management teams within a variety of diverse ambulatory practice settings and provide direct patient care through various practice models.
Pharmacists provide patient education, therapeutic recommendations, have prescriptive authority through collaborative drug therapy management agreements.
Diets rich in grains, fruits, vegetables, legumes, nuts, moderate in alcohol consumption, and lower in refined grains, red/processed meats, and sugar-sweetened beverages reduces diabetes risk.
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Diabetes mellitus (DM), commonly referred to as diabetes, is a multifaceted metabolic disorder characterized by elevated levels of blood glucose, known as hyperglycemia. This abnormal physiological condition arises from irregularities in either insulin secretion, insulin action, or both, leading to chronic and diverse disruptions in carbohydrate, fat, and protein metabolism. Diabetes exhibits a progressive nature, involving intricate pathogenesis and presenting in various ways (American Diabetes Association, 2014; American Diabetes Association, 2018).
The presence of high blood sugar levels, known as hyperglycemia, and its related metabolic dysfunctions have profound consequences on various organs within the body, causing disruptions to their normal operations. These disruptions develop gradually and stem primarily from the adverse effects of elevated blood glucose levels and associated metabolic irregularities on the structure and function of both small and large blood vessels in the body. These structural and functional complications in the blood vessels contribute to micro- and macrovascular issues, which, in turn, impact organs such as the eyes, kidneys, heart, and nerves. Ultimately, these complications lead to organ damage, dysfunction, and ultimately, organ failure (American Diabetes Association, 2018a; American Diabetes Association, 2018b).
Diabetes, a widespread health concern with an escalating global prevalence, has become a significant and formidable challenge for the current human population. The surge in diabetes cases observed across most regions worldwide corresponds to rapid economic growth, urbanization, and the adoption of modern lifestyle habits (Blas and Kurup, 2010).
According to the World Health Organization (2023), the number of individuals affected by diabetes increased from 108 million in 1980 to 422 million in 2014. The prevalence of diabetes has been rising at a faster pace in low- and middle-income countries compared to high-income countries. In 2019, it was estimated that approximately 463 million adults aged 20-79 years had diabetes, representing approximately 9.3percent of the worldwide adult populace. Projections indicate that by 2030, this number is expected to rise to 578 million, encompassing 10.2% of the worldwide adult populace.
In 2014, diabetes affected 8.5% of adults aged 18 years and older. By 2019, diabetes was identified as the direct cause of 1.5 million deaths, with 48% of those deaths occurring before the age of 70. If appropriate measures are not implemented, the prevalence of diabetes is projected to rise to 10.9% (700 million) by 2045 (Saeedi et al., 2019).
The prevalence of diabetes in Nigeria is on the rise, with current estimates from the World Health Organization (2022) indicating a rate of 4.3%. However, there is a widespread belief that the actual prevalence and impact of diabetes in Nigeria are significantly underestimated. This is largely due to the high number of undiagnosed cases resulting from poverty and limited access to healthcare services. Recent studies conducted across the country by various researchers (Nyenwe et al., 2003; Gezawa et al., 2015; Puepet and Ohwovoriole, 2008; Sabir et al., 2015) have reported diabetes prevalence rates ranging from 2% to 12%. The most recent nationwide population estimate of diabetes in Nigeria was conducted during the 1992 Nigerian National Non-communicable Diseases (NCD) survey, which reported a prevalence rate of 2.2% in the population (Akinkugbe and Akinyanju, 1997).
The impact of diabetes reaches beyond individual health implications, as it places a significant economic burden on both the global healthcare system and the broader global economy. This burden can be assessed by considering direct medical expenses, indirect costs stemming from decreased productivity and premature mortality, as well as the negative influence of diabetes on a nation's gross domestic product (GDP) (Roglic, 2016).
Thus, it is crucial to effectively manage diabetes to prevent complications such as cardiovascular diseases, kidney issues, neuropathy, and diabetic retinopathy. Successful management encompasses a combination of medication therapy, lifestyle adjustments, dietary modifications, and patient education (Elgzyri, 2006). Consequently, the optimal treatment outcomes for diabetes mellitus (DM) are expected to require a multidisciplinary team approach. This approach involves collaboration among physicians, pharmacists, nurses, diabetes educators, nutritionists, and other healthcare specialists to ensure comprehensive and effective care.
The role of pharmacists has undergone significant transformations in the past five decades. They have transitioned from being solely responsible for dispensing medications to playing a more active role in delivering clinical services. This expanded role encompasses patient education, direct patient care responsibilities, and involvement in the management of chronic diseases through team-based care. The advancement of pharmacists' responsibilities has been supported by specialized training programs such as residency programs and certificate programs, which have been instrumental in broadening their scope of practice.
For instance, community pharmacists now have a unique position that allows them to enhance access to care for patients within their community. They not only dispense medications but also provide education to patients. With additional certifications, they can also prescribe and administer immunizations and medications. On the other hand, clinical pharmacists who have undergone residency training possess specialized knowledge and skills in providing direct patient care. They are often placed within clinic settings and work as part of a team of healthcare providers, enabling them to provide more targeted and comprehensive care to patients.
The importance of pharmacists in diabetes care is acknowledged by the American Diabetes Association. As healthcare models shift from fee-for-service to value-based care, with a focus on improving population health, reducing costs, enhancing patient experience, and improving provider satisfaction (Bodenheimer and Sinsky, 2014), there is a significant opportunity for pharmacists to contribute. The involvement of pharmacists in managing diabetes care can take various forms.
Hence, this study seeks to investigate the role of pharmacists in diabetes management specifically in Nigeria.
1.2 Statement of the Problem
Previous studies conducted in other countries have highlighted the valuable role of pharmacists in diabetes management (Choe et al., 2005; Farland et al., 2013; Ragucci et al., 2005; Scott et al., 2006; Morello et al., 2006; Sullivan et al., 2016). These studies have shown that pharmacist interventions can lead to improved medication adherence, better glycaemic control, increased patient knowledge, and reduced healthcare costs.
However, the Nigerian healthcare system has its unique characteristics and challenges, which may influence the role and effectiveness of pharmacists in diabetes management. Therefore, there is a need to extensively explore the specific context of Nigeria and examine the contributions of pharmacists in diabetes care within this setting.
1.3 Aim of the Study
The aim of this study is to examine the role of pharmacists in diabetes management in Nigeria.
1.4 Objectives of the Study
The study had the following specific objectives:
- To identify the roles of pharmacists in diabetes management in Nigeria.
- To determine the impact of pharmacist interventions in diabetes management.
- To propose recommendations for improving the role of pharmacists in diabetes management.
1.5 Research Questions
- What are the roles and responsibilities of pharmacists in diabetes management in Nigeria?
- What is the impact of pharmacist interventions in diabetes management?
- What recommendations can be made to improve the role of pharmacists in diabetes management?
1.6 Research Hypothesis
H0: Pharmacists play significant roles in diabetes management in Nigeria.
Ha: Pharmacists do not play significant roles in diabetes management in Nigeria.
1.7 Justification of the Study
The significance of this study lies in its potential to contribute to the existing body of knowledge on the role of pharmacists in diabetes management, particularly within the context of Nigeria. By examining the specific activities and contributions of pharmacists, the study aims to provide insights into the effectiveness and impact of their interventions on patient outcomes. The findings of this study can inform healthcare policy, guide the development of pharmacist-led diabetes care programs, and enhance the collaboration between pharmacists and other healthcare professionals.
1.8 Scope of the Study
This study will focus specifically on the role of pharmacists in diabetes management in Nigeria. It will encompass various aspects of pharmacist involvement. It is important to note that the study does not cover other healthcare professionals' roles in diabetes management, but specifically focuses on the contributions and effectiveness of pharmacists in improving patient outcomes and enhancing the quality of diabetes care.
