TABLE OF CONTENTS
ABSTRACT. ii
TABLE OF CONTENTS……………………………....………………………iii
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study. 1
1.2 Statement of the Problem.. 4
1.3 Objectives of the Study. 5
1.4 Research Questions. 6
1.5 Research Hypothesis. 6
1.6 Significance of the Study. 7
1.7 Scope of the Study. 7
1.8 Limitations of the Study. 8
1.9 Organization of the Study. 8
1.10 Definition of Terms. 9
CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.1 Introduction. 12
2.2 Theoretical Review.. 12
2.2.1 Social Cognitive Theory. 12
2.2.2 Theory of Planned Behavior 12
2.2.3 Health Belief Model Theory. 13
2.2.4 Diffusion of Innovations Theory. 13
2.3 Conceptual Review.. 14
2.3.1 Overview.. 14
2.3.2 Pharmacists' Education and Training. 14
2.3.3 Community and Clinical Pharmacy Practices. 14
2.3.4 Patient Counseling and Education. 15
2.3.5 Role in Drug Information and Public Health. 15
2.3.6 Challenges Faced by Pharmacists. 15
2.3.7 Regulatory Framework and Policy Implications. 16
2.3.8 Impact on Healthcare Outcomes. 16
2.3.9 Collaborative Healthcare Models. 16
2.4 Empirical Review.. 17
2.5 Summary of Literature Review.. 19
CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Introduction. 21
3.2 Research Design. 21
3.3 Study Population. 21
3.4 Sample Size and Sampling Techniques. 22
3.5 Data Collection Methods. 22
3.6 Instrumentation. 23
3.7 Method of Data Analysis. 23
3.8 Ethical Considerations. 23
3.9 Scope and Limitations of the Study. 23
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS AND INTERPRETATION
4.1 Preamble. 25
4.2 Data Analysis. 25
4.3 Tables based on research questions. 29
4.4 Testing Hypothesis. 38
4.5 Discussion of findings. 40
CHAPTER FIVE
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
5.1 Summary of Findings. 42
5.2 Conclusion. 44
5.3 Recommendations. 44
REFERENCES. 46
APPENDICES. 51
Appendix I:Research Questionnaire. 51
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Drugs are essential in healthcare; when used correctly, they can cure diseases, alleviate symptoms, and minimize patient suffering. However, irrational medication use continues to pose a serious challenge to global health systems (WHO, 2011). The World Health Organization (WHO) defines rational medicine (RUM) as. “patients receiving medications appropriate to their clinical needs, in doses that meet their individual requirements, for an adequate period of time, and at the lowest cost to them and their community.” (Arvinth and Suganya, 2022; WHO, 2002).
Rational use of medicine is also conventionally defined as the appropriate, safe, cost-effective, and effective use of drugs that are prescribed for the right reasons, in the right dosage and formulation, and given at the right times.
More than half of all pharmaceuticals are allegedly prescribed, dispensed, or sold incorrectly, according to estimates from the World Health Organization (WHO). Additionally, roughly half of patients do not properly follow their prescription regimens (WHO, 2004). Because routine monitoring of medication use is frequently inadequate or nonexistent in developing nations with weak health systems, the problem of irrational medication use is especially severe there (Ofori-Asenso et al. , 2016).
Irrational use of medicines is often typified by polypharmacy, antimicrobial misuse, excessive injection use, noncompliance with clinical guidelines, and inappropriate self-medication—often involving prescription-only medications and noncompliance with dosing instructions (Sema et al., 2021).
harmacy has expanded in both scope and complexity since its founding, encompassing every aspect of healthcare (Daniel and Betty, 2002). Pharmacist experts currently play an important role in ensuring the efficacy and safety of medications, and their position has developed throughout time. However, the pharmacy profession is still viewed through a narrow lens, ignoring the broad and diverse characteristics of modern pharmacy practice (Muhammad et al. in 2022).
Pharmacists are frequently viewed as merely manufacturers of medications, pill dispensers, and labelers who prioritize management and entrepreneurship over providing patient care as medication experts (Muhammad et al. 2022). However, a community pharmacist's typical workday entails answering inquiries regarding the adverse effects of drugs, offering therapeutic substitutes, going over patient medication histories, and endorsing over-the-counter drugs. On the other hand, the duties of hospital pharmacists include delivering drug information, managing medications, preparing and supplying medications, counseling patients, and creating pharmaceutical care plans. Pharmacists now play a more patient-centered and outcome-focused role in pharmacy practice than simply dispensing medications (Otuto, 2020; Muhammad et al. 2022).
In Nigeria, pharmacists are essential to ensuring safe drug therapy because they give patients accurate medication information and counseling (Musa et al. 2020), and their specialized knowledge of pharmacotherapy allows them to evaluate prescriptions for suitability, potential drug interactions, and side effects (Ezeuko et al. in 2021. In a nation where poor pharmaceutical quality and fake drugs pose a major threat to public health, this information is particularly crucial (Lawal et al. 2022). Patients are shielded from the dangers of improper or hazardous drug use by pharmacists who check prescriptions and guarantee the quality of the drugs they dispense.
Additionally, pharmacists actively promote responsible medication use as members of healthcare teams (Oparah et al. 2019). They work together with physicians and other health care professionals to assist in making therapeutic decisions that reduce risks and optimise treatment outcomes. Collaboration is crucial to addressing Nigeria's healthcare challenges, such as the high rate of non-communicable illnesses and the need for effective chronic disease management (Adebayo et al., 2023).
Beyond hospitals and clinics, pharmacists also have a role in community settings by teaching the public how to take drugs properly and regularly and taking part in health promotion programs (Onwuka et al. 2021). Pharmacists in Nigeria play a crucial role in promoting legislation that ensures the rational and secure use of drugs (Abdulsalim et al. 2022).
Moreso, they contribute their expertise to government and regulatory authorities, assisting in the development of healthcare legislation that improve pharmaceutical safety and drug misuse prevention. This campaign shows pharmacists' proactive approach to addressing structural difficulties in the healthcare system, as well as their commitment to public health (Amadi et al., 2023).
Pharmacists also play an important role in making Nigeria's healthcare system more sustainable and efficient by promoting evidence-based procedures and complying to global pharmaceutical standards. In light of this, this study aims to evaluate the role of pharmacists in rational and safe drug use, with a focus on the PSN Uyo chapter.
1.2 Statement of the Problem
Irrational drug usage is a leading cause of morbidity and mortality and although there are many factors that promote the practice of rational drug usage and the role of governments, manufacturers, society, drug authorities, the educational system, the media, and cannot be denied, most of the responsibilities fall on health care providers (Durga et al., 2020; Khan and Karatas, 2021). In recent decades, the pharmacist’s role in therapy has expanded; many factors have an influence on prescribing and have expanded the pharmacist’s role from a passive dispenser to an active participant in the therapeutic decision-making team and introduce many clinical pharmacists’ activities as a selection of medications, consulting and advise about drug information, its formulation and preparation, drug use studies and research, clinical trials, pharmacokinetics/ therapeutic drug monitoring, pharmacoeconomic of drugs, dispensing, administration, teaching, and training to reach the main goal in promoting the correct, appropriate, and rational use of medications products with reduce treatment cost (Mohiuddin, 2020). However, there is a paucity of evidence on pharmacists' role in promoting the safe and rational use of drugs in Nigeria.Top of FormBottom of Form
1.3 Objectives of the Study
The main objective of the study is to examine the role of pharmacists in promoting the safe and rational use of drugs in Nigeria. Specific objectives of the study are:
- To assess the impact of pharmacist interventions on medication adherence and rational use in Nigeria.
- To explore the challenges faced by pharmacists in promoting safe and rational drug use in Nigeria.
- To evaluate the effectiveness of existing policies and regulations in supporting pharmacists' role in promoting safe and rational drug use in Nigeria.
1.4 Research Questions
To guide the study and achieve the objectives of the study, the following research questions were formulated:
- To what extent do pharmacist-led medication reviews and counseling sessions improve patient adherence to prescribed medications in Nigerian healthcare settings?
- What are the main barriers faced by Nigerian pharmacists in providing optimal medication counseling and education to patients due to factors like workload, time constraints,
- To what extent do current pharmacy practice regulations in Nigeria empower pharmacists to participate in medication reviews, dose adjustments, and other interventions to optimize drug therapy?
1.5 Research Hypothesis
The following research hypothesis was developed and tested for the study:
Ho: There is no significant association between the role of pharmacists and the promotion of safe and rational drug use in Nigeria.
1.6 Significance of the Study
The study is important for many reasons. The following are the major stakeholders this paper through its practical and theoretical implications and findings will be of great significance:
Firstly, the paper will benefit major stakeholders and policy makers in the Pharmacy sector. The various analysis, findings and discussions outlined in this paper will serve as a guide in enabling major positive changes in the industry and sub-sectors.
Secondly, the paper is also beneficial to the organizations used for the research. Since first hand data was gotten and analysed from the organization, they stand a chance to benefit directly from the findings of the study in respect to their various organizations. These findings will fast track growth and enable productivity in the organisations used as a case study.
Finally, the paper will serve as a guide to other researchers willing to research further into the subject matter. Through the conclusions, limitations and gaps identified in the subject matter, other student and independent researchers can have a well laid foundation to conduct further studies.
1.7 Scope of the Study
The study is delimited to Pharmaceutical Society of Nigeria, Uyo Chapter. Findings and recommendations from the study reflects the views and opinions of respondents sampled in the area. It may not reflect the entire picture in the population.
1.8 Limitations of the Study
The major limitations of the research study are time, financial constraints and delays from respondents. The researcher had difficulties combining lectures with field work. Financial constraints in form of getting adequate funds and sponsors to print questionnaires, hold Focus group discussions and logistics was recorded. Finally, respondents were a bit reluctant in filling questionnaires and submitting them on time. This delayed the project work a bit.
1.9 Organization of the Study
The study is made up of five (5) Chapters. Chapter one of the study gives a general introduction to the subject matter, background to the problem as well as a detailed problem statement of the research. This chapter also sets the objectives of the paper in motion detailing out the significance and scope of the paper.
Chapter Two of the paper entails the review of related literature with regards to corporate governance and integrated reporting. This chapter outlines the conceptual reviews, theoretical reviews and empirical reviews of the study.
Chapter Three centers on the methodologies applied in the study. A more detailed explanation of the research design, population of the study, sample size and technique, data collection method and analysis is discussed in this chapter.
Chapter Four highlights data analysis and interpretation giving the readers a thorough room for the discussion of the practical and theoretical implications of data analyzed in the study.
Chapter Five outlines the findings, conclusions and recommendations of the study. Based on objectives set out, the researcher concludes the paper by answering all research questions set out in the study.
1.10 Definition of Terms
1. Pharmaceutical Care: Pharmaceutical care refers to the provision of drug therapy management and patient-centered services aimed at achieving definite therapeutic outcomes. It involves pharmacists working closely with patients to optimize medication use, ensure adherence, and monitor for effectiveness and safety.
2. Drug Utilization Review DUR
Drug Utilization Review involves the systematic evaluation of prescription drugs to ensure that each patient receives appropriate medication therapy. Pharmacists conduct DUR to identify potential drug interactions, therapeutic duplications, and inappropriate drug doses, thus promoting safe and effective drug use.
3. Medication Therapy Management MTM
MTM involves pharmacists collaborating with patients and healthcare providers to optimize therapeutic outcomes through effective medication use. This includes medication reviews, patient education, and monitoring to ensure safe and rational drug therapy.
4. Adverse Drug Reaction ADR
An adverse drug reaction is any harmful or unintended reaction to a medication, occurring at normal doses during clinical use. Pharmacists play a crucial role in identifying, reporting, and managing ADRs to enhance patient safety and promote rational drug use.
5. Pharmacovigilance
Pharmacovigilance involves the monitoring, detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. Pharmacists actively participate in pharmacovigilance activities to ensure the safe use of medications and contribute to public health efforts.
6. Drug Information Services
Drug information services provided by pharmacists involve the dissemination of accurate, unbiased, and up-to-date information about medications to healthcare professionals, patients, and the public. These services promote rational drug use by enabling informed decision-making regarding medication therapy.
7. Formulary Management
Formulary management refers to the development, implementation, and evaluation of medication formularies or lists of preferred medications within healthcare settings. Pharmacists contribute to formulary management by recommending safe, effective, and cost-effective medications, thereby promoting rational drug use and optimizing therapeutic outcomes.
