The Impact of Education Intervention on the Blood Pressure Control of the Elderly Nigerian Hypertensives

Hypertension plays a major role in morbidity and mortality in Nigeria. Evidence from developed countries showed that intensive patient education has resulted in improved compliance to therapy reducing morbidity and mortality. There was a need to explore the impact of health educational intervention on the blood pressure control among elderly hypertensives. Ninety-five hypertensive patients aged sixty and above attending the Hypertension Clinic of the Lagos University Teaching Hospital were recruited. An initial level of their awareness of hypertension, its risk factors and management were assessed through a structured research questionnaire. A score of 60% was deemed adequate. Over a two year period, health talk on the need to comply with life style modification and drug therapy followed by a question and answer session was given on each clinic day. Adequate blood pressure control was define

Assessment of Rational Prescribing of Antihypertensive Drug combinations in Lagos University Teaching Hospital

Purpose: The study aimed to assess prescribing trends of antihypertensives and proportion of prescriptions containing irrational combinations of antihypertensives and co-prescribed drugs. Methods: Five hundred and fifty four prescriptions, containing antihypertensives, were collected prospectively over a period of twelve months, from the internal medicine clinic of the Lagos University Teaching Hospital, and evaluated. Results: The average number of drugs prescribed per encounter was 2.9. Encounters with injections were 0.5%. The percentage of drugs prescribed by generic name was 31.6%. All the drugs prescribed were from the National Essential Drugs List. Calcium antagonists were the most frequently used group of drugs (41.3%), followed by Diuretics (33.0%) and Angiotensin-Converting Enzyme inhibitors (ACEIs) (22.4%). Nifedipine (31.9%), Methyldopa (22.4%) and Propranolol (20.2%) were the most frequently used individual drugs. Beta-blockers with Calcium antagonists (13.3%), Methyldopa with Diuretics (10.6%), Calcium antagonists with ACEIs (10.3%) were the most frequently prescribed drug combinations. Irrational drug combinations with NSAIDs were observed in 21.8% of the prescriptions. Also beta-blockers were prescribed in 22% of prescriptions for hypertensive / diabetic patients. Conclusion: There is need to educate prescribers on appropriate therapeutic combinations that would provide optimal management of hypertension and associated clinical conditions. KEY WORDS: Antithypertensive, rational, drug combination. Nig. Jnl Health & Biomed. Sciences Vol.3(1) 2004: 8-1

IMPACT OF A SHORT-COURSE IN PHARMACOTHERAPY FOR UNDERGRADUATE MEDICAL-STUDENTS - AN INTERNATIONAL RANDOMIZED CONTROLLED-STUDY

Irrational prescribing is a habit which is difficult to cure. However, prevention is possible and for this reason the WHO Action Programme on Essential Drugs aims to improve the teaching of pharmacotherapy to medical students. The impact of a short problem-based training course in pharmacotherapy, using a WHO manual on the principles of rational prescribing, was measured in an international multi-centre controlled study of 219 undergraduate students in (Netherlands), Kathmandu (Nepal), Lagos Newcastle (Australia), New Delhi (India), San Francisco (USA), and Yogyakarta (Japan). The manual and the course presented the students, who were about to enter the clinical phase of their studies, with a normative model for pharmacotherapeutic reasoning in which they were taught to generate a ''standard'' pharmacotherapeutic approach to common disorders, resulting in a set of first-choice drugs called P(ersonal)-drugs. The students were then taught how to apply this set of P-drugs to specific patient problems on the symptomatic treatment of pain, using a six-step problem-solving routine. The impact of the course was measured by tests before training, immediately after, and six months later. After the course, students from the study group performed significantly better than controls in all patient problems presented (