Awareness and Practices of Pharmacists in the Use of Guidelines in the Management of Heart Failure in Nigeria
Published: 2024-05-29
Page: 94-103
Issue: 2024 - Volume 7 [Issue 1]
Chibuike Eze Nwafor *
Cardiology Unit, Department of Medicine, University of Port Harcourt and University of Port Harcourt Teaching Hospital, Nigeria.
Marvis Somtochukwu Muo
Research Unit, Good Heart Medical Consultants Hospital, Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background Pharmacist involvement in medication reconciliation and transitions of care in high-risk HF patients has become gold standard. The pharmacist is to provide patient education and assess for improper medication use at every visit. Knowledge of the attitude and awareness of heart failure guidelines among pharmacists will aid the delivery of effective interventions to prevent disease progression and control cardiovascular complications among these patients. The study points out the awareness and attitudes of pharmacists towards guideline adherence in the management of heart failure patients in southern, Nigeria.
Methods: A survey was conducted among 320 pharmacists, yielding a response rate of 68.75%. Demographic characteristics, guideline awareness, frequency of reference, access sources, perceptions, and challenges were computed and analyzed.
Results: Pharmacists exhibited heterogeneous demographics, with varied experience (1-5 years: 50.00%), education (B Pharm: 59.09%), and practice areas (clinical pharmacy: 48.18%). While 75.00% were aware of heart failure guidelines, 61.36% referenced AHA/ACC/HFSA guidelines most frequently. Access was diverse, including national/international websites and professional journals. Positive attitudes towards guideline-mediated management were prevalent (relevant: 79.54%), though barriers such as lack of awareness (50.00%) and time constraints (25.00%) were noted. Perceived adequacy of guidelines in addressing challenges was divided (confident: 50.00%, uncertain: 43.18%, skeptical: 6.82%).
Conclusion: Nigerian pharmacists demonstrated awareness and positive attitudes towards heart failure guidelines, yet face barriers to adherence. Tailored interventions such as inclusivity of the Nigerian pharmacists in the decision-making societies and other interventions are warranted to enhance guideline utilization and optimize patient outcomes.
Keywords: pharmacists, guidelines, heart failure, perception, attitudes, awareness, HF treatments
How to Cite
References
Ogah OS, Kushimo OA, Adebiyi A, Onyema CT, Uchenna OC, Adebayo BE, et al. Heart failure in Nigeria: Protocol for a systematic review and meta-analysis. Afr Health Sci. 2023;23(2):530–6.
Afify MA, Shahzad N, Tawfik N, Ibrahim IA, Abduljaleel Z, Khan W, et al. Evaluation of drug prescribing practices in private and general hospitals in Makkah, Saudi Arabia. Afr J Pharm Pharmacol. 2015;9(39):966–73.
Mendez GF, Cowie MR. The epidemiological features of heart failure in developing countries: a review of the literature. Int J Cardiol. 2001;80(2):213–9.
Aetiology of Heart Failure as Seen from a National Cardiac Referral Centre in Africa | Cardiology | Karger Publishers
Accessed On:2024 Mar 29. Available:https://karger.com/crd/article-abstract/93/1-2/11/83506/Aetiology-of-Heart-Failure-as-Seen-from-a-National
Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW. Heart disease and stroke statistics-2021 update: a report from the American Heart Association; 2021
Accessed On:2024 Apr 2 Available:https://dukespace.lib.duke.edu/items/037a2fff-9b13-4a1b-93b8-2304e9324799
Dodiyi-Manuel ST, Ajala OA, Edafe E, Akpa MR. Heart failure clinics: Much More than pharmacotherapy. Asian J Cardiol Res. 2023;8(1):1–12.
Update AS. Heart disease and stroke statistics–2017 update. Circulation. 2017; 135:e146-603.
Carolina GBS PharmD, BCACP Associate Professor of Pharmacy Practice Presbyterian College School of Pharmacy Clinton, South. Revisiting Heart Failure: Guidelines and Beyond.
Accessed On:2024 Apr 2.
Available:https://www.uspharmacist.com/article/revisiting-heart-failure-guidelines-and-beyond-1
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, 2013 ACCF/AHA Guideline for the Management of Heart Failure. J Am Coll Cardiol. 2013;62(16): e147–239.
Folsom AR, Shah AM, Lutsey PL, Roetker NS, Alonso A, Avery CL. American heart association’s life’s simple 7: Avoiding heart failure and preserving cardiac structure and function. Am J Med. 2015;128(9):970–6.
Egan BM, Li J, Sutherland SE, Jones DW, Ferdinand KC, Hong Y. Sociodemographic determinants of Life’s Simple 7: implications for achieving cardiovascular health and health equity goals. Ethn Dis. 2020;30(4):637.
Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019;380(4):347–57.
Neal B, Perkovic V, Mahaffey KW, De Zeeuw D, Fulcher G, Erondu N. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377(7):644–57.
Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med. 2019;380(24):2295–306.
McMurray JJV, Solomon SD, Inzucchi SE, Køber L, Kosiborod MN, Martinez FA. Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med. 2019;381(21):1995–2008.
Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373(22):2117–28.
Armstrong PW, Pieske B, Anstrom KJ, Ezekowitz J, Hernandez AF, Butler J. Vericiguat in patients with heart failure and reduced ejection fraction. N Engl J Med. 2020;382(20):1883–93.
Seid MA, Abdela OA, Zeleke EG. Adherence to self-care recommendations and associated factors among adult heart failure patients. From the patients’ point of view. PloS One. 2019;14(2):e0211768.
Peri-Okonny PA, Mi X, Khariton Y, Patel KK, Thomas L, Fonarow GC, et al. Target Doses of Heart Failure Medical Therapy and Blood Pressure. JACC Heart Fail. 2019;7(4):350–8.
Martinez AS, Saef J, Paszczuk A, Bhatt-Chugani H. Implementation of a pharmacist-managed heart failure medication titration clinic. Am J Health Syst Pharm. 2013;70(12):1070–6.
Murray MD, Young J, Hoke S, Tu W, Weiner M, Morrow D. Pharmacist intervention to improve medication adherence in heart failure: A Randomized Trial. Ann Intern Med. 2007;146(10): 714.
Warden BA, Freels JP, Furuno JP, Mackay J. Pharmacy-managed program for providing education and discharge instructions for patients with heart failure. Am J Health Syst Pharm. 2014;71(2):134–9.
Christensen M, Lundh A. Medication review in hospitalized patients to reduce morbidity and mortality. Cochrane Database Syst Rev;2016. 2024;(2). Available:https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008986.pub3/abstract
Ryan R, Santesso N, Hill S, Lowe D, Kaufman C, Grimshaw J. Consumer-oriented interventions for evidence-based prescribing and medicines use an overview of systematic reviews. Cochrane Database Syst Rev; 2011.
Aceessed On:2024 Apr 2];(5). Available:https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007768.pub2/abstract
Eggink RN, Lenderink AW, Widdershoven JWMG, Bemt PMLA. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure. Pharm World Sci. 2010;32 (6):759–66.
Cheng J. Current perspectives on the role of the pharmacist in heart failure management. Integr Pharm Res Pract. 2018;7:1–11.
Mohanan H, Rajesh A, Aswathi VV. Sareena A. Role of Pharmacists in Health Care: A Review on Pharmacist and Consumer Views, Journal of Pharmaceutical Research International, 2021;33(42B):258–263. DOI: 10.9734/jpri/2021/v33i42B32444
Chao BMP, Razera A, Lopes MF, Grosko SA, Machado AM, Cordeiro MER, Camargo LEA, de Tortorella CC, da S, Bini ACD. The influence of the clinical pharmacist in the management of depression: A systematic review. Journal of Advances in Medicine and Medical Research. 2024;36(2):135–142. Available:https://doi.org/10.9734/jammr/2024/v36i25374
Anderson SL, Marrs JC. A Review of the Role of the Pharmacist in Heart Failure Transition of Care. Adv Ther. 2018;35(3):311–23.
Mitwalli AH, Harthi AA, Mitwalli H, Juwayed AA, Turaif NA, Mitwalli MA. Awareness, attitude, and distribution of high blood pressure among health professionals. J Saudi Heart Assoc. 2013;25(1):19–24.
Neu R, Leonard MA, Dehoorne ML, Scalia SJ, Kale-Pradhan PB, Giuliano CA. Impact of Pharmacist Involvement in Heart Failure Transition of Care. Ann Pharmacother. 2020;54(3):239–46.
Interventions for Optimization of Guideline-Directed Medical Therapy: A Systematic Review | Cardiology | JAMA Cardiology | JAMA Network .
Accessed On:2024 Apr 11. Available:https://jamanetwork.com/journals/jamacardiology/article-abstract/2815079