MEDICATION THERAPY MANAGEMENT AND PATIENTS SATISFACTION WITH PHARMACEUTICAL SERVICES IN PUBLIC HEALTHCARE FACILTIES IN OYO STATE, NIGERIA

Abstract

Medicines or drugs are used to improve the health of patients by relieving symptoms and curing diseases. However, drugs may produce adverse effects when not taken according to prescriptions by pharmacists. Adverse Drugs Events (ADEs) are increasingly becoming common. Pharmacists play critical roles in Medication Therapy Management (MTM) to reduce ADEs, ensure optimal health outcomes and promote patient’s satisfaction. These roles have largely been misconstrued by patients and their relatives. Only few studies have focused on patients’ satisfaction with pharmaceutical care. This study was, therefore, designed to examine patients’ satisfaction with pharmaceutical services and MTM in public healthcare facilities in Oyo State, Nigeria. Social Action and Consumer Satisfaction Equity theories were used as the framework, while the cross-sectional survey design was adopted. Oyo State was purposively selected with low pharmacist-patient ratio of 1:25,000. Two public hospitals were randomly selected from each senatorial district of Oyo North (Ogbomoso and Saki), Central (Oyo and Moniya) and South (Adeoyo and Ring Road). A total of 769 copies of standard questionnaire were administered to patients and their relatives across Adeoyo (141 and 70), Ring Road (133 and 66), Oyo (35 and 18), Moniya (36 and 18), Ogbomoso (102 and 51) and Saki (66 and 33) through random selection. The instrument focused on respondents’ knowledge of pharmacists’ roles, factors influencing patients’ knowledge of pharmacists’ roles, patients’ satisfaction with pharmacists’ roles in MTM and sociocultural factors influencing patients’ satisfaction. Scores of <50.0%, 50–69% and ≥70% indicated low, average and high knowledge, respectively. Satisfaction was similarly classified as low, moderate and high respectively. In-depth interviews were conducted with 24 patients and their relatives, while key informant interviews were conducted with 12 pharmacists. While quantitative data were analysed using chi-square and multiple regression, qualitative data were contentanalysed. Respondents’ mean age was 40±15 years. Most (69.4%) were females. Mean monthly income was N42,000.00. Respondents’ knowledge of pharmacists’ roles in MTM showed that 47.6%, 7.5% and 44.9% had low, average and high knowledge, respectively. Respondents’ satisfaction indicated that 35.4% were highly satisfied, 40.4% were moderately satisfied and 24.2% had low satisfaction with pharmaceutical services. Age (χ2=15.715), education (χ2=25.265) and occupation (χ2=33.039) of respondents and operating environment like space (χ2=12.837) and adequacy of resources in the pharmacy (χ2=28.294) significantly influenced their perceived knowledge. Level of satisfaction was significantly influenced by religion (χ2=13.218), education (χ2=18.740), perceived knowledge of roles (χ2=828.552), operating environment, namely sufficiency of pharmacists (χ2= 17.106) and adequacy of resources in the pharmacy (χ2=28.825). Socio-cultural factors like language of communication of medication (β= -0.047) and courteous response (β=0.013) significantly influenced level of satisfaction. Pharmacists identified ineffective drug policies, inadequate staffing and unhealthy relationship with physicians as problems of MTM. Pharmacists were not actively involved in review of prescribed drugs in cases of ADEs. Patients complained of inadequate supply and high cost of medication for chronic ailments. Patients in public health facilities in Oyo State were moderately satisfied with pharmaceutical care in relations to Medication Therapy Management. Pharmacists should be involved in review of prescriptions, especially for adverse drug events.