Pharmacists-led diabetes care in Nigeria (2000-2022): A systematic review
Keywords:Pharmacists, Diabetes Care, systematic review, Nigeria
Background: Diabetes mellitus (DM) is a noncommunicable disease of global health concern, which is targeted for reduction according to the Sustainable Development Goals 3.4. The burden in Nigeria rose from 2.2% in 1997 to 5.77% in 2018. It is associated with high morbidity and mortality, thus requiring a collaborative care approach involving the patients and all healthcare providers to ensure optimal care. Pharmacists worldwide are involved in diabetes care, with evidence of positive outcomes, but the contributions of pharmacists in diabetes care have not been extensively reviewed in Nigeria. This review was aimed at describing the trends, geographical spread and quality of pharmacist-led diabetes care/research in Nigeria
Methods:To identify diabetes-care research conducted by pharmacists in Nigeria, literature search for articles published between January 1, 2000 and June 5, 2022 was conducted, using databases such as PubMed/Medline, African Journal Online, Clinical Trials Registries, and Google Scholar. Medical subject headings (MeSH) and search terms combined with Boolean operators were among the keywords and search terms used for article identifification. Only studies published in English language were considered.
Results: Of the 62 studies retained for review, 51 were conducted in the southern zone of Nigeria (South-West 25, South-East 15 and South-South 11) and 11 in the north (North-East 6, North-Central 4 and North-West 1). Most of the studies (92%) were published between 2010 and 2022, with 83.9% conducted using cross-sectional design, 4.8% were Quasi-Randomized Studies and 11.3% were Randomized Controlled Trials. This review revealed that compared to usual care, patients who received pharmacist-delivered care had signifificantly improved medication adherence, quality of life and other clinical variables, with more cost-effffective management outcomes.
Conclusion: The contributions of pharmacists to diabetes care in Nigeria have signifificantly improved over the last decade. Majority of studies (82.3%) were conducted in the country's southern zone and only 11.3% were Randomized Controlled Trials with signifificant improvement in patients' treatment outcomes. More pharmacist-led high quality patient care research are recommended at the state (especially northern states) and national levels to improve on the current evidence of pharmacists' contribution to diabetes management in the Nigeria.
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