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Opportunistic screening of cardiovascular disease risk factors in community pharmacies in Nigeria: a cross-sectional study

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Abstract

Background Early identification and treatment of cardiovascular disease (CVD) risk factors through screening are crucial in the primary prevention of CVD and reduction in healthcare-related costs. Use of Non-Physician Healthcare-workers including Community Pharmacists has been advocated as an effective and cost-efficient model of healthcare delivery. In Nigeria the use of community pharmacists for mass screening of CVD risk factors has not been explored. Objective We sought to investigate the possibility of mass CVD risk factor screening in community pharmacies by pharmacists. Setting Lagos, Nigeria. Methods Between October and December 2018 eight hundred and eighty-nine apparently healthy participants were screened for obesity, hypertension, diabetes and hypercholesterolaemia in ten community pharmacies. Diabetes and hypercholesterolaemia were screened for using point-of-care testing modalities. A structured questionnaire was used to obtain the socio-demographic data of the participants. Main outcome measures Prevalence of overweight/obesity, hypertension, diabetes, hypercholesterolaemia, smoking and alcohol intake. Results Mean age of the subjects was 56.8 ± 21.1 years. Majority (57.4%) were females. Prevalence of smoking and alcohol intake were 4.3% and 26.7% respectively. 59.7% and 71.5% of males and females were either overweight (BMI ≥ 25 kg/m2) or obese (BMI ≥ 30 kg/m2) respectively. Prevalence of hypertension was 28.2% in all subjects, 30.9% in males and 26.3% in females, p < 0.001. Using BP > 130/80 mmHg prevalence of hypertension was 55.1%. Diabetes was detected in 3% of the subjects while 45.3% had hypercholesterolaemia. In total, 64.1% of the subjects were diagnosed with CVD risk factors for the first time. Conclusion Opportunistic screening for CVD risk factors is possible in community pharmacies and has the ability to detect previously undiagnosed risk factors. This community pharmacy based model could serve as a cost-effective approach to primary prevention of CVD.

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Acknowledgements

The authors wish to acknowledge the management of Rapid Check Diagnostic and Wellness Ltd, Roche Diabetes Care, Omron Healthcare, Victory Drugs and Meridian Cardiac Clinic for providing the equipment and training for the research.

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Authors and Affiliations

  1. Department of Medicine, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria

    Casmir Amadi, Amam Mbakwem, Jayne Ajuluchukwu & David A. Oke

  2. Victory Drugs Ltd, Festac, Lagos, Nigeria

    Folasade Lawal

  3. St Michael’s Hospital, Toronto, ON, Canada

    Wale Ajiboye

  4. Silver Line Pharmacy, Mushin, Lagos, Nigeria

    Rosarii Agbim

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  1. Casmir Amadi
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Correspondence to Casmir Amadi.

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Although the above mentioned corporate entities provided the equipment and training for the research, there were no branded promotional information/materials from them around the vicinity of the screening exercises. No prescription for drugs was given to those subjects with elevated CVD risk factors and they were duly referred to physicians whose names and practices were not known to the investigators.

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Amadi, C., Lawal, F., Ajiboye, W. et al. Opportunistic screening of cardiovascular disease risk factors in community pharmacies in Nigeria: a cross-sectional study. Int J Clin Pharm 42, 1469–1479 (2020). https://doi.org/10.1007/s11096-020-01112-2

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