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Published in: BMC Palliative Care 1/2019

Open Access 01-12-2019 | Care | Research article

Pharmacists’ knowledge, attitude and involvement in palliative care in selected tertiary hospitals in southwestern Nigeria

Authors: Rasaq ADISA, Aderonke Tolulope ANIFOWOSE

Published in: BMC Palliative Care | Issue 1/2019

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Abstract

Background

The growing number of people living with life-limiting illness is a global health concern. This study therefore aimed to explore the involvement of pharmacists in selected tertiary hospitals in Nigeria in palliative care (PC). It also sought to evaluate their knowledge and attitude to PC as well as factors that hinder pharmacists’ participation in PC.

Method

Questionnaire-guided survey among pharmacists working in three-tertiary hospitals in southwestern Nigeria. The self-administered questionnaire comprised 18-item general knowledge questions related to PC, attitude statements with 5-point Likert-scale options and question-items that clarify extent of involvement in PC and barriers to participation. Overall score by pharmacists in the knowledge and attitude domains developed for the purpose of this study was assigned into binary categories of “adequate” and “inadequate” knowledge (score > 75% versus≤75%), as well as “positive” and “negative” attitude (ranked score > 75% versus≤75%), respectively. Descriptive statistics, Mann-Whitney-U and Kruskal-Wallis tests were used for analysis at p < 0.05.

Results

All the 110 pharmacists enrolled responded to the questionnaire, given a response rate of 100%. Overall, our study showed that 23(21.1%) had adequate general knowledge in PC, while 14(12.8%) demonstrated positive attitude, with 45(41.3%) who enjoyed working in PC. Counselling on therapy adherence (100;90.9%) was the most frequently engaged activity by pharmacists; attending clinical meetings to advise health team members (45;40.9%) and giving educational sessions (47;42.7%) were largely cited as occasionally performed duties, while patient home visit was mostly cited (60;54.5%) as a duty not done at all. Pharmacists’ unawareness of their need in PC (86;79.6%) was a major factor hindering participation, while pharmacists with PC training significantly felt more relaxed around people receiving PC compared to those without training (p = 0.003).

Conclusion

Hospital pharmacists in selected tertiary care institutions demonstrate inadequate knowledge, as well as negative attitude towards PC. Also, extent of involvement in core PC service is generally low, with pharmacists’ unawareness of their need in PC constituting a major barrier. Thus, a need for inclusion of PC concept into pharmacy education curriculum, while mandatory professional development programme for pharmacists should also incorporate aspects detailing fundamental principles of PC, in order to bridge the knowledge and practice gaps.
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Literature
2.
go back to reference Chan KS. Palliative care: the need of the modern era. Hong Kong Med J. 2018;24:391–9.PubMed Chan KS. Palliative care: the need of the modern era. Hong Kong Med J. 2018;24:391–9.PubMed
5.
go back to reference Guo Q, Jacelon CS, Marquard JL. An evolutionary concept analysis of palliative care. J Palliat Care Med. 2012;2:1–6.CrossRef Guo Q, Jacelon CS, Marquard JL. An evolutionary concept analysis of palliative care. J Palliat Care Med. 2012;2:1–6.CrossRef
8.
go back to reference Smith TJ, Coyne PJ, Cassel JB. Practical guidelines for developing new palliative care services: resource management. Ann Oncol. 2012;23(Suppl 3):70–5.PubMedPubMedCentralCrossRef Smith TJ, Coyne PJ, Cassel JB. Practical guidelines for developing new palliative care services: resource management. Ann Oncol. 2012;23(Suppl 3):70–5.PubMedPubMedCentralCrossRef
9.
go back to reference Soyannwo OA. Palliative care and nursing. Afr J Med Med Sci. 2009;38(Suppl 2):67–70.PubMed Soyannwo OA. Palliative care and nursing. Afr J Med Med Sci. 2009;38(Suppl 2):67–70.PubMed
10.
go back to reference Mathers CD, Loncor D. Projections of global mortality and burden of disease from 2012 to 2030. PLoS Med. 2006;3:2011–30.CrossRef Mathers CD, Loncor D. Projections of global mortality and burden of disease from 2012 to 2030. PLoS Med. 2006;3:2011–30.CrossRef
12.
13.
16.
go back to reference Hussain SY, Marriot IL, Beattie J, Nation RL, Dooley MJ. A palliative cancer care flexible education program for Australian community pharmacists. Am J Pharm Educ. 2010;74:1–9.CrossRef Hussain SY, Marriot IL, Beattie J, Nation RL, Dooley MJ. A palliative cancer care flexible education program for Australian community pharmacists. Am J Pharm Educ. 2010;74:1–9.CrossRef
17.
go back to reference American Society of Health-System Pharmacists (ASHP). ASHP statement on the pharmacist’s role in hospice and palliative care. Am J Health Syst Pharm. 2002;59:1770–3.CrossRef American Society of Health-System Pharmacists (ASHP). ASHP statement on the pharmacist’s role in hospice and palliative care. Am J Health Syst Pharm. 2002;59:1770–3.CrossRef
18.
go back to reference Needham DS, Wong IC, Campion PD. Hull, east riding pharmacy development G. evaluation of the effectiveness of UK community pharmacists’ interventions in community palliative care. Palliat Med. 2002;16(3):219–25.PubMedCrossRef Needham DS, Wong IC, Campion PD. Hull, east riding pharmacy development G. evaluation of the effectiveness of UK community pharmacists’ interventions in community palliative care. Palliat Med. 2002;16(3):219–25.PubMedCrossRef
19.
go back to reference Edwards Z, Blenkinsopp AB, MI. A community pharmacist medicines optimisation service for patients with advanced cancer pain: a proof of concept study. Int J Clin Pharm. 2019;41:700–10.PubMedPubMedCentralCrossRef Edwards Z, Blenkinsopp AB, MI. A community pharmacist medicines optimisation service for patients with advanced cancer pain: a proof of concept study. Int J Clin Pharm. 2019;41:700–10.PubMedPubMedCentralCrossRef
21.
go back to reference O’Connor M, Fisher C, French L, Halkett G, Jiwa M, Hughes J. Exploring the community pharmacist's role in palliative care: focusing on the person not just the prescription. Patient Educ Couns. 2011;83:458–64.PubMedCrossRef O’Connor M, Fisher C, French L, Halkett G, Jiwa M, Hughes J. Exploring the community pharmacist's role in palliative care: focusing on the person not just the prescription. Patient Educ Couns. 2011;83:458–64.PubMedCrossRef
22.
go back to reference Atayee RS, Best BM, Daniels CE. Development of an ambulatory palliative care pharmacist practice. J Palliat Med. 2008;11(8):1077–82.PubMedCrossRef Atayee RS, Best BM, Daniels CE. Development of an ambulatory palliative care pharmacist practice. J Palliat Med. 2008;11(8):1077–82.PubMedCrossRef
23.
go back to reference Jiwa M, Hughes J, O'Connor M, Tuffin P. Field testing a protocol to facilitate the involvement of pharmacists in community based palliative care. Aust Pharm. 2012;31(1):72–6. Jiwa M, Hughes J, O'Connor M, Tuffin P. Field testing a protocol to facilitate the involvement of pharmacists in community based palliative care. Aust Pharm. 2012;31(1):72–6.
24.
go back to reference Fadare JO, Obimakinde AM, Olaogun DO, Afolayan JM, Olatunya O, Ogundipe KO. Perception of nurses about palliative Care: experience from south-West Nigeria. Ann Med Health Sci Res. 2014;4(5):723–7.PubMedPubMedCentralCrossRef Fadare JO, Obimakinde AM, Olaogun DO, Afolayan JM, Olatunya O, Ogundipe KO. Perception of nurses about palliative Care: experience from south-West Nigeria. Ann Med Health Sci Res. 2014;4(5):723–7.PubMedPubMedCentralCrossRef
25.
26.
go back to reference Smith AK, Thai JN, Bakitas MA, Meier DE, Spragens LH, Temel JS, Weissman DE, Rabow MW. The diverse landscape of palliative care clinics. J Palliat Med. 2013;16:661–8.PubMedPubMedCentralCrossRef Smith AK, Thai JN, Bakitas MA, Meier DE, Spragens LH, Temel JS, Weissman DE, Rabow MW. The diverse landscape of palliative care clinics. J Palliat Med. 2013;16:661–8.PubMedPubMedCentralCrossRef
28.
go back to reference Farber NJ, Urban SY, Colllier VU, Metzger M, Weiner J, Boyer EG. Frequency and perceived competence in providing palliative care to terminally ill patients: a survey of primary care physicians. J Pain Symptom Manag. 2004;28:364–72.CrossRef Farber NJ, Urban SY, Colllier VU, Metzger M, Weiner J, Boyer EG. Frequency and perceived competence in providing palliative care to terminally ill patients: a survey of primary care physicians. J Pain Symptom Manag. 2004;28:364–72.CrossRef
29.
go back to reference O’Connor M, Pugh J, Jiwa M, Hughes J, Fisher C. The palliative care interdisciplinary team: where is the community pharmacist? J Palliat Med. 2011;14:7–11.PubMedCrossRef O’Connor M, Pugh J, Jiwa M, Hughes J, Fisher C. The palliative care interdisciplinary team: where is the community pharmacist? J Palliat Med. 2011;14:7–11.PubMedCrossRef
30.
go back to reference O’Connor M, Hewitt LY, Tuffin PHR. Community pharmacists attitude toward palliative Care. An Australian Nationwide survey. J Palliat Med. 2013;16:1575–81.PubMedPubMedCentralCrossRef O’Connor M, Hewitt LY, Tuffin PHR. Community pharmacists attitude toward palliative Care. An Australian Nationwide survey. J Palliat Med. 2013;16:1575–81.PubMedPubMedCentralCrossRef
31.
go back to reference Ise Y, Morita T, Maehori N, Kutsuwa M, Shiokawa M, Kizawa Y. Role of the community pharmacy in palliative care: a nationwide survey in Japan. J Palliat Med. 2010;13:733–7.PubMedCrossRef Ise Y, Morita T, Maehori N, Kutsuwa M, Shiokawa M, Kizawa Y. Role of the community pharmacy in palliative care: a nationwide survey in Japan. J Palliat Med. 2010;13:733–7.PubMedCrossRef
32.
go back to reference Akram G, Bennie M, McKellar S, Michels S, Hudson S, Trundle J. Effective delivery of pharmaceutical palliative care: challenges in the community pharmacy setting. J Palliat Med. 2012;15:317–21.PubMedCrossRef Akram G, Bennie M, McKellar S, Michels S, Hudson S, Trundle J. Effective delivery of pharmaceutical palliative care: challenges in the community pharmacy setting. J Palliat Med. 2012;15:317–21.PubMedCrossRef
33.
go back to reference Ahmed N, Bestall JC, Ahmedzai SH, Payne SA, Clark D, Noble B. Systematic review of the problems and issues of accessing specialist palliative care by patients careers and health and social care professionals. Palliat Med. 2004;18:525–42.PubMedCrossRef Ahmed N, Bestall JC, Ahmedzai SH, Payne SA, Clark D, Noble B. Systematic review of the problems and issues of accessing specialist palliative care by patients careers and health and social care professionals. Palliat Med. 2004;18:525–42.PubMedCrossRef
34.
go back to reference Yamane T. Statistics, an introductory analysis, vol. 886. 2nd ed. New York: Harper and Rao; 1967. Yamane T. Statistics, an introductory analysis, vol. 886. 2nd ed. New York: Harper and Rao; 1967.
35.
go back to reference Pitzen KM. Occupational therapy and palliative care: a survey of attitudes and knowledge (scholarly project). Ohio: Department of Occupational Therapy, University of Toledo Digital Repository, Toledo; 2009. Pitzen KM. Occupational therapy and palliative care: a survey of attitudes and knowledge (scholarly project). Ohio: Department of Occupational Therapy, University of Toledo Digital Repository, Toledo; 2009.
36.
go back to reference Abdullahi A, Hassan A, Kadarnman N, Saleh A, Baraya YS. Lua PL food safety knowledge, attitude and practice toward compliance with abattoir laws among the abbatoir workers in Malaysia. Int J Gen Med. 2016;9:79–87.PubMedPubMedCentralCrossRef Abdullahi A, Hassan A, Kadarnman N, Saleh A, Baraya YS. Lua PL food safety knowledge, attitude and practice toward compliance with abattoir laws among the abbatoir workers in Malaysia. Int J Gen Med. 2016;9:79–87.PubMedPubMedCentralCrossRef
37.
go back to reference Hahida A. Knowledge, attitude and practice of denque fever prevention among people in male Maldives. Thailand: Published Masters Dissertation. Chulalongkorn, University; 2007. Hahida A. Knowledge, attitude and practice of denque fever prevention among people in male Maldives. Thailand: Published Masters Dissertation. Chulalongkorn, University; 2007.
38.
go back to reference Ingleton C, Gardiner C, Seymour JE, Richards N, Gott M. Exploring education and training needs among the palliative care workforce. BMJ Support Palliat Care. 2013;3:207–12.PubMedCrossRef Ingleton C, Gardiner C, Seymour JE, Richards N, Gott M. Exploring education and training needs among the palliative care workforce. BMJ Support Palliat Care. 2013;3:207–12.PubMedCrossRef
39.
go back to reference Gilbar P, Stefaniuk K. The role of the pharmacists in palliative care: results of a survey conducted in Australia and Canada. J Palliat Care. 2002;18:287–92.PubMedCrossRef Gilbar P, Stefaniuk K. The role of the pharmacists in palliative care: results of a survey conducted in Australia and Canada. J Palliat Care. 2002;18:287–92.PubMedCrossRef
40.
go back to reference McClement SE, Care D, Dean R, Cheang M. Evaluation of education in palliative care: determining the effects on nurses’ knowledge and attitudes. J Palliat Care. 2005;21:44–8.PubMedCrossRef McClement SE, Care D, Dean R, Cheang M. Evaluation of education in palliative care: determining the effects on nurses’ knowledge and attitudes. J Palliat Care. 2005;21:44–8.PubMedCrossRef
41.
go back to reference McDonald N, Boston W, Scott JF. The Canadian palliative care undergraduate curriculum. J Cancer Educ. 1993;8:197–201.CrossRef McDonald N, Boston W, Scott JF. The Canadian palliative care undergraduate curriculum. J Cancer Educ. 1993;8:197–201.CrossRef
42.
go back to reference Nelson JE. Identifying and overcoming the barriers to high quality palliative care in the intensive care unit. Crit Care Med. 2016;34:320–31. Nelson JE. Identifying and overcoming the barriers to high quality palliative care in the intensive care unit. Crit Care Med. 2016;34:320–31.
43.
go back to reference McDonough RP. Intervention to improve patient pharmaceutical care outcomes. J Am Pharm Assoc (Wash). 1996;NS36:453–66.CrossRef McDonough RP. Intervention to improve patient pharmaceutical care outcomes. J Am Pharm Assoc (Wash). 1996;NS36:453–66.CrossRef
44.
go back to reference Joranson DE, Gilson AM. Pharmacists’ knowledge of and attitudes toward opioid pain medications in relation to federal and state policies. J Am Pharm Assoc. 2001;41:213–20. Joranson DE, Gilson AM. Pharmacists’ knowledge of and attitudes toward opioid pain medications in relation to federal and state policies. J Am Pharm Assoc. 2001;41:213–20.
45.
go back to reference Adriaansen MJ, van Achterberg T, Borm G. Effects of a post-qualification course in palliative care. J Adv Nurs. 2005;49:96–103.PubMedCrossRef Adriaansen MJ, van Achterberg T, Borm G. Effects of a post-qualification course in palliative care. J Adv Nurs. 2005;49:96–103.PubMedCrossRef
46.
go back to reference Shipman C, Burt J, Ream E, Beynon T, Richardson A, Addington-Hall J. Improving district nurses’ confidence and knowledge in the principles and practice of palliative care. J Adv Nurs. 2008;63:494–505.PubMedCrossRef Shipman C, Burt J, Ream E, Beynon T, Richardson A, Addington-Hall J. Improving district nurses’ confidence and knowledge in the principles and practice of palliative care. J Adv Nurs. 2008;63:494–505.PubMedCrossRef
47.
go back to reference Hansen L, Goodell TT, Dehaven J, Smith M. Nurses’ perceptions of end-of-life care after multiple interventions for improvement. Am J Crit Care. 2009;18:263–71.PubMedCrossRef Hansen L, Goodell TT, Dehaven J, Smith M. Nurses’ perceptions of end-of-life care after multiple interventions for improvement. Am J Crit Care. 2009;18:263–71.PubMedCrossRef
48.
go back to reference Center to Advance Palliative Care (CAPC). Improving Care for People with Serious Illness through Innovative Payer-Provider Partnerships, 2015. http://www.capc.org. Accessed 20 Feb 2019. Center to Advance Palliative Care (CAPC). Improving Care for People with Serious Illness through Innovative Payer-Provider Partnerships, 2015. http://​www.​capc.​org. Accessed 20 Feb 2019.
49.
go back to reference Forbes JF. Toward an optimal teaching programme for supportive care. Support Care Cancer. 1994;2:7–15.PubMedCrossRef Forbes JF. Toward an optimal teaching programme for supportive care. Support Care Cancer. 1994;2:7–15.PubMedCrossRef
50.
go back to reference Department of Health. A health future for Western Australians: report of the health reform committee Perth. Western Australia: Department of Health; 2004. Department of Health. A health future for Western Australians: report of the health reform committee Perth. Western Australia: Department of Health; 2004.
51.
go back to reference Lynn J. Serving patients who may die soon and their families: the role of hospice and other services. J Am Med Assoc. 2001;285:925–32.CrossRef Lynn J. Serving patients who may die soon and their families: the role of hospice and other services. J Am Med Assoc. 2001;285:925–32.CrossRef
52.
go back to reference Gibbs M. In: Cherny N, Fallon M, Kaasa S, DC PRKC, editors. The contribution of the clinical pharmacist in palliative care in. Oxford textbook of palliative medicine. 5th ed. London: Oxford University Press; 2015.CrossRef Gibbs M. In: Cherny N, Fallon M, Kaasa S, DC PRKC, editors. The contribution of the clinical pharmacist in palliative care in. Oxford textbook of palliative medicine. 5th ed. London: Oxford University Press; 2015.CrossRef
53.
go back to reference Savage I, Blenkinsopp A, Closs SJ, Bennett MI. ‘Like doing a jigsaw with half the parts missing’: community pharmacists and the management of cancer pain in the community. Inter J Pharm Pract. 2013;21(3):151–60.CrossRef Savage I, Blenkinsopp A, Closs SJ, Bennett MI. ‘Like doing a jigsaw with half the parts missing’: community pharmacists and the management of cancer pain in the community. Inter J Pharm Pract. 2013;21(3):151–60.CrossRef
54.
go back to reference Hill RR. Clinical pharmacy services in a home-based palliative care program. Am J Health Syst Pharm. 2007;64:806–10.PubMedCrossRef Hill RR. Clinical pharmacy services in a home-based palliative care program. Am J Health Syst Pharm. 2007;64:806–10.PubMedCrossRef
Metadata
Title
Pharmacists’ knowledge, attitude and involvement in palliative care in selected tertiary hospitals in southwestern Nigeria
Authors
Rasaq ADISA
Aderonke Tolulope ANIFOWOSE
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Palliative Care / Issue 1/2019
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-019-0492-8

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