Objectives:

The objectives of this research traversed:

(1). Analysis of the inter-professional collaboration among healthcare professionals, specifically physicians and pharmacists in Nigeria.

(2). Evaluating the factors that hinder this collaboration in Nigeria.

(3). Evaluating the factors that improve this collaboration in Nigeria.

(4). Suggesting feasible solutions that will bolster the collaboration between physicians and pharmacists in Nigeria.

Methodology:

The research methodology employed was a mixture of qualitative and quantitative approaches through a mixed-method questionnaire making use of the online platform, google forms. The questionnaire was devoid of bias, no personal questions were asked and there was no interference on the part of the author to the responses garnered. The qualitative approach was phenomenological centered around the daily experiences of physicians and pharmacists. The questionnaire was dispersed to physicians and pharmacists in government hospitals, primary care centers, community pharmacists and patients in these environments. Likert scales were employed in measuring the varying views on the subject. The patients were also asked their opinion of physicians, pharmacists and the quality of healthcare they receive.
 
Findings:

The research confirmed a finding from the literature review that in this relationship, community pharmacists are indispensable as they account for the majority of pharmacists in Nigeria. This is also important because they interact the most with patients. The research also showed a current scarcity of interactions between physicians and pharmacists which shows why this has been foreign in Nigeria's healthcare sector. Physicians and pharmacists that have interacted have had an amenable relationship, this shows that the relationship is welcome and has the capacity to improve healthcare in Nigeria. Finally, patients visit their pharmacists for the more common ailments highlighting their importance and the possibility of a good relationship when these two professionals work hand in hand.
 
Analysis:

This research to the best of my knowledge was the first of its kind in Nigeria. It is important because for a developing country, healthcare is an important sector that cannot be overlooked. In developed countries, inter-professional collaboration has been widely researched and confirmed to improve the healthcare of their patients and the goal of the research is to test the veracity of this knowledge in a developing country like Nigeria. This was done by gathering responses from physicians, pharmacists and patients by employing a mixed method questionnaire, seeking their opinion because it directly affects them. The result showed that this collaboration is almost non-existent in Nigeria and a lot of work needs to be done by the government, healthcare professionals, the governing bodies of these professions and even the public in order to bring this collaboration to fruition and cause good clinical outcomes.

Conclusions:

A major discovery of this body of work from the secondary research was that community pharmacists have a huge role to play in this relationship, findings from primary research also confirmed this. This relationship also has not been developed effectively in Nigeria, but it is welcome nonetheless. Unsurprisingly also, physicians in Nigeria do not view pharmacists as colleagues, they have little respect for this profession this is enhanced by lack of proper communication between these professionals and even the patients. The Nigerian government need to be more proactive and invest in the Nigerian healthcare system, the study of this relationship should also be introduced into the curriculum of medical and pharmacy students. Finally, there should be establishment of electronic medical records and accountable care organizations that enhances access to patient information under the strictest regulations.

 Objectives:

The author explored the knowledge, attitude and experience of ADR spontaneous reporting among medical doctors and pharmacists in line with established guidelines and regulations by the relevant authorities in Nigeria. Although current spontaneous reporting practices are less than optimal, this research dissertation was aimed at articulating effective strategies that could be optimally leveraged to improve the frequency and quality of reporting while driving better positive health outcomes for patients across Nigeria. An outline of the research objectives include:

1. To evaluate the knowledge and awareness of ADR reporting among healthcare professionals in Nigeria

2. To assess challenges among healthcare professionals in the practice of ADR reporting in Nigeria.

3. To make sustainable recommendations to improve ADR reporting among healthcare professionals in Nigeria.

Methodology:

Primary and secondary research methods were utilised by the author through the electronic dissemination of questionnaires, phone interviews and literature reviews. The secondary research was first carried out to explore relevant current literature from reputable research databases and journals on ADR reporting to determine the gaps as it pertains to the established research objectives. Attempts to fill these gaps were subsequently carried out through primary research by distributing questionnaires to 140 medical doctors and pharmacists (74.3% response rate), which constituted the approach for quantitative analysis. Phone interviews were further conducted for qualitative analysis with 10 highly experienced healthcare professionals (over 10 years of experience). The author applied the positivism and interpretivism philosophies to analyse the questionnaire and phone interview findings respectively.

Findings:

Both groups of healthcare professionals were compared to determine their opinions on frequency of observed and reported ADRs, reasons for high underreporting rates, awareness of ADR reporting methods, guidelines and regulations as well as the NAFDAC regulatory body responsible for handling submitted ADR reports. A total of 104 out of 140 responded to the survey, of whom 53 (75.7%) were medical doctors and 51 (72.9%) were pharmacists. 34.0% of medical doctors who responded did not know how to report ADRs compared to just 5.9% of pharmacists who responded. In ascertaining familiar ADR reporting method, 39.0% of respondents selected yellow cards/ADR forms, 11.0% of respondents selected the ADR e-reporting form while 25.0% of respondents were familiar with both methods. 25.0% of respondents were unfamiliar with any of the methods for reporting ADRs in Nigeria. 36.0% of respondents admitted having reported an ADR within the past 12 months. The majority 57.0% of respondents indicated not to have reported an ADR in the past 12 months while 7.0% of respondents were unsure if they did. An overwhelming 90.0% of respondents opted for ADR reporting being made compulsory as a professional obligation towards pharmacovigilance.

Analysis:

Analysis showed that medical doctors and pharmacists have only an average knowledge and awareness of ADR reporting in Nigeria. They can correctly identify ADRs and the criteria for reporting but effective reporting remains a challenge. Pharmacists had better knowledge, awareness and experience over medical doctors regarding ADR reporting in Nigeria. However, despite overall poor attitudes to reporting ADRs, both groups exhibited a willingness to do better if proper continuous education and training is made available. NAFDAC performed poorly in raising awareness, providing training and encouraging better drug safety practices and pharmacovigilance. Very few healthcare professionals are aware of the guidelines or regulations governing the ADR reporting system in Nigeria. The authorities rarely acknowledge or follow up on reported ADRs which results in poor reporting rates. Factors varied among both groups as the challenges faced by medical doctors does not translate to the same challenge faced by pharmacists. However, both groups of HCPs agree that ADR reporting should be made a professional obligation to improve ADR reporting in Nigeria. Despite an overwhelming acceptance of the authors' recommendations, some opposed extra remunerations for every ADR reports made as it might distract from the ideal purpose of ADR reporting and pharmacovigilance- improving drug and patient safety in Nigeria.

Conclusions:

Factors ranging from indifference to ADR reporting, poor knowledge and accessibility of reporting methods, poor awareness of guidelines surrounding the reporting procedures are to great extent the same as observed from other studies in Nigeria and other countries. While few studies on ADR reporting in Nigeria compare multiple groups of healthcare professionals, this study demonstrates that pharmacists are more predisposed to favorable outcomes regarding ADR reporting than their medical doctor counterparts. Improving ADR reporting in Nigeria would greatly reduce the healthcare costs and mortality rates and further reduce the incidence of ADRs observed. As suggested by both groups of healthcare professionals, a review of regulations to make ADR reporting compulsory as a professional obligation towards patient safety bears great potential. The course content of the medical and pharmaceutical students should be reviewed to include modules on ADR reporting and tutorials on pharmacovigilance and drug safety practices prior to graduation. Health institutions should establish ADR departments headed by ADR specialists to improve reporting rates in Nigeria and foster liaison with the National Pharmacovigilance centers.

 Objectives:

The aim of the present work is to explore the practice of community pharmacy in Lagos state through the eyes of community pharmacists and their perception on the use of the novel information and communication technology ICT, and its effective implementation in the practice of community pharmacy in state and hence the Nigerian communities. Other objectives include:

• Exploration of the professionalism, work practice and ethics of community pharmacist in Lagos state, Nigeria

• Exploration of the observed non-adoption and hence ineffective usage of ICT-based techniques such as the use of computerized network in recording, storing and accessing patients’ health information; electronic prescription as well as telecare services by community pharmacists in the research study locality.

• Identify the bottlenecks and hence barriers responsible for non-employment/ineffective use of ICT in the practice of community pharmacy which overshadowed the field in Nigeria.

• Explore the importance of and how ICT-based techniques usage in the practice of community pharmacy would improve and thus benefit all stakeholders associated with the Nigerian healthcare system.

• Proffer novel and insightful ideas and solutions that can lead to the effective adoption and full implementation of ICT techniques across various community pharmacies in Lagos state and thus improving the Nigeria health care system 

Methodology:

The present work was modelled on qualitative research pedagogy and relied on the use of deductive survey questions. The research study was conducted specifically in the selected locality of Eti-Osa, EtI-Osa Local government area within the Lagos State metropolis, Nigeria. This was facilitated through a conducted semi-structured interview that led to the generation of in-depth explanatory data obtained from a small sample of licensed and practicing community pharmacists (those in stand-alone stores) using the pre-drafted qualitative survey questions as research tool
 
Findings:

Based on the research findings obtained from semi-structured interviews conducted on licensed and practicing pharmacists in Eti Osa LGA, Lagos metropolis, it is found that information and communication technology just like how it always enhances and thus redefine professional functions in every work station, can also redefine community pharmacy practice in Nigeria. In the present research study area community pharmacists, which discharge their professional duties in a standalone pharmacy were well conversant with the concept of ICT application which is somehow lacking in the practice of community pharmacy in developing countries such as Nigeria,
 
Analysis:

For the present study, the research data from the respondents were analyzed through Deductive Thematic Analysis approach. This qualitative method of data analysis follows six models which include (1) Reading through transcribed text and establishing data correspondence with the research focus; (2) “Coding” of texts to bring out the salient points and similar response pattern from respondents; (3) Using the coded texts to generate a themes; (4) Reviewing the generated themes so as to offset data anomaly and research bias; (5) Renaming the themes as the case may be; and (6) Writing up a theme to aptly capture and project a particular research observation.

Conclusions:

The findings made shows the non-existent or usage of ICT-based techniques such as Electronic Prescription in the line of duty of community pharmacists strained these health professionals who had to deal with the enormous workload that comes with manual filling of medication prescriptions, while researchers including Afolabi and Oyebisi (2007) as well Leung and colleagues (2013) opined that the professional duties of community pharmacists in Nigeria do not measure up greatly as ICT-based techniques which would help offset the never ending problems of medication error were lacking. Consequently, community pharmacists in the present studies advocated for the introduction of such ICT based techniques into their work station and laid much emphasis on the need of real technical and professional training on the use of these ICT techniques which they regard as one of the key determinants that would make them to be flexible while discharging their professional functions, saving them a sizeable time that had been chunked and helping combat problems such as medication errors.