Knowledge and preventive practices of diabetes and cardiovascular disease risk factors among pharmacists and pharmacy auxiliary staff in community pharmacies in Kampala district.

Abstract

Background; Non-communicable diseases (NCDs) have become a major public health concern contributing 71% of all deaths globally each year and 80% of NCD deaths occur in low and middle income countries. WHO projects that NCDs death will increase by 17% over the next ten years with diabetes mellitus and CVD as the leading burden. These two NCDs have common risk factors which can be preventable by integrating pharmacist and pharmacy auxiliary staff as member of the health care team and empowering them to provide diabetes and CVD risk factors awareness, assessment and preventive services in community pharmacies. Objectives; The study explored knowledge of diabetes and CVD risk factors, factors associated with the knowledge, the practice of primary prevention of diabetes and CVD among community pharmacists and pharmacy auxiliary staff as well as their monitivators and demotivators. Methods; A mixed methods study design involving 217 community pharmacists and 217 auxiliary staff working in community pharmacies in Kampala district. Their knowledge and primary prevention practices of diabetes and CVD risk factors were assessed with diabetes and CVD risk factors widely validated heart disease fact questionnaire. Key informant in depth interviews were conducted using interview guides to assess and describe challenges and motivation opinions for diabetes and CVD risk factor preventive practice. Availability of assessment tools and devices was assessed using a check list. Data was entered in EPI Data and analysed by using SPSS version 20. Descriptive data was expressed as means (SD) while categorical data was expressed as percentages. Chi-square test was used to compare proportions for categorical data whereas bivariate logistic regression analysis was performed to determine the relationship of each independent variable with knowledge. A p value < 0.05 indicated statistical significance. Qualitative data was analysed using thematic analysis. Results; Among the 434 (217 pharmacists and 217 auxiliary staffs) study participants, the mean knowledge score for pharmacists was 19.2 (± 3.3) and 18.6 (± 3.3) for auxiliary staff with 324 (74.4%) of total subjects scoring above 70%. An average of 75% of the participants correctly identified hypertension, smoking, obesity, physical inactivity, diabetes and dyslipidaemia as CVD risk factors. All participants had a generally poor score of diagnostic cut offs (38.4%), 64.3% had functional sphygmomanometer, 59.2% had functional glucometer while 48.6% had functional weighing scales. Poor practice of primary CVD prevention (48.8%) was generally exhibited. Conclusion; Generally, the pharmacists and pharmacy auxiliary staff working in community pharmacies in Kampala had good knowledge regarding diabetes and CVD risk factors, poor knowledge of diagnostic cut offs, fair availability of assessment devices and poor primary prevention practices of diabetes and CVD. Strategies should be designed to address these areas and empower community pharmacies to contribute to NCD prevention.