International Journal of Clinical Pharmacy

, Volume 40, Issue 6, pp 1587–1595 | Cite as

Knowledge of cardiovascular disease risk factors and practice of primary prevention of cardiovascular disease by Community Pharmacists in Nigeria: a cross-sectional study

  • Casmir E. AmadiEmail author
  • Folasade O. Lawal
  • Amam C. Mbakwem
  • Jayne N. Ajuluchukwu
  • David A. Oke
Research Article


Background Studies in international literature have shown that Community Pharmacists can make considerable impact in controlling cardiovascular disease risk factors, especially hypertension. In Nigeria, there are no studies on the knowledge of CVD risk factors by Community Pharmacists and their practice of primary prevention. Objective To assess the knowledge of CVD risk factors and practice of primary prevention of CVD amongst Nigerian community pharmacists. Setting Community Pharmacists in Lagos, Nigeria. Methods This cross-sectional study involved 168 Community Pharmacists. Their knowledge of CVD risk factors was assessed with the Heart Disease Fact Questionnaire. Their opportunistic screening practices for CVD risk factors (primary prevention) were also assessed. Main outcome measures Knowledge of CVD risk factors and practice of primary CVD prevention. Results The mean age of the participating pharmacists was 41.7 (± 11.2) years and 87 (51.8%) of them were males. The median number of years of practice was 9.0 (3–15) years. Mean knowledge score was 22.1 (± 3.0) with 154 (91.7%) of the subjects scoring above 70%. An average of 95.5% of the participants correctly identified hypertension, smoking, dyslipidaemia, obesity, physical inactivity and diabetes as CVD risk factors. Eighty-one (48.2%) had good practice of primary CVD prevention. Conclusion: This study shows that Community Pharmacists in Nigeria have very good knowledge level of CVD risk factors and almost 50% of them practised primary prevention of CVD.


Community Pharmacists CVD Hypertension Primary prevention Nigeria 




Conflicts of interest



  1. 1.
    World Health Organization. Prevention of cardiovascular disease: guidelines for assessment and management of cardiovascular risk. Geneva, Switzerland; 2007. Accessed 22 July 2015.Google Scholar
  2. 2.
    Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367(9524):1747–57.CrossRefGoogle Scholar
  3. 3.
    Bygbjerg IC. Double burden of non-communicable and infectious diseases in developing countries. Science. 2012;337(6101):1499–501.CrossRefGoogle Scholar
  4. 4.
    Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part II. Variation in cardiovascular diseases by specific ethnic groups and geographic regions and preventive strategies. Circulation. 2001;104(23):2855–64.CrossRefGoogle Scholar
  5. 5.
    Steyn K, Sliwa K, Hawken S, Commerford P, Onen C. Risk factors associated with myocardial infarction in Africa: the INTERHEART Africa Study. Circulation. 2005;112:3554–61.CrossRefGoogle Scholar
  6. 6.
    Adeloye D, Basquill C, Aderemi AV, et al. An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis. J Hypertens. 2015;33(2):230–42.CrossRefGoogle Scholar
  7. 7.
    International Diabetes Federation. 6th ed. 2013. p. 23–6. Accessed 17 Nov 2018.
  8. 8.
    Ogbera OA, Ekpebegh C. Diabetes mellitus in Nigeria: the past, present and future. World J Diabetes. 2014;5(6):905–11.CrossRefGoogle Scholar
  9. 9.
    Odeyemi KA, Osibogun A, Akinsele AO, Sadiq L. The prevalence and predictors of cigarette smoking in secondary students in Nigeria. Niger Postgrad Med J. 2009;16:40–5.PubMedGoogle Scholar
  10. 10.
    Akaralo-Anthony SN, Adebamowo CA. Prevalence and correlates of leisure-time physical activity among Nigerians. BMC Public Health. 2014;14:529.CrossRefGoogle Scholar
  11. 11.
    World Health Organization. Global strategy on diet, physical activity & health. 2004. Accessed 17 Nov 2018.
  12. 12.
    Ogundamola OJ, Oladosun OY. Pattern and outcomes of admissions in the medical wards of a tertiary health centre in a rural community of Ekiti State, Nigeria. Ann Afr Med. 2014;13:195–203.CrossRefGoogle Scholar
  13. 13.
    Oguanobi NI, Ejim EC, Onwubere BJ, Ike SO, Anisiuba BC, Ikeh VO, Aneke EO. Pattern of cardiovascular disease amongst medical admissions in a regional teaching hospital in South-eastern Nigeria. Niger J Cardiol. 2013;10:77–80.CrossRefGoogle Scholar
  14. 14.
    Schwappach D, Boluarte T, Suhrcke M. The economics of primary prevention of cardiovascular disease—a systematic review of economic evaluations. Cost Eff Resour Alloc. 2007;5(1):5.CrossRefGoogle Scholar
  15. 15.
    Ferdinand KC, Patterson KP, Taylor C, Fergus IV, Nasser SA. Community-based approaches to prevention and management of hypertension and cardiovascular disease. J Clin Hypertens (Greenwich). 2012;14:336–43.CrossRefGoogle Scholar
  16. 16.
    Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part II: systematic review and meta-analysis in hypertension management. Ann Pharmacother. 2007;41(11):1770–81.CrossRefGoogle Scholar
  17. 17.
    Blenkinsopp A, Anderson C, Armstrong M. Systematic review of the effectiveness of community pharmacy-based interventions to reduce risk behaviours and risk factors for coronary heart disease. J Public Health. 2003;25(2):144–53.CrossRefGoogle Scholar
  18. 18.
    Morgado M, Rolo S, Castelo-Branco M. Pharmacist intervention to enhance hypertension control: a randomised controlled trial. Int J Clin Pharm. 2011;33(1):132–40.CrossRefGoogle Scholar
  19. 19.
    George J, McNamara GJ, Stewart K. The roles of community pharmacists in cardiovascular disease prevention and management. AMJ. 2011;4(5):266–72.CrossRefGoogle Scholar
  20. 20.
    Santschi VS, Colosimo AL, Chilero A, Burnand B, Paradis G. Pharmacists interventions to improve cardiovascular risk factors in diabetes. a systematic review and meta-analysis. Diabetes Care. 2012;35:2706–17.CrossRefGoogle Scholar
  21. 21.
    Araoye MO. Sample size determination. In: Research methodology with statistics for health and social sciences. 1st Ed. Ilorin: Nathadex Publishers; 2004. p. 115–20.Google Scholar
  22. 22.
    Wagner J, Lacey K, Chyun D, Abbot D. Development of a questionnaire to measure heart disease risk knowledge in people with diabetes. The Heart Disease Facts Questionnaire. Patient Educ Couns. 2005;58:82–7.CrossRefGoogle Scholar
  23. 23.
    Wagner J, Lacey K, Chyun D, Abbot D. Knowledge of heart disease risks among Spanish speakers with diabetes. The role of interpreters in the medical encounter. Ethn Dis. 2005;15:679–84.PubMedGoogle Scholar
  24. 24.
    Akintunde AA, Akintunde TS, Opadijo OG. Knowledge of heart disease risk factors among workers in a Nigerian University. A call for concern. Niger Med J. 2015;56(2):91–5.CrossRefGoogle Scholar
  25. 25.
    Joyce A, Berbatis C, Sunderland VB. Analysis of primary prevention services for cardiovascular disease in Australia’s community pharmacies. Aust N Z J Public Health. 2007;31:516–9.CrossRefGoogle Scholar
  26. 26.
    Jahangard-Rafsanjani Z, Hakimzadeh N, Sarayani A, Najafi S, Heidari K, Javadi MR, Hadjibabaie M, Gholami K. A community pharmacy-based cardiovascular risk screening service implemented in Iran. Pharm Pract. 2017;15(2):919–25.CrossRefGoogle Scholar
  27. 27.
    Via-Sosa MA, Toro C, Trave P, March MA. Screening premorbid metabolic syndrome in community pharmacies: a cross-sectional descriptive study. BMC Public Health. 2014;14:487.CrossRefGoogle Scholar
  28. 28.
    Willis A, Rivers P, Gray LJ, Davies M, Khunti K. The effectiveness of screening for diabetes and cardiovascular disease risk factors in a community pharmacy setting. PLoS ONE. 2014;9(4):e91157.CrossRefGoogle Scholar
  29. 29.
    Horgan JMP, Blenkinsopp A, McManus RJ. Evaluation of cardiovascular opportunistic risk assessment pilot (‘Heart MOT’ service) in community pharmacies. J Public Health. 2010;32(1):110–6.CrossRefGoogle Scholar
  30. 30.
    O’Donovan DO, Byre S, Sahm LJ. Pharmacists use of screening tools to estimate risk of CVD: a review of the literature. Pharmacy. 2014;2:27–39.CrossRefGoogle Scholar
  31. 31.
    Rohla M, Haberfeld H, Sinzinger H, et al. Systematic screening for cardiovascular risk in pharmacies. Open Heart. 2016;3:e000497.CrossRefGoogle Scholar
  32. 32.
    Taylor J, Krska J, Mackridge A. A community pharmacy-based cardio-vascular screening service: views of service users and the public. Int J Pharm Pract. 2012;20:277–84.CrossRefGoogle Scholar
  33. 33.
    Hindi AMK, Schafheutle EI, Jacobs S. Patients and public perspectives of community pharmacies in the UK: a systematic review. Health Expect. 2018;21:409–28.CrossRefGoogle Scholar
  34. 34.
    Chiazor EI, Evans M, van Worden H, Oparah AC. A systematic review of community pharmacists’ interventions in reducing major risk factors for cardiovascular disease. J Value Health Reg Issues. 2015;7c:9–21.CrossRefGoogle Scholar
  35. 35.
    Jahangard-Rafsanjani Z, Sarayani A, Javadi MR, Hadjibabaie M, Rashidian A, Ahmadvand A, et al. Pharmacists’ attitudes and perceived barriers about community pharmacy-based cardiovascular risk screening services. J Pharm Care. 2014;2(4):142–8.Google Scholar
  36. 36.
    Kotecki JE, Elanjian SI, Torabi MR. Health promotion beliefs and practices amongst pharmacists. J Am Pharm Asso. 2000;40:773–9.Google Scholar
  37. 37.
    Uema SA, Vega EM, Armando PD, Fontana D. Barriers to pharmaceutical care in Argentina. Pharm World Sci. 2008;30:211–5.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019
corrected publication 2019

Authors and Affiliations

  • Casmir E. Amadi
    • 1
    Email author
  • Folasade O. Lawal
    • 2
  • Amam C. Mbakwem
    • 1
  • Jayne N. Ajuluchukwu
    • 1
  • David A. Oke
    • 1
  1. 1.Department of Medicine, College of MedicineUniversity of Lagos, NigeriaLagosNigeria
  2. 2.Victory Drugs LtdLagosNigeria

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