Clinical pharmacy practice in Nigerian hospitals: Flourishing or floundering?

Abstract

In Nigeria, a shift from the traditional pharmacist's role of dispensing and compounding of medications began in the 1980s with the introduction of drug information services and unit dose dispensing systems in some hospitals. More than three decades after this, clinical pharmacy practice is still underdeveloped. Qualitative, semi-structured interviews were conducted with 49 purposefully sampled Nigerian stakeholders including hospital pharmacists, pharmacy technicians, doctors, policymakers and
patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach.Two major themes emerged from the study: (i) pharmacists' professional identity and (ii) the structure of hospital pharmacy practice. The results revealed an ongoing struggle by Nigerian hospital pharmacists to establish their clinical identities as many non-pharmacy stakeholders viewed their roles to be mainly supply-based. Barriers to the development of clinical pharmacy practice in Nigerian hospitals included pharmacists' lack of confidence, shortage of pharmacy staff, underutilisation of pharmacy technicians, lack of specialisation and clinical career structure, medical dominance and opposition, and lack of policies that support clinical pharmacy practice.Several years after its introduction, clinical pharmacy practice is yet to be fully developed in many hospitals. The barriers identified in this study need to be addressed in order for clinical pharmacy practice to flourish in Nigeria.