Aim: The aim was to determine the pattern and predictors of medication use among adults in the communities of Southwestern Nigeria. Methods: A cross-sectional study was conducted among adults selected by multi-stage sampling from Oyo State communities. The questionnaires, adapted from the WHO Students’ Drug Use Questionnaire and previous studies, were pretested and interviewer-administered. The respondents’ socio-demographic characteristics, the pattern of medication use, prescribers and sources of drug acquisition were obtained. Binary logistic regression was used to determine the predictor of medications used. Results: Of the 999 respondents, 501 resided in rural communities while 498 dwelled in urban areas. The mean (±SD) age of the respondents was 38±15years. The median (range)% prevalence of medication use were: lifetime use, 58.2(17.7-81.0), current use, 31.2(8.9-65.9) and past use, 20.3(9.2-28.9). Medications were mainly obtained from patent medicine stores, median (range%), 71(65-80). The commonly used drugs were paracetamol,626(67.6), Nonsteroidal anti-inflammatory drugs, 174(18.8), artemether/lumefantrine, 422(68.2), Ampicillin/cloxacillin, 220(48.6), and chlorpheniramine, 59(40.4). Factors predictive of current medication use, AOR (95% CI) were: antimalarial [male, 0.7(0.5, 0.9)]; antibacterial [male, 0.6(0.4-0.9)]; analgesics [married, 1.5(1.1-2.2), presence of health facilities, 0.5(0.3-0.7), and shorter distance to health facility, 1.5(1.1-2.1)]. Conclusion: Antimalarials, antibacterial and analgesics were commonly used and inappropriately obtained by adults in Southwestern Nigeria. Factors predictive of current medication use were gender, marital status, the presence of health facilities and distance to health facilities. There is a need for more extensive countrywide medication use studies and enlightenment programs to ensure the appropriate use of medications.

Background Adverse drug reactions (ADRs) constitute major clinical burden of public health concern. Intensive adverse drug reactions monitoring in hospitals, though advocated are rare. Aims Intensive monitoring of medical patients for ADRs to assess incidence, risk factors and fatality of ADRs leading to hospital admission or occurring in the hospital. Research design and methods Prospective cohort study on 1280 adult patients admitted to the six medical wards of a tertiary institution over a 12-month period. Patients were assessed for ADRs during and throughout admission. Causality assessment and preventability of ADRs were assessed. Results Sixty-seven (5.2%) patients had ADRs, which was the cause of admission in 46 (3.6%), and majority 61(91%) of the ADRs were preventable. NSAIDs, 14 (20.3%), antidiabetics, 12 (17.4%) and antibacterial, 11 (15.8%) were the most suspected drugs. Gastrointestinal tract (37%), CNS (30.2%), and skin (24.7%) were the most affected organ/systems, while upper GI bleeding and hypoglycaemia were the most observed ADRs. ADRs led to deaths in 7(10.4%) patients, with overall case fatality rate of 0.5%. Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis 3/7(42.9%) had the highest fatality rate. Risk factors, relative risk, 95% confidence interval for ADRs were alcohol intake, 1.7 (1.04, 2.80) and duration of hospital stay, 2.0 (1.16, 3.26). Conclusions Preventable ADRs are common and important cause of hospitalization and inpatients’ morbidity and mortality among medical patients in Nigeria. Upper GI bleeding and hypoglycaemia, resulting from NSAIDs and antidiabetic drugs were the most observed ADRs. Strategic planning for intensive follow up of ADRs in Nigeria is advocated.