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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1495328
Assessing Ethical Practices among Community Pharmacists in Nigeria: Prevalence, Drivers, and Implications -A Mixed Methods Study
Provisionally accepted
Olanrewaju Olamide Popoola1,2*
Igbagboyemi Adebowale Adebisi3
Adebowale Sylvester Adeyemi4
Damilola Samson Adepitan.5
Opeyemi Fortunate Oladeru2,6- 1HealthPlus, Lagos, Nigeria
- 2Obafemi Awolowo University, Ife, Nigeria
- 3Drugfield Pharmaceuticals, Nigeria, Ogun, Nigeria
- 4Arkland Health Limited, Abuja Nigeria, Abuja, Nigeria
- 5University of Ilorin, Ilorin, Nigeria
- 6University College Hospital Ibadan, Ibadan, Nigeria
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IntroductionGiven the accessibility of community pharmacists as the first point of care in Nigeria and their expanding role in optimising public health, it is critical that they employ evidence-based, ethical practices. This study assessed ethical practices and identified drivers of unethical practices among community pharmacists in Nigeria.MethodsA convergent-parallel mixed method study design was employed, collecting quantitative and qualitative data, which were analyzed using SPSS and inductive content analysis.ResultsMost pharmacists maintained patients' confidentiality (93.2%), and disclosed side effects of medicines to patients (80.3%). Nearly half (48.9%) dispensed antibiotics without prescriptions and more than onethird purchased medicines from the unregulated open market (38.4%). Conversely, only 53.4% performed quality checks to identify possible or suspected substandard and falsified medicines. Pharmacists who regularly consulted the PCN code of ethics were less likely to dispense antibiotics without prescriptions (p=0.011), stock medicines not approved by NAFDAC (p=0.010), or purchase from open markets (p=0.027). Key drivers of unethical pharmacy practices include poor physician-pharmacist interprofessional collaboration (76.3%), patient pressure (73.9%), and managerial pressure to meet sales targets (70.3%). Qualitative responses highlighted competitive pressure, expressed as fear of losing clients, poor working conditions, poor regulation, and unethical, profit-driven, managerial practices as drivers of unethical pharmacy practices. Potential limitations to this study include recall bias and the Hawthorne effect.ConclusionCommunity pharmacists' unethical practices potentially contribute to the prevalence of substandard and falsified medicines and antimicrobial resistance. Improved regulations, improved remuneration, providing incentives for professionalism, training on ethics and improved interdisciplinary collaborations could promote ethical community pharmacy practices.
Keywords: Pharmacy Practice, Community pharmacists, antimicrobial resistance, Substandard and falsified medicines, drivers, Ethics
Received: 12 Sep 2024; Accepted: 14 Apr 2025.
Copyright: © 2025 Popoola, Adebisi, Adeyemi, Adepitan. and Oladeru. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Olanrewaju Olamide Popoola, HealthPlus, Lagos, Nigeria
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.