Impact of a 100% Drug Prescription Fill Policy on Physical Activity and Quality of Life among Hospital Staff: A Cross-sectional Study from Nigeria

Abstract

Aims and Objectives: To evaluate the sedentary behaviours of the staff of UBTH and educate them toward compliance with the global recommendations by the WHO. To also measure their level of physical activity and compare it with the global recommended standards of 150-300 minutes per week. To educate the staff on the usefulness of engaging in physical activity to their health, mental health and social lifestyles and the relationship between physical activity and noncommunicable diseases like diabetes mellitus and some cancers. Background: The University of Benin Teaching Hospital implemented a 100% drug prescription fill policy in 2018, and this has a multiplier effect on the workload on the staff. This leaves little or no time for leisure time activities, social and physical alike.  Physical activity is an integral component of quality of life (QoL). Physical activity planned for the recess period at workplaces could act as an effective interlude that could help to improve the health and the quality of life of the staff, mitigate against all-cause diseases. The health of some staff sometimes becomes traumatised by some ailments which could be acute, critical or even chronic in nature, and death occurs in some cases. Some suffer some mild, moderate to severe pains, which could be managed under the staff health insurance or by referral services. These could diminish their inputs, effectiveness and efficiency at work and constitute an additional cost burden on the staff and or on the health insurance body. One sure way to mitigate these is by measuring the quality of life (QoL) of the workers in the establishment on a scheduled basis. This would expose so much hidden information about the staff’s health and wellbeing and provide advisory information as to whether or not the staff are keeping with the minimum recommended guidelines on physical activity by the World Health Organisation and other reputable scholarly reports and recommendations on physical activity and sedentary life style. It is expedient for the staff of UBTH to determine their own perception of self in the organisation they work for in relation to their life goals, expectations, standards, religious and other concerns. Methodology: The International Physical Activity Questionnaire (IPAQ), a self-report assessment form (about 400), were distributed to the staff of UBTH. They were filled freely by answering the questions therein, which requested them to state how much time they spend on each physical activity (vigorous, moderate, walking and sitting) per day. The data were collected and collated into various categories, viz, male, female, clinical and non-clinical staff members in correspondence with various times spent on each type of PAs. They were tabulated, and for each table, the total population, the mean of population, the total time, the percentage of population, and the mean of time spent on each physical activity by each category of staff were calculated. For each table, the paired t-test parametric GraphPad Prism- 6 was used to compare the male with female, and clinical with nonclinical, and tests for levels of confidence intervals (CI), standard deviations (SD), standard error mean (SEM), correlation coefficient (r), R square and coefficients of variability (CV) were determined. The One-Way ANOVA repeated measures was used to compare the four categories of population participation in physical activities at various times. The total number of staff obtained from the Hospital record is 2000. Substituting these into the Taro-Yamane equation above gives: n = 333 sampled population. Findings: Out of about 400 IPAQ data forms distributed to staff for completion, only 382 (95.5%) were returned, with some, about 18(4.5%) incompletely filled. The number of responses said ‘No or Not sure’ for all three categories of PAs assayed was 261(22.8%) out of a total of 1,146 responses, while 885(77.2%) of the responses gave useful data for this research.  Despite the increased workload on the UBTH staff, their levels of physical activity are still within acceptable and commendable limit for both males, females, clinical and non-clinical staff categories who respectively spent at least 26.1 minutes per day (182.7 minutes per week), 20.8 minutes per day (145.6 minutes per week), 24 minutes per day (168 minutes per week) and 23.9 minutes per day (167.3 minutes per week). Conclusion: This research work revealed that males of UBTH are compliant with the global minimum physical activity requirement per week, while the females fall short by 4.4 minutes per week. Though the female respondents were more who were engaged in various PAs in minutes per week than the males, they nonetheless spent less time in performing physical activities, with a mean difference of 37.1 minutes per week. The Clinical and non-clinical staff were found to be ‘equi-active’ in physical activities, and compliant with the global minimum PA requirement.