Community Pharmacy-Based Screening and Health Education for Hypertension and Diabetes: A Public Health Strategy for Primary Care in Southeastern Nigeria

Background: Non-communicable diseases, especially hypertension and type 2 diabetes mellitus, are responsible for a rising proportion of adult illness and death in sub-Saharan Africa. In Nigeria, weak primary healthcare systems, long hospital wait times, and direct out-of-pocket expenses limit early screening and routine monitoring. Community pharmacies are accessible retail locations where staff interact with the public daily, making them practical points for health checks and disease prevention education. Objective: This study evaluated the detection rates, clinical findings, and referral outcomes of community pharmacy-based point-of-care screening and structured health education for hypertension and diabetes in Imo State, Southeastern Nigeria. Methods: A descriptive cross-sectional survey was conducted across 16 registered community pharmacies in urban and semi-urban sections of Owerri, Imo State, between January and May 2026. A total of 400 adult clients visiting pharmacies for retail purchases, consultations, or voluntary checks were enrolled through systematic sampling. Seated blood pressure (BP) and capillary blood glucose (CBG) were measured using calibrated digital sphygmomanometers and point-of-care glucometers. Structured questionnaires gathered data on demographics, physical activity, dietary salt, and family medical history. Participants with high readings received a 10-minute lifestyle counseling session and written referral forms to local medical facilities, with referral completion verified via telephone follow-up at 4 weeks. Multivariable logistic regression identified independent predictors of newly detected cardiometabolic risks. Results: The mean age of participants was 44.8 +/- 13.2 years (53.5% female). Among screened clients with no prior clinical diagnosis, 29.8% (n = 119) had elevated blood pressure (>= 140/90 mmHg) and 14.3% (n = 57) had impaired fasting glucose or random capillary glucose suggestive of diabetes (>= 200 mg/dL). Both elevated blood pressure and high blood glucose occurred in 7.8% (n = 31) of clients. Frequent table salt addition (AOR = 2.41, 95% CI: 1.48-3.92), sedentary lifestyle (AOR = 1.95, 95% CI: 1.21-3.14), and age over 45 years (AOR = 3.12, 95% CI: 1.96-4.97) were significant independent predictors of elevated blood pressure. At 4 weeks, 58.0% of referred clients had visited a hospital or primary health center for medical evaluation. Conclusion: Community pharmacies provide an accessible venue for the early identification of undiagnosed hypertension and diabetes in urban and semi-urban Nigerian communities. Incorporating pharmacy point-of-care checks and lifestyle counseling into primary healthcare strategies can improve early diagnosis and support timely management of non-communicable diseases.