ASSOCIATION OF HOSPITAL AND ADMINISTRATIVE PHARMACISTS OF NIGERIA (AHAPN)
PRESS RELEASE TO MARK THE 2020 WORLD PHARMACISTS DAY
This year 2020 is the tenth edition of our World Pharmacists Day. The theme of this year’s celebration is “Pharmacists transforming global health.” The aim is to show how pharmacists contribute to a world where everyone benefits from access to safe, effective, quality and affordable medicines and health technologies, as well as from pharmaceutical care services.
Pharmacists are one of the key health professions that will help meet the United Nations Sustainable Development Goals. Colleagues in all fields of the profession are all individually playing a part in transforming the health of their communities. Pharmacists throughout the world are one of the most accessible health care providers and are often the first health professional individuals seek for care. Many pharmacies in the communities operate for 24 hours a day without insisting on pre-appointment. Pharmacists are uniquely positioned across communities to provide care and advice to the populace. Currently, pharmacists all over the world are working tirelessly to stop the spread of COVID-19, and to ensure people continue to have access to medicines they need.
Throughout the world, pharmacists are utilized in increasing access to safe, quality medications that save lives. From medication safety and the responsible use of medications to supply chain management and immunizations, pharmacists utilize their medication expertise not only for addressing local gaps in care but also for broader global health efforts.
Improper medication use is a multi-billion dollar challenge worldwide with pharmacists positioned to be part of the solution, given their medication expertise. More than half of this cost is due to medication adherence issues that pharmacists can readily address.
A recent research of self-medication use in developing countries estimates that over 38% of patients self-diagnose and treat, contributing to the growing global burden of antimicrobial resistance. Pharmacists can address this by developing optimal treatment regimens based on available resources, providing appropriate patient medication education, and conducting medication reviews to help improve health outcomes. Pharmacists can contribute towards improving medication use and other global health issues at both individual and systems level. The rational use of medications will be essential in helping address the burden of communicable and non-communicable diseases in developing countries like Nigeria.
In the area of medication safety, substandard and falsified medications pose a significant health risk worldwide with poor quality medications often having the wrong amount or lack of active ingredients, leading to increased morbidity and mortality. Developing countries are impacted the most by falsified and substandard medications where life-saving treatments for communicable diseases such as malaria, tuberculosis, and HIV are often the targets. A recent review collectively assessing more than 16 000 samples of medications across Africa, Asia, and South America found that 9%-41% of medications failed to meet quality standards.
Medication errors also pose significant issues to medication safety. Given their role in quality assurance across pharmaceutical systems, pharmacists can contribute to the design of processes and programs to mitigate medication errors, improve medication quality, and improve health outcomes across a variety of health care settings.
From manufacturing roles within the pharmaceutical industry to the community pharmacy where innovative approaches are being developed to test medication quality on-demand, pharmacists can impact the health of populations in different ways. Beyond quality assurance and medication errors, pharmacovigilance, or the detection and prevention of adverse drug reactions, is another aspect of medication safety for pharmacists engagement.
The World Pharmacists Day theme this year is an opportunity to communicate how pharmacists are transforming health through a variety of health services in their communities, including advising on healthy living, vaccinating to prevent diseases, and ensuring that medicines are taken correctly, thereby managing diseases well and improving quality of life. It also covers how pharmaceutical scientists transform and prolong peoples lives by developing safe and effective medicines and vaccines.
On the education front, pharmacy educators are transforming outcomes by ensuring that there are enough qualified and competent pharmacists and scientists to meet the growing needs of our societies.
The roles of pharmacists have been expanding in the last couple of years. Specialist pharmacists are becoming highly sought after based on the need to maximize benefits of pharmacotherapy for better patient outcomes. Pharmaceutical care has emerged to replace the traditional dispensing role with its inherent limitations of practice.
The consultant clinical pharmacist is a specialist in drugs and drug related matters, who has undergone a thorough and didactic training to provide the highest level of pharmaceutical care to patients in clinical settings, in collaboration with other health care givers. He equally provides expert advice to the physicians, nurses and other team players to ensure that the safest and best medications are provided to patients on individual basis (individualization of therapy) based on the patient’s biodata. This ensures optimization of individual therapy with best medications that are cost- effective, safe, available, affordable and with minimal side effects.
Generally, clinical roles of pharmacists include: to evaluate and validate prescriptions or treatment regimens; reconcile the various prescriptions from various prescribers especially in comorbid patients. Many COVID-19 patients also suffer from elevated blood pressure and diabetes mellitus. Pharmacists are involved in identifying, preventing and resolving potential and actual drug related problems such as drug interactions, low and high doses and duplicate therapy. For example, use of Azithromycin and Hydroxychloroquine together may have a serious impact on the cardiovascular system and are a potentially lethal combination. In other words, taking the 2 drugs together can affect the heart rhythm and may increase the risk of irregular heartbeat, which may be life threatening.
Pharmacists monitor progress of Drug Therapy, by checking the doses, drug interactions, monitoring blood pressure and blood sugar levels of patients. They also improve medication adherence and compliance by encouraging and educating patients on the importance, while at the same time cautioning on the dangers of non-adherence to their prescribed medications.
Pharmacists provide drug information services and disease education by providing counselling on drugs and risks of use, signs and symptoms of the disease, and life style modifications.
Pharmacists provide cost-effective drugs on time, as well as expert advice to prescribers and nurses on the proper time and route for drug administration, to ensure optimum blood concentration of drug, that is bioavailability.
Pharmacists provide post discharge pharmaceutical care to patients upon discharge. This is to ensure that the patient still adheres to his medications, measures his/her blood pressure and sugar levels. In some cases, these are achieved by counselling via phone calls to patients.
Pharmacists ensure that safety and the expected therapy outcomes are achieved and generally take responsibility for drug therapy.
Challenges confronting Pharmacy practice in Nigeria
- Need to fully integrate pharmacists into the healthcare sector
Pharmacists in Nigeria are not yet fully integrated into the health care sector. Pharmacists should be granted access to the patient’s bedside, to enable patients benefit from the expertise of the clinical consultant pharmacists, in terms of improved quality of life, reduced costs of care and improved treatment outcomes. The recent approval for Consultant Pharmacists cadre by the Federal Government is a step in the right direction and nothing must be done by any group or persons to derail or sabotage the approval.
- Implementation of newly approved Consultancy Cadre for Pharmacists in Nigeria
Pharmacists are grateful to the Federal Government for the Release of the Circular for Consultant Pharmacists cadre recently issued by the Office of the Head of the Civil Service of the Federation. We are now appealing to government to expedite action on payment of the new remuneration to consultant pharmacists, so that the Nigerian people will begin to benefit from the expertise of consultant pharmacists. This approval among other benefits will lead to eventual reduction in brain drain among pharmacists.
- Additional clinical roles for Pharmacists
Nigeria needs to imbibe the new global trends in Pharmacy practice, such as the shift in focus from product to patient centered care (Pharmaceutical care), Doctor of Pharmacy Degree (PharmD), and more clinical roles for pharmacists such as vaccination, disease screening and others. We are equally awaiting Release of Circular for enhanced entry point for our Doctor of Pharmacy graduates, in line with global trends.
- Drug Revolving Fund Recapitalization
The Drug Revolving Fund (DRF) was set up by government to ensure continuous drug availability in hospitals and for out of stock syndrome to be reduced to the barest minimum in our health institutions. Unfortunately, this has not been the case and out of stock syndrome continues to thrive, due largely to mismanagement of the DRF by most hospital management who are owing drug manufacturers huge debts running into billions of naira. This is a call to government to assist in bailing out tertiary health institutions to enable then settle their indebtedness to drug manufacturers so they can resume supply of medicines to these institutions. Similarly. drug revolving fund incentives meant for pharmacists which was discontinued with consolidation of salaries by the federal government, must be paid to pharmacists in line with the provisions of the policy guidelines setting up the DRF.
- Employment of more Pharmacists and increased remuneration for Pharmacists
Our Association has severally harped on the need to employ more pharmacists to work in our health institutions in Nigeria, in line with the recommendations of the World Health Organization, which recommends on the average about one pharmacist to 2,000 of the population, but in reality what obtains right now is about one pharmacist to over 50,000 persons. We are also advocating for increased salaries for pharmacists who have been stagnated on the same basic salary since 2014, even when government has increased salaries of some other category of healthcare workers since then.
- Central Placement for Pharmacy Interns
Despite assurances of central placement for fresh pharmacy graduates and others, many graduates are still roaming the streets, looking for nonexistent internship space, two to three years after graduation, thereby constituting huge financial burdens to their parents. We are calling on government to expedite action on central placement for pharmacy interns.
- Payment of earned allowances to Pharmacists
We wish to seize this opportunity to call upon government to pay all outstanding monies to pharmacists such as the withheld April and May 2018 salaries of pharmacists and other healthcare workers, as well as balance of Call Duty arrears approved since 2014, to ameliorate the sufferings of pharmacists especially in view of the Corona pandemic hardship.
- Improvement in Infrastructure development for better performance
CoVID-19 has exposed the inherent challenges and shortcomings in our healthcare institutions in the country, which government officials have also acknowledged. What is remaining is for government to summon the political will and resources to reposition the healthcare sector in line with global best practices. This will help to curb brain drain among healthcare professionals in Nigeria.
- Dismantling of open drug markets in Nigeria
Open drug markets in Nigeria remain a major source of falsified and substandard medicines and continue to pose huge risks to the health of Nigerians. We call on the Nigerian government to dismantle these markets and implement the National Drug Distribution Guidelines as proposed by the Pharmacists Council of Nigeria and the Pharmaceutical Society of Nigeria so as to sanitize the chaotic drug distribution system in Nigeria once and for all.
- Need to reduce cost of imported Medicines in Nigeria
Allowing Pharmaceutical manufacturers and importers to source foreign exchange direct from the Central Bank will go a long way to bring down the costs of imported medicines in Nigeria which are currently on the high side. AHAPN calls on the Federal Government to give this suggestion urgent and positive consideration.
On this occasion of the 2020 World Pharmacists Day, the Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN) wishes all pharmacists in Nigeria and Diaspora Happy World Pharmacists Day.
Dr. Kingsley Chiedu Amibor PharmD, MPH, FPCPharm
National Chairman AHAPN