Access to Pharmacists is Access to Health-2014 World Pharmacists day ondo psn

Access to pharmacists is access to health

Remi Adeseun, FPSN FNAPharmKeynote Address Delivered at thePSN Ondo State 2014 World Pharmacists DaySeptember 2014

I My Pharmacist!

Introduction World Pharmacists Day (HBD FIP@102!) Aptness of Theme (Access to Pharmacists is Access to

Health) Pharmacy in Healthcare Linkages of Pharmacy to Nigerian National Healthcare Timelines/Evolution in Pharmacy Issues in Pharmacy Emerging Opportunities Focus on Ondo State A Gaze into the Crystal Ball Summary Conclusion

Key Considerations in Effective Healthcare Delivery

Access Quality Affordability

Pharmacy in Healthcare Role of Pharmacy in Healthcare

Traditionally.. regarded as a transitional discipline

between the health and chemical sciences Seen as a profession charged with ensuring

the safe use of medication


Traditionally.. Some aspects of the profession have been

constant, unchanged over centuries – the focus on helping patients deal with

maladies, the ability to apply contemporary

understanding of science and technology to health-related issues, and

the ethical mandate to place the patient at the center of all we do as pharmacists.


Contemporary.. Pharmacists are currently recognized as drug

experts whose role is to work in collaboration with patients, physicians and other health care professionals to optimize medication management to produce positive health outcomes.

Pharmaceutical Care embodies a patient-centered, outcomes-oriented practice of pharmacy. This practice model promotes the Pharmacist as a key member of the healthcare team, with responsibility for the outcomes of medication therapy.


Contemporary.. The ability of pharmacists to provide true

"pharmaceutical care“ hinges on: the redesign of the traditional pharmacy environment and

services, "revolutionary changes" such as private consulting areas in

pharmacies "adding value" to the pharmacist license via expanded

patient services. Immunization clinics, emergency contraceptives, and

collaborative practice provisions for optimal medication therapy management.


Contemporary.. Need to raise the profile of the

Pharmacist from a quiet but valuable member of the Healthcare team to a more visible and vital component of patient care.

Pharmacy in Healthcare Linkages through the National Health Policy

(NHP) Goal of NHP: Comprehensive Healthcare System

based on Primary Healthcare (PHC)-Promotive, Protective, Preventive, Restorative & Rehabilitative

Key PHC Elements: Education about prevailing Health problems

and methods of prevention/control Prevention and Control of locally endemic

and epidemic diseases Provision of Essential Drugs and Supplies

Pharmacy in Healthcare Linkages through the National Drug Policy

(NDP) Goals of NDP:

Improve Quality of Healthcare through the Rational Use of Drugs

Make available (Access) at all times, Drugs which are Effective, Affordable, Safe and of Good Quality throughout the Healthcare System

Key Success Factor For NDP: Qualified & Duly Registered Pharmacists in

ALL Community Pharmacies & Hospital/Health Systems

Pharmacy in Healthcare Linkages through the National Health

Insurance Scheme (NHIS) Goal of NHIS:

Improve the Health of All Nigerians at an Affordable Cost

Key Success Factor For NHIS: Re-Classify Pharmacist as Primary

Healthcare Providers with direct payment from NHIS for Services Rendered

Time-lines in Pharmacy Practice Early 1900s- Pharmacists fulfilled the

role of Apothecary —preparing drug products secundum artem

(according to the art) for medicinal use. At a point there was an Apothecary-General

By the 1950s, Large-scale manufacturing of medicinal products Introduction of prescription-only legal status for most

therapeutic agents Consequence: limited the role of Pharmacists to

compounding, dispensing and labelling prefabricated products.”

Time-lines in Pharmacy Practice

Mid-1960s- Clinical Pharmacy: Evolution toward a more patient-oriented practice rapid transition characterized by an

expansion and integration of professional functions,

increased professional diversity and closer interaction with physicians and other health care

Time-lines in Pharmacy Early 1990s - Pharmaceutical Care Model

adopted to emphasize that the role of the Pharmacist involves “the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life.”

Evolution in Nomenclature Apothecaries: Dates back to 1600’s. legally ratified

members of the medical profession, able to prescribe as well as dispense medicines. Still in use in USA

Pharmaceutical Chemist/Chemist in Australia, New Zealand, and the UK, a pharmacy is

often referred to as “the chemist.” 19th Century. Druggist

A druggist was a pharmacist who owned a pharmacy, Pharmacist: Dates back to 18th Century in UK

Pharmacy Training Apprenticeship

Pharmacy Extern Pharmacy Intern

Academic Diploma Degree

B.Sc B.Pharm Pharm. D

Specialisation Continuing Professional Education

Evolution in Training

Apprenticeship an aspiring apothecary, would work side-

by-side with the established professional practitioner,

learning by observing and doing medication-related activities

under the tutelage of the master craftsman or “master”

Evolution in Training…Apprenticeship

Student Pharmacist required to complete a period of practical experience under a Practitioner approved by the Pharmacy Board

“Pharmacy Extern”: hours, usually totalling nearly a year overall, could be completed during the summers between terms of enrollment in classes.

“Pharmacy Intern”: Total hours completed following graduation.

Evolution in Training…University Degree USA

1820’s to 1860’s: Private Pharmacy Schools operating as Independent Colleges were the Pioneers of University Education for Pharmacists

1940s (WW2 era): Schools/Colleges became affiliated with Universities (many of which were Public Uni’s)

academic health centres began to emerge at U.S. universities as clusters of schools of the health professions assembled with a university hospital


1820’s to 1860’s: Private Pharmacy Schools/Colleges

1940s (WW2 era): Schools/Colleges became affiliated with Universities

Academic Health Centres (schools of the health professions assembled with a university hospital) providing patient care educating future professionals. Many of

these operations included colleges of pharmacy.


1821: First college to train Pharmacists in the U.S.-Philadelphia College of Pharmacy.

1823: Second college was the Massachusetts College of Pharmacy, now the Massachusetts College of Pharmacy and Health Sciences

1860’s: First Pharmacy program in a public institution at the University of Michigan

Evolution in Training…University Degree USA: Curriculum (1)

In the 1800s, colleges of pharmacy offered the

academic degree Graduate in Pharmacy (Ph.G.).

For an additional year of study the student would be awarded the degree Pharmaceutical Chemist (Ph.C.)

even further study could earn the student the degree Doctor of Pharmacy (Phar.D.).

Evolution in Training…University Degree USA: Curriculum (2)

1940s: B.Sc (4 years) B.S.Pharm (5 years) Professional Degree 1990s: Pharm.D (6 years)

Nigeria Diploma B.Sc B.Pharm Pharm.D??

Evolution in Training…University Degree USA: Focus

1800s: Chemistry- Prepare & Dispense Medications

Early 1900’s: Prepare & Dispense Medications + Clinical Chemistry eg Urinalysis

1960’s: The Chemical focus gradually transferred over to a biological focus during the with increasing emphasis on pharmacology

1970’s: A Clinical focus moving the emphasis from the product to the patient.

1990’s: Pharmaceutical care- A new philosophy of Pharmacy Practice was advanced by Helper and Strand.

Evolution in Training: Licensure USA: Exams designed to assess whether the

licensure applicant possesses the minimum competence to be admitted to practice as well as to assess the licensure candidate’s knowledge in the areas of Pharmacy Laws.

Nigeria: No Exams. Only completion of a 12 month period of internship required. Once licensed the Pharmacist has a

Professional, Ethical and Legal obligation to maintain competence to practice.

Pharmacy Schools in Nigeria 1 Faculty of Pharmacy, University of Ibadan, lbadan. OyO State 2 Faculty of Pharmacy, University of Lagos, Lagos, Lagos State 3 Faculty of Pharmaceutical Sciences, Ahmadu Bello University. Zaria.

4 FacuIty of Pharmaceutical Sciences, University of Nsukka. 5 Faculty of Pharmaceutical Sciences, University of Jos, Jos, Plateau

State 6 Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Osun

State 7 Faculty of Pharmacy, Olabisi Onabanjo University, .Sagamu. Ogun

State 8 Faculty of Pharmacy, University of Uyo, UyO, Akwa Ibom State 9 Facultv of Pharmacy, University of Benin, Benin City, Edo State

Pharmacy Schools in Nigeria 10 Faculty of Pharmacy, Niger Delta University. Wilberforce Island

Bayelsa 11 Facultv of Pharmacy, Madonna University of Elele, Rivers State I2 Faculty of Pharmacy, University of Maduguri, Maiduguri, borno

State 13 Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University,

Awka 14 Faculty of Pharmacy, Igbinedion University, Okada Edo State 15 Faculty of Pharmaceutical Sciences, Unveristy of Port-Harcourt, Port-Harcourt, River State 16 Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo

University

Issues

Rapid Change in Healthcare Delivery Significant Growth & Development

Opportunities for Pharmacy Expansion of the scope of Pharmacy

Practice and, in some jurisdictions, the assumption of the

authority to prescribe medications in defined situations.

Considerable Ambiguity & Uncertainty by Outsiders

Issues Rapid Change in Healthcare Delivery

Significant Growth & Development Opportunities for Pharmacy Assumption of the authority to prescribe

medications in defined situations. USA: Collaborative Drug Therapy Management

by Pharmacists UK: Independent & Dependent Prescribing

Rights for Pharmacists Canada: Alberta—“adapting a prescription”— &

“initiating/managing drug therapy.” Nigeria: National Prescription Drug Policy (work

in progress) to include Pharmacists as Prescribers of “Safe Medicines” (20 Categories)

Issues Prominence in Community Health Systems Pharmacy vs Hospital

Pharmacy IT in Pharmacy

E-Prescribing E-Patient Health Records E-Dispensing

Veterinary Pharmacy

Emerging Opportunities

Public Health and Chronic Conditions Pharmacist-Initiated Prescription Ondo State Govt Positive Disposition

to Pharmacists Reference OSPHCDB Career Pathway for Govt Pharmacists NDDC/SDDC PPP with Pharmacists

Ambulance Services Pharmacist

Change Management for New Laws/Regulations/Guidelines

Vision

Success

StructuresCapabilities

Sysytems

Neccesity

Spirit

New Drug Distribution Guidelines Introduced in March 2011 Sanctions for Non-Compliance expected to

commence with effect from 12th July 2012, Now shifted till 2015.

Does it pass the test? Necessity & Vision? A resounding YES. Are the necessary Structures, Capabilities &

Systems in place to ensure Success? A big NO! What should be the right spirit? Create

Awareness, Interest and Participation of major stakeholders. Address Concerns raised. Run a Pilot Scheme in a few locations.

Public health and chronic conditions

Resources to help with health promotion,

preventing disease and supporting people with chronic

conditions


Alcohol use disorders Asthma: Supporting patients with

asthma Bowel cancer Chronic obstructive pulmonary

disease (COPD): Supporting patients with COPD

Dementia: Pharmacy & the call-to-action resources


Diabetes (blood glucose and cholesterol screenings)

Hygiene & Infectious Diseases (EBOLA)

Immunization/Vaccines Lung cancer Mental health Obesity and weight management


Sexual health Smoking cessation Supporting patients on oral anti-

coagulants

Services you can get from your Pharmacist in Nigeria (ACPN):

Counselling

Medication Therapy Management (MTM)

Disease prevention strategies erms

Immunization

Rapid tests (Cholesterol, Blood Pressure, Sugar, Malaria, Hepatitis, etc.)

HIV counselling and testing

Family planning


Family wellness

Pharmaceutical care for chronic conditions like (Hypertension, Diabetes, etc)

Medication Use Review (MUR)

Drug Information (DI)

Documentation of your medical matters for continuum of care

Online consulting.


Home delivery

Home visits

Referral to other Healthcare Providers

Public health Services and Campaign

First Aid kits

Training

Ondo State: Leader in Healthcare Systems Achievements

Abiye Agbebiye ORIREWA OSPHCDB describes Primary

Healthcare as: “a diverse field which encompasses a wide range of health Professionals such as Pharmacists, Doctors, Nurses, Allied Health Workers and Dentists.”

Ondo State Primary Health Care Development Board

• Goal 1: Control preventable diseases • Goal 2: Improve access to basic health

services • Goal 3: Improve quality of care • Goal 4: Strengthen the Institution • Goal 5: Develop a high-performing and

empowered health workforce • Goal 6: Strengthen partnerships • Goal 7: Engage communities

Pharmacy Stats: Ondo State Number of Pharmacists: 130 (PCN 2012) State Population:3,460,877 (2006 Census) Pharmacist/Population

Ratio:1/26,222(3.75/100,000) National Pharmacist/Population Ratio:1/14,941

(6.69/100,000) WHO Pharmacist/Population Ratio:1/2000

(50/100,000). USA: 85/100,000

Pharmacy Stats: Ondo State Pharmacy Distribution

Manufacturer: 1 (Tisco) Importers: 2 (Ideal Eagles/Silvahill) Wholesalers+Distributors: 14+2 (Akure: 8

+2, Ondo: 5 , Igbokoda: 1 Retailers: 20 (Akure:13, Ondo:3, Ikare:2,

Igbokoda:1, Owo:1) Hospital???

Healthcare Facilities Stats: Ondo State Primary Healthcare: 769 Secondary Healthcare: 40 Tertiary Healthcare: 2 Total: 811 Akure-183; Akoko-129; Ondo-88;

Odigbo-76; Idanre-59; Ilaje/Ese-Odo-58; Owo-43; Okitipupa-40; Ile-Oluji/Okeigbo-40; Others-95

Ref: FMOH Directory 2011

What does the future look like for Pharmacy & Pharmacists? (1)

The future is limited only by the imaginations and abilities of those entering and leading the profession.

Change is a certainty – will you be positioned to capitalize on opportunities as they emerge and evolve?

“It is not the strongest of the species that survives, nor the most intelligent that survives, but the one most responsive to change.” Charles Darwin.


Globally Bright and Rewarding very highly regarded by individual

patients and the public collectively Locally

Community > Hospital Need to reposition Pharmacy as Central

to Healthcare by offering more Value Added Services to the Consumer

What does the future look like for Pharmacy & Pharmacists? (3) Do Pharmacists have knowledge and abilities to

provide services valued by others? Can their services have a positive impact on others? Are they accessible so people can avail themselves

of these services? 24/7 Call Centre

Can Pharmacists discern emerging trends and opportunities to advance the profession and themselves? Chain Pharmacies? Public Health?


“As the leading healthcare authority on medication, the pharmacist is the most logical member of a total healthcare management team to gauge the usage and efficacy of medication, patients’ medication use patterns and alternative therapies,”

Plus, no one is better equipped to keep costly medication mistakes from happening than Pharmacists.

What does the future look like for Pharmacy & Pharmacists? (5) The potential for a medication error is

particularly high when a patient leaves the hospital with new medications and has old ones at home.

Add to that the mix of prescriptions with over-the-counter medications and supplements – often from a variety of doctors:

It’s a “prescription” for trouble that has a simple remedy: Increased ACCESS to the One Healthcare

Professional overseeing it all:

The Pharmacist.

Summary The Future of Pharmacy

Depends to a great extent on: the Pharmacists ability to INNOVATE ETHICS, INTEGRITY & PROFESSIONALISM Pharmacy’s ability to demonstrate its

RELEVANCE by creating VALUE for Patients/Consumers/Customers/Chain members

ALERTNESS, COHESION, ARTICULATION, & POLITICAL SAVVY to institute Friendly Laws & Policies as well as to pre-empt and counteract unfriendly laws

Remi ADESEUN

Conclusion

“Those that are creative, entrepreneurial and able to develop a value-added “Win-Win” approach will find more opportunities.”

ACCESS TO PHARMACISTS IS ACCESS TO HEALTH!

What will Success Look Like?

I Really Do...

When the Patient/Consumer Says...

Pharmacists: Tested & Trusted!

Thank You!

Contact Information:

Remi ADESEUN FPSN, FNAPharm

Chairman

Rodot Group

.Healthcare

.Architecture

.Consulting

08057713769/07065156473

[email protected]

[email protected]

mailto:[email protected]

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Access to Pharmacists is Access to Health-2014 World Pharmacists day ondo psn