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Opinions of Sunday, 18 December 2022

Columnist: Ernest Cudjoe Anorbor

Proper integration of Doctors of Pharmacy(PharmDs) into Ghana’s health care system = Better Patient Health

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The most common therapeutic intervention in the world is pharmacotherapy, also called drug therapy. As healthcare evolves, the need to properly integrate Doctors of Pharmacy, who are the medication experts, into our healthcare system to oversee the provision of safe, effective and economic drug therapy to patients has become essential.

This call is even more relevant in the face of the heavy reliance on drug therapy for the management of many chronic conditions like diabetes mellitus, hypertension, and other cardiovascular disorders. In all these conditions, the diseases are usually lifelong and come with a number of co-morbidities, making polypharmacy part and parcel of the overall treatment strategy.

Patients, therefore, need pharmacists to guide them on their medications to promote medication adherence and compliance. Patients with chronic illness face a number of challenges managing their day-to-day and long-term health, in part because medications are complex, confusing, costly, and potentially dangerous.

Doctors of Pharmacy can help optimize medication use and improve the health of patients with chronic illness through Medication Therapy Management (MTM).

Given unmet patient needs, especially in the area of primary care, pharmacists can offer a comprehensive approach to patient care and population health by providing drug information, medication reviews, promoting the safe and rational use of medicines, etc.

In compelling terms, pharmacists can help improve patient and health system outcomes by delivering expanded patient care services. The knowledge that pharmacists share can lead to better use of medications, increase cost-effectiveness, optimize clinical outcomes, and improve patient care.

In line with current best international practice, pharmacists in countries such as the US, UK, and Canada are now able to prescribe, renew, refuse to fill, adjust, initiate, or substitute prescriptions. They can order and interpret laboratory tests and can administer injections and vaccines.

Based on a review of the evidence, patients are likely to benefit from pharmacist participation in vaccination efforts and from drug management for clinical indications such as diabetes, hypertension, dyslipidemia, anticoagulation, and adverse drug events.

Health care is expensive and the impact of inappropriate medication use is staggering. Unsafe medication practices and medication errors are leading causes of injury and avoidable harm in healthcare systems across the world. Adverse drug event is the third leading cause of death in the United States after heart disease and cancer.

Each year, there are more than 1.5 million preventable medication-related adverse events in the United States alone. Globally, the cost associated with medication errors has been estimated at $42 billion USD annually by WHO.

Unsafe medication practices and medication errors are epidemics in Ghana hospitals that have resulted in severe harm, disability, and even death to many Ghanaians. Unfortunately, there is no data on costs incurred due to inappropriate medication use and medication non-adherence in Ghana but one can be certain that the situation is worse due to our fragile healthcare system.

Pharmacists can help ensure medication safety in our hospitals and society because they have training in the use of medications for the treatment, management, and prevention of diseases. They can help ensure patients and society have a thorough understanding of their medications (i.e., mechanism of action, adverse effects, monitoring parameters). Doctors of Pharmacy must be empowered to lead the campaign to reduce medication-related harm by improving practices and reducing medication errors.

Studies and practice-based experience have shown that when pharmacists are properly integrated into the healthcare team, patient outcomes improve, patients report higher rates of satisfaction, and overall healthcare costs are reduced. But without the proper integration of Doctors of Pharmacies into Ghana’s healthcare system, patients and medical doctors are often blocked from accessing the benefits achievable through pharmaceutical care.