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Health News of Saturday, 15 December 2012

Source: Kumi, Frank

S tay Safe: Insist on Talking to Your Pharmacist

The role of the modern pharmacist has evolved from just filling up prescriptions, compounding, and selling medicines to a more patient-centred orientation. In fact, contemporary training of pharmacists recognizes the need to train pharmacists to deliver direct patient care for the improvement of health outcomes.
Of note, is the recently extended period of training pharmacy graduates from 4 years to 6 years at the Faculty of Pharmacy and Pharmaceutical Sciences of the Kwame Nkrumah University of Science and Technology in consultation with the Pharmaceutical Society of Ghana (PSGh) and the Pharmacy Council of Ghana. Such a seismic change in pharmacy training is envisaged to ensure that the country’s new breeds of pharmacists are at par with their counterparts from developed countries and are also well equipped to face the ever dynamic world of drug therapy.
Careful observations have revealed that Ghanaians are poorly utilizing the professional expertise of pharmacists working in hospitals and the various community pharmacies scattered across the country. A confluence of factors has contributed to such a worrying observation.
This dismal situation can mainly be attributed to the brazen violation of the Pharmacy Act 489 by both private hospitals as well as government hospitals. The Pharmacy Act 489 (passed in 1994 to ensure public safety and high standards of pharmaceutical services) explicitly prohibits any person to operate a pharmacy/dispensary without the supervision of a registered pharmacist.
In sharp contrast to this law, most private hospitals and government hospitals are operating pharmacies without the supervision of pharmacists to ensure patients safety and optimum benefits in using medications. Although the Pharmacy Act bestows a legal mandate upon the Pharmacy Council to enforce strict compliance with the provisions of the pharmacy law, human and financial resources, coupled with logistical constraints are making it difficult for the Council to effectively discharge regulatory duties.
Regardless of these challenges, the public has a right and an obligation to receive quality pharmaceutical services from any pharmaceutical outlet in this country. Insisting on pharmaceutical services delivered by a highly skilled and trained pharmacist at the pharmacy is a guaranteed step of achieving such an objective.
Pharmacists provide invaluable treatment and medication counselling to clients as a way of ensuring that optimum benefits are derived from medications and treatment whiles minimizing the potential side effects associated with the use of medicines.
Some medicines have special instructions that come with them and therefore have to be faithfully obeyed. Failure in knowing and following these pieces of advice may result in sub-optimal treatment and ultimately leading to treatment failure. Take for example a medicine called omeprazole, commonly prescribed for treating stomach ulcer. The oral form of this medicine has to be taken before meals because of its intrinsic mechanism of action. If you fail to heed to the pharmacist’s advice that your medication “should be swallowed at least 30mins before meals,” chances are that you will miss out on the efficacy of this anti-ulcer drug.
Apart from providing you with special pieces of medication counselling points, your pharmacist is also well trained in disease management to proffer relevant lifestyle changes to compliment your medications in order to achieve your treatment goals faster. Lifestyle changes evidenced to improve and manage chronic diseases such as hypertension, diabetes, asthma, gout, etc would be gladly provided by the pharmacist at no extra cost at all.
Unlike seeing your doctor, neither special appointment nor queue is needed before you can see a pharmacist. Even though pharmacists are not systematically trained to diagnose diseases, they are able to offer advice about minor ailments, such as coughs, colds, cold sores and general aches and pains in accordance with established laws. Ghanaians are accordingly encouraged to talk to a pharmacist about any health topic. Many pharmacies do allocate private consulting area for this special purpose.
Since pharmacists obtain extensive erudition on drugs during their period of pharmacy education and training, they are in the best position to advice on how to store medications. Proper storage conditions are needed to ensure that the potency of medicines are not lost--but kept intact to prevent treatment failure. Essential advice such as keeping medicines in their original container; keeping heat sensitive drugs in the appropriate part of the refrigerator; proper cabinet for keeping medicines etc will all be delivered by the pharmacist.
It is also important to get to know from a pharmacist that whether a new prescription written for you by your doctor does not contain drugs that could significantly affect one another or might not profoundly interact with any other medicine you are currently taking. In furtherance, pharmacists are best situated to avert any catastrophic circumstances whereby a medicine written for you could worsen or degenerate any of your previous or new ailment.
Similarly it is always good to know from your pharmacist whether you should avoid certain foods while taking your medicines. Research has led to the identification of a number of food-drug interactions of clinical significance. In late 2012, a study published in the Canadian Medical Association Journal observed that “the number of drugs which had serious side effects with grapefruit had gone from 17 in 2008 to 43 in 2012.” In similar vein, certain medications—especially antibiotics—should not be concurrently taken with milk otherwise the drug will be poorly absorbed; eventually leading to poor control of that particular infection. However, relying on the professional competencies of a pharmacist will definitely prevent the occurrence of such unwanted circumstances because they are the best port of call to let you know how your diet may affect your medication.
Pregnancy and lactation are dainty situations which could easily be complicated by certain medicines. Since most drugs are not tested in pregnancy or breastfeeding prior to their approval, it is difficult—even for health professionals—to vouch for their safety in these special conditions. It has been established that some drugs—including common pain killers—can cause serious birth defects or delay labour. Pregnant women and lactating mothers should therefore always talk to their doctor or pharmacist before taking any medicine that they need. Adopting this practice is a safety measure for the unborn or breastfeeding baby.
You also need to know the side effects associated with the medicines you are about to take. Knowing beforehand the side effects of a medicine could enhance medication compliance as the pharmacist may advise on measures that need to be taken to mitigate any unwanted effects that will likely occur. Next time you find yourself in a pharmacy, ask your pharmacist what the side effects of your medicines are and when they might begin to occur. What should you do if they occur?
Lastly, it is important to establish a relationship with one pharmacy so that your pharmacist has a complete history of your prescribed medications. If you visit a pharmacy which has no pharmacist, as a safety measure for your life, you have the right as a patient to seek the services of another pharmacy which has a pharmacist present. You can even take it further by reporting it to the Pharmacy Council or the professional body of pharmacists in this country, PSGh. It is against the laws of this country to operate a pharmacy without the physical presence of a pharmacist at any point in time.
In summary, there is a great deal of benefit you stand to gain by interacting with a pharmacist as the role (both clinical and non-clinical) of the pharmacist in healthcare delivery certainly goes beyond what has been elaborated in this piece. Your pharmacist is an important resource when it comes to your safety in medication usage.

Frank Kumi
Registered Pharmacist (R.Ph.)
Member, Pharmaceutical Society of Ghana (PSGh)