PE Newsletter | December 2012
International Pharmaceutical Students’ Federation
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PEN Pharmacy Education Newsletter
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PEN editorial Dear IPSFers, Today, IPSF pharmacy education releases its third monthly newsletter. We’re still on the start but we are improving especially with your suggestions and comments as well as your participation. Do not hesitate to submit any idea of article you find relevant for PEN!
Chairperson of Pharmacy Education 2012-2013
publication team Decemnber 2012
Design & Layout
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Ms. Alexandra Marques IPSF Chairperson of Media and Publications
Cover photo
Pre-event
FIPEd corner
4th Kuwait IPC Ali Qadsawy Al Shammari
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Ed innovation
Proofread by
BIMFI Pony Purnamasari H
Ms. Yuqian Liu [Editor-in-Chief] Ms. Michelle Garner Ms. Hannah Svedlung
publications@ipsf.org editor@ipsf.org
Enjoy reading and Viva la pharmacy.
content
WISE Qatar 2012 by Mr. Radoslaw Mitura
Recently, Radek and myself represented IPSF in an NGOs meeting in UNESCO Paris. While attending a bioethics committee meeting, one of the lecturers said : “ too much science kills culture …”. This made me think about how us , pharmacist, need to learn a lot of complex scientific information, while in practice (when dealing with patients) we use much more simplified approach, which turns our scientific background into … culture.This is particularly true when it comes to complex patients. The pharmacist is the scientist who turns his science into culture, thus being the closest healthcare professional to the people … Think about it.
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Prescribing Challenges in Elderly Patients
Sailishni Kartigayam
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IPSF-FIP Student Learning Experience Questionnaire Naoko Arakawa
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Mr. Marouen Ben Guebila
I would like to present briefly what are the axis of today’s publication. First, Ms.Vhony is sharing with you an amazing experience about the local association journal that become international and recognized scientific magazine. Vhony was Phuture coordinator last year and she is taking care of this new magazine. I am full of happiness and pride when I see motivated people taking IPSF experiences back home to improve their associations work. We are all meant to give back to our mother associations at least a little of what they gave us in terms of friendships, care, self-fulfillment and free food! It is even better when you make your association grow bigger and be a model to follow for IPSF! This said, we are aiming to make the same process with IPSF scientific magazine Phuture! Second, Radek attended the WISE in Qatar and will be sharing with you an “educational” trip, a must-read! Then, Ali from Kuwait will tell
you about a biannual event taking place in his university. The last article is truly a pleasure to read, it deals with prescribing drugs to the elderly. It is a short version of Ms. Sailishni’s thesis, which will give us an insight about a very important topic: How to deal with complex patients.
World Innovation Summit for Education 2012 Radoslaw Mitura Page 12
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PEN pre-event
4th Kuwait International Pharmacy Conference by Mr. Ali Qadsawy Al Shammari Kuwait, KPSS Faculty of pharmacy at Kuwait University holds an international conference every two years. the 4th Kuwait International Pharmacy Conference will be held from February 4 to 6, 2013. This year’s conference will include contemporary issues and developments from pharmacy practice to basic pharmaceutical science. There will be plenary sessions and proffered oral abstracts as well as posters related to advances in pharmacotherapy, medication adherence, drug delivery and pharmacogenomics. Invited lectures will be given by distinguished scholars from North America and Europe as well as from the Gulf region. Workshops will deal with a variety of topics including pharmacy education ( Medication adherence and the social responsibility of schools of pharmacy to address this problem in Society) as well as patient education techniques (Role of pharmacists in assessing well-being of the patient pre and post treatment). The newest scientific discoveries will be a part of the programme as well (Tools for optimization of individualized chemotherapy , Nanomedicine: polymeric systems for controlled drug delivery to tumors, Drug delivery for multi-drug resistance and metastatic cancers).
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Healthcare inter-cooperation is a key element for the success in a clinical environment, This interesting topic is detailed in the workshop: New health delivery models in relation to patient-centeredness and health teams. A lot of interesting talks and lectures will deal with topics related to pharmacy, and we’re also expecting an international attendance to this conference. If you have been working on one of the topics up mentioned then don’t hesitate to submit your abstract to KIPC.2013@ku.edu.kw . Visit http://www.kipc2013.com/ for more information.
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PEN Ed innovation
BIMFI
(Berkala Ilmiah Mahasiswa Farmasi Indonesia/Scientific Journal Of Indonesian Pharmaceutical Students)
To Address The Needs Of Pharmacy Students In Publishing Their Studies by Ms. Pony Purnamasari H, President of BIMFI, University of Indonesia (UI) Directorate General of Higher Education Ministry of Education and Culture (DGHE) in Indonesia has identified that a lack of published studies can hinder further development and improvement of clinical practice. Therefore, DGHE, through Health Professionals Education Quality (HPEQ) Project-Students’ Component, supports an e-journal to facilitate health professional students in publishing their studies and find earlier studies for references. As a national scaled organization which facilitates pharmacy students in Indonesia, ISMAFARSI actively contributes in managing BIMFI (Scientific Journal of Indonesian Pharmaceutical Students). ISMAFARSI and all of the health professional students have collaborated to initiate and manage a big umbrella which will cope with publications of all health professionals students, BIMKES (Indonesian Health Professional Students’ Journal). Therefore, BIMKES is divided into several units according to the professions which contribute papers. Those units are JIMKIfor medicines, BMKGIfor dentistry, BIMIKI for nursing, BIMABI for midwifery, BIMFI for pharmacy, BIMGI for nutrition, and BIMKMI for public health. It is founded and managed 100% by Indonesian students. The students are trained by experts in managing journals
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prior to taking over responsibility for managing the journal. The Scientific Journal of Indonesian Pharmaceutical Students is peer-reviewed and allows access to abstracts and full-text. The journal is devoted to the promotion of pharmaceutical sciences and related disciplines (Pharmacology, Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical Medicinal Chemistry, Computational Chemistry & Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmaceutical Analysis, Pharmacy Practice, Clinical & Hospital Pharmacy, Cell Biology, Genomics & Proteomics, Pharmacogenomics, Bioinformatics including biotechnology, cell & molecular biology, Pharmaceutical biotechnology/microbiology, medical and other life sciences, etc). ISSN (International Standard Serial Number) of Scientific Journal of Indonesian Pharmaceutical Students is 2302-7851. It has a printed version and is published twice a year. BIMFI has also recieved an award as The Most Cooperatid Journal by Directorate General of Higher Education Ministry of Education and Culture-World Bank Mission. Although Scientific Journal of Indonesian Pharmaceutical Students is primarily devoted to original research papers, the journal also welcomes reviews
PEN Ed innovation
on current topics of special interest and relevance. All manuscripts will be subjected to rapid peer review. Those of high quality (not previously published and not already under consideration for publication) will be published. Papers submitted could be in Bahasa or English, and in a means or article, reference, study report, refreshing pharmaceuticals & health article, advertorial, practical instructions, or editorial. The papers are original works of the author (no plagiarism), which is made based on the competency of the students (pharmacy).
access to knowledge so researchers are encouraged to apply and publish their articles at BIMFI. The articles are also an open access for all the readers after a simple registration at on the web. Hopefully this will generate improved health research amongst new researchers. Do not hesitate to contact us at bimfi@ ismafarsi.org or bimfi@bimkes.org. We also love to share our experiences and ideas in this field. Viva la Pharmacie !
Now, we are proud to launch the first edition of our electronic journal at www.bimfi.bimkes.org. This website is available in Bahasa and English and is accessible now. The website was officially soft launched on Oct 20th, 2012 at The Education Harmonization of Indonesian Heath Professional Students Conference, and witnessed by all health professional students in Indonesia through a video conference. The grand launch will be held on National Education Day on May 2013. By using technologies we could enhance the equity of knowledge from Sabang until Merauke (which are the east and west border of Indonesia). We believe that everyone in this world has the same right to get education and
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PEN Ed innovation
Prescribing Challenges in Elderly Patients by Ms. Sailishni Kartigayam Medical care of the elderly requires a body of knowledge and skills distinct from those needed in other medical fields. Exposure to specialised training in geriatric practice will enhance the capacity of physicians and general practitioners to provide appropriate high quality health care both for the relatively healthy well older person and for those elderly who are hospitalised with multiple medical problems. Adverse drug effects are effects that are unwanted, uncomfortable, or dangerous. Common examples are oversedation, confusion, hallucinations, falls, and bleeding. Among ambulatory people ≥ 65 years, adverse drug effects occur at a rate of about 50 events per 1000 person-years. Optimising drug therapy is an essential part of caring for an older person. The process of prescribing medication is complex and includes: deciding that a drug is indicated, choosing the best drug, determining a dose and schedule appropriate for the patient’s physiological status, monitoring for effectiveness and toxicity, educating the patient about expected side effects, and indications for seeking consultation. Prescribing for older patients presents unique challenges. Many medications need to be used with special caution because of age-related changes in pharmacokinetics (absorption, distribution, metabolism, and excretion) and pharmacodynamics (the physiologic effects of the drug).
I. MEDICATION USE BY OLDER ADULTS Medications (prescription, over-the-counter, and herbal preparations) are widely used by older.
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Herbal and dietary supplements — Use of herbal or dietary supplements (eg, ginseng, ginkgo biloba extract, and glucosamine) by older adults has been increasing, from 14 percent in older women in 1998 to 26 to 27 percent in 2002 and 49 percent in 2006. Often, clinicians do not question patients about use of herbal medicines and patients do not routinely volunteer this information. Herbal medicines may interact with prescribed drug therapies and lead to adverse events, underscoring the importance of routinely questioning patients about the use of unconventional therapies. Examples of herbaldrug therapy interactions include ginkgo biloba extract taken with warfarin, causing an increased risk of bleeding.
II. POLYPHARMACY Polypharmacy is defined simply as the use of multiple medications by a patient. The precise minimum number of medications used to define “polypharmacy” is variable, but generally ranges from 5 to 10. There are multiple reasons why older adults are especially impacted by polypharmacy: •
Older individuals are at greater risk for adverse drug events due to metabolic changes and decreased drug clearance associated with aging; this risk is compounded by increasing numbers of drugs used.
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Polypharmacy increases the potential for drugdrug interactions.
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Medication adherence may be poor due to visual or cognitive compromise in many older adults.
PEN Ed innovation
III. UNDERUTILIZATION OF APPROPRIATE MEDICATION Much attention has been paid to over-prescribing for older adults and under-prescribing appropriate medications. Clinicians may be better at avoiding over-prescribing of inappropriate drug therapies than at prescribing indicated drug therapies. Accordingly, many older adults need to take six or more essential medications. In this context, clinicians may make informed decisions to “under prescribe,” to foster compliance with essential medications, limit drug interactions, and prioritize health benefits for active treatment of serious conditions over preventive therapies or conditions that have less impact on quality of life. Factors leading to unintended underutilization include clinicians not recognizing medication benefit in the older population, affordability, and dose availability.
IV. A STEPWISE APPROACH TO PRESCRIBING Regardless of the sequence of steps, what is essential in prescribing is to continually reappraise the patient’s medication regimen in light of his or her current clinical status, goals of care, and the potential risks/benefits of each medication. Review current drug therapy — Periodic evaluation of a patient’s drug regimen is an essential component of medical care for an older person. Such a review may indicate the need for changes to prescribed drug therapy. Discontinue unnecessary therapy — Clinicians are often reluctant to stop medications, especially if they did not initiate the treatment and the patient seems to be tolerating the therapy. Sometimes, this exposes the patient to the risks for an adverse event with limited therapeutic benefit. Consider adverse drug events for any new symptom — Before add-
ing a new therapy to the patient’s drug regimen, clinicians should carefully consider whether the development of a new medical condition could be linked to an existing drug therapy. Substitute with safer alternatives — When drug therapy is indicated for the older patient, it may be possible to substitute a safer alternative for the current regimen. As an example, in treatment of non-inflammatory arthritis, acetaminophen may provide adequate pain relief and be a safer alternative to NSAIDs . Reduce the dose — Many adverse drug events are doserelated. When prescribing drug therapies it is important to use the minimal dose required to obtain clinical benefit. As an example, one study evaluated the relationship between prescribing of the newer atypical antipsychotic therapies (eg, olanzapine, risperidone, and quetiapine) and the development of parkinsonism in older adults. Simplify the dosing schedule — When multiple medications are required, greater regimen complexity will increase the likelihood of poor compliance or confusion with dosing. Prescribe beneficial therapy — The fewer-the-better approach to drug therapy in older adults is often not the best response to optimizing drug regimens. Avoiding medications with known benefits to minimize the number of drugs prescribed is inappropriate. Patients must be informed about the reason to initiate a new medication, and what the expected benefits are. So, as a conclusion we as pharmacists as a part of the healthcare team should encounter the errors and make the necessary amendment for the betterment of the geriatrics patients. Thank you
“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” page 9
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PEN FIPEd corner
FIPEd -IPSF
Student Learning Experience Questionnaire:
Giving your voice to evidence-based advancement of pharmacy education by Ms. Naoko Arakawa, PhD Candidate, FIP Collaborating Centre
There is much global interest in quality and standards of professional pharmacy education as health policy world-wide becomes more focussed on extending the roles of pharmacy practitioners to provide more effective medicines-related health services. To achieve higher and equitable quality, the global infrastructure for pharmacy education needs to be mapped to the required competencies of pharmacy practitioners in order to meet the given health needs in any country. As students are at the centre of pre-service education, their input is important in the development of educational policies and practices. It is of global interest and relevance to survey the student learning experience. “FIPEd - IPSF Student Learning Experience Questionnaire” is the continuation of the IPSF Moving On II, which was a project with the main focus on the pharmacy students’ perceptions on their education (data being collected since 2004 by IPSF) and has now been revised to include the students’ ways of studying about their degree based on Study Process Questionnaire (Biggs, 1987) as well as the original Moving On II questionnaire based on Course Experience Questionnaire (Wilson et al., 1997). Students’ approaches to learning are likely to affect future habits of lifelong learning, which is now one of the important aspects of professional development for pharmacists. Furthermore, the students’ expressions about how they go about their learning are a key indicator in assessing how well pharmacy education systems are working (Biggs, 2001). Thus, the new additions to the questionnaire will enable the capture of better evidence on how students perceived their learning experiences throughout their undergraduate periods.
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The “FIPEd - IPSF Student Learning Experience Questionnaire” will allow world-wide comparisons and mapping of the learning experiences and the quality of learning of students enrolled in pharmacy programmes. It is the largest study of its type to date. Data collected will provide key evidence for education advancement. The “FIPEd – IPSF Student Learning Experience Questionnaire” English version is now on-line (http:// www.codegnet.org.uk/moII_2013/) and in 6 different languages (Arabic, French, Japanese, Mandarin-Chinese, Portuguese, and Spanish) from January 2013. The next article will provide more information about this project and other translations online. Please remember that your voice is the best evidence to inform the future of pharmacy. Tell us how you feel about your learning experiences and become changemakers.
References: Biggs, J. B. 1987. Student Approaches to Learning and Studying, Hawthorn, Australian Council for Educational Research. Biggs, J. B. 2001. Enhancing Learning: A Matter of Style or Approach? In: Sternberg, R. J. & Zhang, L. (eds.) Perspectives on Thinking, Learning, and Cognitive Styles. New York: Routledge. Wilson, Keithia L., Lizzio, Alf & Ramsden, Paul 1997. The development, validation and application of the Course Experience Questionnaire. Studies in Higher Education, 22, 33-53.
PEN FIPEd corner
FIP-WHO Global Survey of Pharmacy Schools Has your school responded? FIP Education Initiatives and WHO are implementing a global survey that aims to collect information: To ascertain the educational background of the pharmacy workforce and production capacity; To ascertain quality assurance accreditation mechanisms and processes. The data will be used to identify gaps, shortages and cooperation opportunities, besides providing the evidence-based information needed for investment policies that will reduce existing gaps and increase pharmacy education capacity. The participation of all pharmacy education institutions in this survey is vital to provide a better understanding of current pharmacy education issues, and will assist in the development of global pharmacy education policy recommendations. For these reasons, FIP and WHO have sent an invitation to the Deans of all schools of pharmacy to complete the Global Survey of Pharmacy Schools. Please help us by ensuring that your Dean or School leader has completed the survey for your pharmacy school/faculty/department [www.fip. org/education].
Should you wish to provide data on behalf of your school or your country please contact Andreia Bruno education@fip.org to obtain the information to be able to complete the survey. If you have any comments or questions concerning the project please send them to education@fip.org.
A million thanks in advance for your help! FIPEd Development Team
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PEN highlight
World Innovation Summit for Education 2012: Doha, Qatar, 12 -14 November by Mr. Radoslaw Mitura, IPSF President 2012-13
After I had solved problems with my lost passport, obtained a new visa and changed the flight tickets, finally I was going to Qatar for this great conference. The meeting was organised perfectly and I was welcomed by the organisers right after I entered the arrival hall and was transferred to my hotel in a very convenient way. When relaxing in my comfortable hotel room, I started going through the conference materials included in the welcome bag. The quality stunned me, so my expectations for the conference itself had been raised. I couldn’t wait for it to start. In the morning the conference began with the official opening ceremony, attended by Her Highness Sheikha Moza from Qatar. The opening was transmitted by the television, as were many of the following sessions. With sophisticated welcome words the event started. During those three days, more than 1000 prominent participants, from diverse education, corporate, political and social backgrounds had an opportunity to gather together at the Qatar National Convention Centre to discuss collaborative methodological approaches to foster education long-term strategies to improve education and inspire innovation. Several high-level interactive discussions were offered. The attendees were given an opportunity to interact with the speakers and experts in the field, share their best experiences and challenge themselves and their thinking during plenary sessions and debates. The workshops and focus sessions allowed the participants to discuss specific issues. More than 70
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sessions and related activities allowed a unique opportunity for all the attendees to learn and broaden their educational horizons, with a particular focus on cuttingedge practices in the field of education, building its future and networking with distinguished guests from diverse sectors. The WISE Prize for Education and 6 WISE projects were awarded this year to highlight outstanding activities undertaken to address the educational needs around the globe. More on www.wise-qatar.org, which also contains recordings of several sessions that took place during WISE 2012. For me, this conference was a great opportunity to connect with high-level experts, academics and policy makers in education. The sessions were rewarding and enjoyable. Thus, I totally recommend visiting the website to get a taste of WISE, its initiatives and overall – success.
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International Pharmaceutical Students’ Federation PO BOX 84200 2508 AE Den Haag The Netherlands Tel: +31 70 302 1992 Fax: +31 70 302 1999 Email: ipsf@ipsf.org Website: www.ipsf.org
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