IPSF-AfRO Newsletter 13

IPSF-AfRO I S S U E

1 3

-

S E P T E M B E R

2 0 1 9

S A F E

A N D

E F F E C T I V E

M E D I C I N E S

Pharmacists

use

F O R

their

A L L

broad

knowledge and unique expertise to ensure that people get the best from their medicines. We ensure access to medicines and their appropriate use, improve adherence, coordinate care transitions and so much more. Today, more

than

charged

ever,

with

the

pharmacists responsibility

are to

ensure that when a patient uses a medicine, it will not cause harm.

Dominique Jordan FIP President

Newsletter 13 Editorial Board Editorial Team: Esther Kisanga

RMPO Subcommittee 2019-20

Laila Kasumba RMPO Subcommittee 2019-20

Designs and Layout: Elton Vidal Francis Decker Regional Media and Publications Officer 2019-20

Sabai Emmanuel Birai RMPO Subcommittee 2019-20

Supervising Team: Purity Wambui Chairperson, IPSF African Regional Office 2019-20

Table of Contents Introduction of the Regional Working Group 2019-20

5

Introduction of the Subcommittee Members 2019-20 What do Pharmacists do?

7

11

By Esther Kisanga, TAPSA, Tanzania

Speak Up for Patient Safety!

13

By Taiwo Dorcas Olawehinmi, PANS, Nigeria

Just In Case Antibiotics Cut Short Happy-Ever-After

15

By Stanley Nandasaba, KEPhSA, Kenya

Increasing Safe and Effective Medicines for All

17

By Yusuf Hassan Wada, PANS, Nigeria

Drug Safety and Effectiveness: Big Deal? 19

By Dr. Ozioma O. C. Ezeofor, EMUPPS, North Cyprus

Medicines for Universal Health Coverage

22

By Oluwatoyin Tella, PANS, Nigeria

Safe and Effective Medicines for All 24

By Melody Okereke. PANS, Nigeria

Safe and Effective Medicines for All Begins with the Right Prescription 26

By Soyebo AbdulAhmed, PANS, Nigeria

Local Associations Celebrate #WPD2019 29

IPSF-AfRO in Abu Dhabi

32

#IAmYourPharmacist Online Campaign

By Elton Vidal Francis Decker, IPSF-AfRO RMPO

33

Introduction of the Regional Working Group 2019-20

Ms. Purity Wambui; Kenya

Mr. Othniel Nimbabazi; Rwanda

Chairperson

Immediate Past Chairperson

E: chairperson@afro.ipsf.org

I look foward to a very interactive mandate from every

Pharmacy

Student

and

recent

graduate

It's a great pleasure and honor being part of the RWG

2019/20

as

Immediate

Past

Chairperson

affiliated to any of our member associations across

working with the team on sustainability of projects

the continent. May you feel at home and actively

initiated and sharing my experience for the growth

contribute to the engagements that come your way,

of

from campaigns to webinars. IPSF AfRO is you and

mandate with all members actively participating in

me and you have a seat at this table. I also look

Federation activities from locally organized events to

foward to more regional growth, working towards

regional and global events. Will be glad to have a

the vision of having IPSF AfRO unite all Pharmacy

number

students

and

to

interact

to

a

with

vibrant

everyone

commit

after what has been done in past 75years.

exciting

for

platforms

forward

more, all for the growth of our beloved federation

an

Africa

look

counting AfPS2020, WC2020, webinars and many

this

in

I

a

making

graduates

of

Office.

common good. As the Regional Working Group, we to

recent

Regional

ride,

with

innumerable opportunities for growth and learning. It

Viva La Pharmacie!!!

is our hope that you'll be ready to utilize that and become the best versions of yourselves, for you for your patients and for your communities at large.

Mr. Elton Vidal Francis Decker

Ms. Nzeribe Emmanuella

Regional

Regional Relations Officer

action

growing

IPSF-AfRO.

mandate

are

members:

Quiniso

Mutesi

the

Kagambo,

plan Of

for

course

really

year

to

amazing

Zikhali, Isaac

the

Yaw

Nii

Publications

Officer

For this mandate, I am looking forward to learning, the

and

E: rmpo@afro.ipsf.org

E: rro@afro.ipsf.org

fulfilling

Media

as

as

several roles, I have allowed myself to be mentored

the

and groomed to take up the mantle of leadership

subcommittee

this mandate. And now, I’m excited to say that the

help

fulfill

Asamoah

Ofoli

well

Having served in the subcommittee the last year in

Anang,

Mfoafo,

world is going to be impressed with how far we’ll

Pascal

take AfRO as a team. From innovation and creativity

Mongane, Ephraim Udokang and Moussa Fofana.

to

implementation

and

inclusiveness,

I

am

particularly confident in the incoming RWG and the subcommittee members. Let’s get it going Pharmily.

AfRO to the top!!!

IPSF-AfRO Newsletter 13

5

Introduction of the Regional Working Group 2019-20

Mr. Ikechukwu Udenze

Ms. Lilian Muthoni

Regional Secretary

Regional Projects Officer

E: secretary@afro.ipsf.org

E: rpo@afro.ipsf.org

My expectations are simple: to have a successful

Hello IPSF Afro, for this mandate I'm looking forward

mandate with the incoming RWG, all subcommittee

to having the projects on the ground in addition to

members

social media and add value directly to the practise

and

entire

AfRO

Team

collaborating

effectively in the advancement and expansion of the regional

office.

I

also

expect

a

passionate

of pharmacy.

and

committed team to be able to carryout the above started

objectives

and

ensure

that

all

member

associations are on the same page with regards to the IPSF activities and objectives.

#GoSuperHeroes!

Mr. Malatji Thabang Owen Chairperson, 9th IPSF AfPS

E: afps@afro.ipsf.org

As the Chairperson of the Reception Committee for AfPS2020

South

Africa,

in

line

with

the

Current

mandate, I will report to the IPSF Regional Working Committee monthly on Progress of the Symposium arrangements. Our target for the Symposium is 300 or more. Our wish is to ensure that all our delegates experience the best of South Africa. We are looking forward

to

work

with

all

federations

and

associations of Pharmacy to re-establish the IPSF in the Region and strengthen existing relations.

6

IPSF-AfRO Newsletter 13

Introduction of the Subcommittee Members 2019-20

Regional Media and Publications Subcommittee 2019-20

Sabai Emmanuel Birai

Abanjye Nzabarinda Gratien

TAPSA, Tanzania

RPSA, Rwanda

Panashe Gabriel Maradza ZPSA, Zimbabwe

Nyakeh Vandy Kamara

Laila Asiimwe Kasumba

NAPS-SL, Sierra Leone

KEPhSA, Kenya

Nassolo Hilary Treasure

Taiwo Dorcas Olawehinmi

UPSA, Uganda

PANS, Nigeria

Esther Kisanga TAPSA, Tanzania

Agbaetuo Barbara Chiamaka GPSA, Ghana

Yusuf Hassan Wada PANS, Nigeria

IPSF-AfRO Newsletter 13

7

Introduction of the Subcommittee Members 2019-20

Regional Relations Subcommittee 2019-20

Qiniso Zikhali SAPSF, South Africa

Isaac Anang GPSA, Ghana

Mutesi Immaculate Kagar

Moussa Fofana

MUPSA, Uganda

AEP, Mali

Yaw Asamoah Mfoafo GPSA, Ghana

Ephraim Udokang PANS, Nigeria

8

IPSF-AfRO Newsletter 13

Introduction of the Subcommittee Members 2019-20

Regional Projects Subcommittee 2019-20

Eseosa Favour Iyagbaye

Fablay Koffi

PANS, Nigeria

ADEPHARM, , Ivory Coast

Florentine Uwineza RPSA, Rwanda

Foday U. Turay

Innocent Agaba

NAPS-SL, Sierra Leone

UPSA, Uganda

Grace Adebayo

Noah Sesay

PANS, Nigeria

NAPS-SL, Sierra Leone

Imelda Mukiri KEPhSA, Kenya

Nqobile Dube SAPSF, South Africa

Frank Efrem TAPSA, Tanzania

IPSF-AfRO Newsletter 13

9

Introduction of the Subcommittee Members 2019-20

Quality, Documentation and Translations Subcommittee 2019-20

David Fiagan

Valerie Webola

CEPHARM, Burkina Faso

KEPhSA, Kenya

Eric Shema KEPhSA, Kenya

Ange Umutoni RPSA, Rwanda

10

IPSF-AfRO Newsletter 13

Samuel Alswell Whyte GPSA, Ghana

What Do Pharmacists Do?

What Do Pharmacists Do?

By Esther Kisanga, TAPSA, Tanzania

If

you

of

Most pharmacists work in a community setting, such

immediate relief or with medication you do not

as a retail drugstore, as community pharmacists, or

know how to use, you know how important the job

in

of a pharmacist is. More than once, I have had to

Community pharmacists are the health professionals

describe Pharmacy and what it entails as people

most accessible to the public as individuals can seek

tend to directly assume that all pharmacists are

their

dispensers.

prescriptions,

slight

have

ever

While

imbalance

been

this in

is

how

sick

not

and

wrong,

in

need

there

pharmacists

is

a

perceive

a

healthcare

facility,

assistance

easily.

fill

them

as

They

hospital

verify

and

pharmacists.

the

provide

appropriate

counselling.

When

medication

through

a pharmacist only functions as the one that sells

mixing of ingredients to form medications that meet

them over the counter medication and fills out

the

their prescriptions.

promotion campaigns, community pharmacists play

of

an

they

of

what they do and what the public think. To most,

needs

required,

legality

compounding

individual

can

prepare

which

involves

patient.

In

health

an essential role in providing education as well as performing screening tests such as blood pressure or blood

sugar

measuring,

due

to

their

frequent

interaction with the people in their localities.

IPSF-AfRO Newsletter 13

11

What Do Pharmacists Do?

Hospital

pharmacists

work

closely

with

the

Collectively, pharmacists aim to ensure provision of

medical staff which puts them in a better position

proper

to promote rational prescribing and use of drugs

and control of medicines or by providing information

to other health professionals and patients alike.

and

They

pharmaceutical products.

may

medicines records,

also

be

themselves.

they

can

qualified With

easily

to

access

monitor

prescribe to

drug

therapy

appropriate

either

in

advice

preparation,

on

the

supply

use

of

medical

drug

use

and

make changes when necessary. Pharmacists may specialize in specific areas, such as Psychiatry or Chemotherapy.

Pharmacists have at least four years of training for a

degree

course

depending

on

the

country

plus

about one year pre-registration training. When the opportunity arises, make use of your pharmacist by asking any questions your medication because no

But these are not the only things pharmacists do.

Alongside

community

and

hospital

pharmacy,

pharmacists are employed in regulatory control and drug management, pharmaceutical industry, academia, and research. In industry, pharmacists involved in research deal with the development of new

drugs

through

clinical

assurance, market from

and

assessment trials.

product

surveillance

drug-induced

marketing

provide

 Others

testing, to

of

side

perform

together

protect

adverse

the

effects.

information

on

effects quality

with

post

community Those the

in

use,

efficacy, and side effects of drugs. Pharmacists that

work

for

the

government

may

be

policy

makers, registrars, data collectors and analysts, as well as regulators. Finally, some pharmacists in academia serve as teachers and researchers.

12

IPSF-AfRO Newsletter 13

one knows them as much as they do.

Speak Up for Patient Safety!

Speak Up for Patient Safety!

By Taiwo Dorcas Olawehinmi, PANS, Nigeria

In

the

wake

of

and

World Health Organisation (WHO) describes Patient

unrecorded cases of patient unsafe care, it has

safety as the absence of preventable harm to a

become imperative for local, national and global

patient

collaborations

reduction

to

millions

solve

of

the

recorded

challenge.

Patient

during of

the

risk

process

of

of

health

unnecessary

harm

care

and

associated

safety is indeed a global public health concern

with healthcare to an acceptable minimum, where

and

an

can

efforts.

only

be

Although

solved a

by

daily

concerted

concern,

global

today,

we

acceptable

notions

of

minimum

given

the

delivered weighed against the risk of non-treatment

the World Patient Safety Day, at the 72nd World

or other treatment. It is a given that every point in

Health

the

the process of care-giving poses a certain degree

about

of inherent unsafety. Patient safety is necessary for

patient safety and encouraging global solidarity

the attainment of Universal Health Coverage (UHC)

and

and

objective

of

action.

raising

With

2019.

global

the

theme,

This

is

with

awareness

Patient

Safety:

a

global health priority and the slogan, Speak up for

Patient

healthcare

Safety!,

today

professionals

signifies and

a

day

for

institutions

to

reaffirm their commitment and re-evaluate their efforts to improve patients' safety and optimal care.

the

United

Nations

in

which

resources

following the endorsement of September 17 as

May

context

collective

available

in

the

to

knowledge,

observe the very first World Patient Safety Day

Assembly

and

refers

current

Sustainable

care

was

Development

Goals (UN SDGs).

Unsafety diverse

in

the

forms

process

of

including

caregiving error

in

occurs

in

diagnosis,

prescription, mode of administration and medication use,

resulting

taking

a

in

large

medication high-risk resistance,

adverse

number

reviews,

drugs,

effects

of

drugs

inappropriate

medication

poor

or

even

without

death, regular

prescribing

mix-up,

communication

of

antibiotic between

healthcare providers and the patients and among healthcare providers themselves.

IPSF-AfRO Newsletter 13

13

Speak Up for Patient Safety!

Patient

harm

has

personal,

social

and

global

the prescriptions and medications properly and ask

impacts leading to losses of trillions of US dollars

questions

globally, and low- and middle-income countries

disease or the general condition of the patient. They

have

also

been

found

to

have

2/3

of

the

global

when

should

in

be

doubt

about

cautious

the

about

medication,

trying

to

stop

patient harm burden. According to WHO, recent

medications without medical supervision. To improve

evidence suggests that 134 million adverse events

patient

occur each year due to unsafe care in hospitals

communicate to patients possible side or adverse

in

effects

low-

and

middle-income

countries

(LMICs),

safety,

of

prescribers

the

need

prescribed

drugs,

including

of every 10 patients are harmed in primary and

also essential for preventing unneeded treatment

outpatient (ambulatory) health care with up to

and potential harm. In addition, it is important for

80%

pharmacists

harm

considered

to

have

been

preventable.

patient

financial

prevention

is

treatment patient harm

due

annually.

up

savings.

much to

involvement

by

patients

to

review

double-check

to

is

be

sure there are no errors and that the medication the

Conversely, investment in patient safety leads to significant

and

medication

the

contraindications.

the

regular

effectively

resulting in 2.6 million deaths annually. Four out

of

A

to

to

lower

than

unsafety. can

15%,

Combating

The the

the

billions

medication

is

the

one

that

has

been

prescribed.

To support the implementation of the third WHO Global

Patient

Safety

Challenge:

Medication

of

Without Harm, The 5 Moments for Medication Safety,

dollars

a patient engagement tool, was launched in March

burden

errors

of

better

of

taking

of

cost

Ensuring

reduce

saving

cost

is

globally

2017

at

the

Global

Ministerial

Summit

on

Patient

can save an estimate of US$ 42 billion annually,

Safety in Bonn, Germany, with the aim of reducing

not counting lost wages, productivity, or health

severe avoidable medication-related harm by 50%

care costs. This otherwise represents almost 1% of

globally over 5 years. The 5 Moments for Medication

global expenditure on health.

Safety serve as quality control points where even more

special

attention

should

be

paid

to

the

medication(s) of the patient. They should be used by patients and their relatives in collaboration with

the

healthcare

provider.

The

5

Moments

for

Medication Safety are when: Starting a medication Taking my medication Adding a medication Reviewing my medication Stopping my medication Human error is not always avoidable. In situations where specific errors are a known risk, the best solution

is

human

factors

engineering

which

forces people to avoid the risk. Medication errors, for example, may occur when weak medication systems and/or human factors such as fatigue, poor working conditions, or staff shortages affect prescribing,

storage,

administration therefore

and

important

preparation,

monitoring for

dispensing,

practices.

patients

and

It

14

IPSF-AfRO Newsletter 13

healthcare relatives,

professionals,

healthcare

Pharmacovigilance Hence,

is

governments

patients

institutions essential must

and to

and

their

governments.

patient

strengthen

safety. existing

pharmacovigilance networks so that they are datadriven and response-ready.

is

their

relatives to know their medications well, check

In conclusion, everyday should be a patient safety day. Patient safety is the responsibility of everyone—

Let's make patient safety a priority, shall we?

Just In Case Antibiotics Cut Short Happy-Ever-After

Just In Case Antibiotics Cut Short Happy-Ever-After

By Stanley Nandasaba, KEPhSA, Kenya

Each fairytale, it appears, closes with the flat

A

condition

in

which

the

appendix

becomes

expression "happily ever after." Yet every couple I

inflamed and filled with pus, causing pain. It’s a

have

medical emergency that almost always requires

ever

about

known

marriage

would

is

concur

forever

that

upbeat.

nothing

There

are

prompt surgery to remove the appendix.

snapshots of bliss, certainly, and lengthy spans of satisfied companionship. However these come at

Enrolled

the

operating

departs

the

altar

is

very

much

end

ere

she

encouraged

to

seek at once a rational woman to set her straight.

He

did

fine

post

cefazolin

operation.

On

to

was

surgical prophylaxis before an incision was made.

will

of

he

fiction

issues

dose

(OR),

given

her

single

room

no little exertion, and the lady who pursues such imagining

a

to

provide

discharge,

the

nurse gave him pain medications and a 10-day course of clindamycin just in case he developed

In 2004, a few days after Christmas, Tim and Leah

got

married.

They

pledged

forever

and

locked it with a kiss and a hug. Attraction like theirs only happens once in a lifetime, it’s been said.

Tim

was

a

foreman

at

one

of

the

best

construction firms in the country. A gentle, soft spoken

man,

he

had

a

wave-of-the-hand

acquaintance with hundreds of people in town.

He was of good health until the fall of 2005 when

an

infection.

develops

On

day

diarrhea,

a

5

post

known

discharge

side

he

effect

of

antibiotics. On day 8, the diarrhea turned out to be severe. He had a high fever, acute abdominal distension and severe pain. Leah brought him to the

emergency

room

and

was

diagnosed

with

Clostridium difficile (C. diff) diarrhea and toxic megacolon, a surgical emergency. He was taken to the OR and unfortunately died.

he developed acute appendicitis.

Death from diarrhea?!

Every

antibiotic

carries

the

risk

of

C.

diff

diarrhea. The condition arises due to disruption in the

balance

of

gut

microbiome

leading

to

overgrowth of C. diff bacteria. Inflammation of the

colon

(pseudomembranous

colitis)

results

from toxins produced by this bacteria. The overall mortality

for

intervention, megacolon preventable

colitis

is

mortality is

66%.

since

2%. in But

the

Even

with

patients this

with

was

10-day

surgical toxic

actually

cause

of

clindamycin was unnecessary. It was prescribed just in case.

IPSF-AfRO Newsletter 13

15

Just In Case Antibiotics Cut Short Happy-Ever-After

1. Keep up-to-date references of current drugs and have those references accessible at the time the medication is prescribed.

2.

Comprehend

diagnosis

and

the

patient's

indication

for

the

condition, medication

considered, including every elective treatment.

3. Consider conditions that may influence the adequacy routes

of

of

the

drugs,

for

administration,

example,

weight,

doses,

renal

and

hepatic sufficiency, and other significant patient attributes, for example, pregnancy.

4.

Determine

the

potential

interactions

between a recently prescribed drug and other medications previously being used by the patient, including

conventional

prescriptions

and

supplements.

5.

Identify

medications

the

that

potential

carry

a

dangers

significant

of

risk

of

causing patient harm. For example, colitis due to antibiotic use.

6.

Guarantee that a patient's current drug

regimen is continued, if suitable, when admitting that patient to the hospital and that other drugs utilized during the stay in hospital is compatible with the patient's current regimen.

7.

Underscore

drug

reconciliation

during

change of hospital shifts, including admission and discharge

and

follow-up

in

the

out-patient

setting.

8. Give significant patient education about the indication

of

the

drug.

Focus

on

factors

that

guarantee understanding, and impart the reasons behind changes to a drug regimen.

These

are

provision patients.

and

broad safe

However,

strategies

and

that

effective

learning

enhance

medicines

and

to

practicing

thorough medication history taking, applying the

right

5 R’s (

drug at the

dose through the

Strategies for improving patient safety

when

right

prescribing

right

and

right right patient)

time at the

route to the

administering

drugs,

sharing patient and drug information clearly with A basic advance in improving medication safety requires

physicians

and

other

health

care

other health care workers, encouraging patients to

be

actively

from

the

process

reporting

are available to treat their patients.There are a

serve as basic guidelines that ensure

few different ways to achieve this:

Effective Medicines for All.

IPSF-AfRO Newsletter 13

learning

in

providers to be acquainted with the drugs that

16

and

involved

medication

and errors

Safe and

Increasing Safe and Effective Medicines for All

Increasing Safe and Effective Medicines for All

By Yusuf Hassan Wada, PANS, Nigeria

The World Pharmacists' Day is celebrated every

In Nigeria, like other countries of the world, it is a

year on September 25th, under the sponsorship

study in contrasts. An ambitious middle-income

of

country

the

FIP.

The

theme

of

this

year's

Annual

and

Africa’s

largest

economy,

it

also

Pharmacists Day is “Safe and effective medicines

struggles to provide some of the most basic of

for

services to its residents.

all”

which

aims

crucial

role

through

improving

medication

in

to

promote

safeguarding

errors

medicines by

policy

pharmacists'

patient

use

and

safety

reducing

attention,

political

consideration and administrative frameworks.

The state of Pharmacy Practice in the country poses a public health crisis mainly with access to medicine,

weak

standard

of

practices

and

a

weak regulatory of Medicines in Nigeria. It is no Role safety

of

through

reducing been

Pharmacists'

improving

medication

seen

in

in

safeguarding medicine

errors

introduction

have of

patient

use

and

increasingly

a

variety

of

coincidence that Nigeria currently has one of the worst drug market controls in the world, a high rate

of

Medication

resistance

and

one

of

the

worst cases of drug abuse.

measures designed to strengthen drug safety and to

increase

patient

safety

thereby

reducing

medication-related errors.

IPSF-AfRO Newsletter 13

17

Increasing Safe and Effective Medicines for All

It

is

disheartening

that

out-of-pocket

health

Most of the occurrences of fake drug dealings

service and detaining patients to pay their bills

go

are

tremendously to untimely and avoidable deaths

a

reality.

There

is

great

disparity

in

the

availability of health services between urban and rural

areas.

"Health

In

for

all"

order

to

which

fulfill

the

"Safe

and

the concept of ‘universal health coverage’ (UHC), which is defined as “all people receiving quality services

that

meet

their

needs

without

exposing them to financial hardship”.

has

also

shown

an

Information

existing

data

achieving safe and effective medicine in Nigeria.

This is supported by a research being done by etal

"Analysis

of

contributed

pharmacy

workforce

capacity in Nigeria" that suggest that only 12,807

and

communication

technologies

offer the opportunity for tremendous innovation in medicine access with rigorous citizen education and sensitization, especially of the uneducated with regards to the what, how, when and where to

indicating a shortage of Pharmacist necessary to

Aniekan

has

especially of the uneducated.

use

drugs.

essential Research

which

Declaration

encompasses

Effective Medicine for all" the WHO presented

health

unrecorded

to

the

While

mobile

Medicine

for

technology

all

efforts,

is

data

coverage towards getting a central database for prescription,

over

the

counter

(OTC)

and

controlled drugs which are abuse will go a long way toward reducing abuse, resistance, misuse and

dependence

on

the

negative

data

to

the

region.

Pharmacist are in active professional practice as indicated by the number of licensed pharmacists in 2016 which represent 1: 15,000 of the country population.

Finally, it is important to generate political will towards the achievement of Safe and Effective Medicine for all. This should be championed by international

Restructuring the drug distribution sector is key to achieving safe and effective medicine for all.

Distribution chain

of

systems

ensure

that

drugs and

the

requires

efficient

appropriate

medicines

supply

regulation

that

reach

to the

consumer are in their intended qualitative state, ensure

that

the

medicine

that

gets

to

the

health

agencies,

NGOs,

health

advocacy agencies and the Ministries of health at all levels in the country. This requires strategic education at all levels of political institutions in the country. Politicians and public office holders should be convinced to view the effective and safe medicine for all goals as an official mandate which must be achieved.

consumers are qualitative, effective, affordable, safe and supported with the required instructor to ensure rational use in entrenching a distribution system that drug and related facilities must be well managed to ensure they can deliver quality service.

Hopefully, as implementation gets into place, all these

issues

structured

system

action

resolved. and

A

more

consequences

emulation, by ensuring strict compliance and the

Open drug market is the greatest barrier also towards

achieving

the

Safe

and

Effective

Medicine for all. The production, distribution and consumption of fake and sub-standard drugs no the

form,

reason

or

quantity,

approach

taken should not be condoned or trivialized which happens a lot in open drug market.

18

of

be

will lead to a health service standard worthy of

enforcement

matter

should

IPSF-AfRO Newsletter 13

towards

effective medicine for all.

achieving

safe

and

Drug Safety and Effectiveness: Big Deal?

Drug Safety and Effectiveness:

Big Deal?

By Dr. Ozioma O. C. Ezeofor, EMUPPS, North Cyprus

Safe Medicine: Medicines

help

us

live

healthier

lives

by

preventing, treating or managing many disease conditions but the use of any medication holds a certain level of risk, especially when used in the wrong

way

Safety

in

or

mixed

drugs

is

in

a

relative

wrong as

combination.

explained

in

the

words of Paracelsus, “All substances are poisons.

There

is

none

differentiates medication

which a

is

is

not.

poison

The

and

considered

a

“safe”

right

dose

remedy”.

A

when

is

it

prescribed for the appropriate condition, in the right dose and for the right duration and used as prescribed by the physician or as directed by a healthcare provider. To ensure safety at all times, a patient must always inform their physician or healthcare provider of their medical history- any family history of disease, any medications

they

are

currently

taken,

including

any supplements, vitamins or herbal drugs. Also, some relevant questions ought to be asked by the patient such as: The name of the medication What the medication is for Medicines are the most common interventions in

How

many

times

a

day

it

should

be

healthcare. In drug development, the major goals

taken and how much should be taken

are

What side effects to look out for and

safety

people

and

are

taking

increasingly outcomes

effectiveness more

important

are

gotten

and

drugs,

that from

the the

since

it’s

more

becoming

best use

possible of

any

what to do about them What you can or cannot do while taking the medication

medication. It has been estimated that “between

How

30% and 50% of medicines prescribed for long-

taken, etc.

term

conditions

are

not

taken

as

long

the

medication

should

be

intended”

(World Health Organisation 2003) and this is a cause for

alarm

since

the

complications

from

wrong medicines use are sometimes worse than the illnesses they were prescribed for in the first place.

IPSF-AfRO Newsletter 13

19

Drug Safety and Effectiveness: Big Deal?

The lifestyle of patients:

Effective Medicine Effectiveness medicine

to

is

the

ability

counter

a

of

a

particular

particular

physical

condition. However, the effectiveness of a drug is closely linked to its safety. For any medicine to be legally

approved

for

administration,

it’s

first

assessed on a risk/benefit analysis. The outcome of

this

analysis

determines

if

a

drug

will

be

marked as “safe and effective” regardless of its

individual

greatly

impacts

The the

lifestyle

of

effectiveness

an of

drug based treatment. Smoking, for example, is a habit that can have untoward effects with certain drugs. Chronic tobacco use interferes with the actions which

of

certain

metabolizes

Alcohol

liver

enzymes

certain

consumption

like

CYP1A4

antipsychotic

also

poses

a

drugs.

threat

to

health when combined with drug-based therapy.

ability to perform the target action.

Concomitant illnesses/diseases:

In our world

today, more people are living with several longterm conditions which are being managed with

The need for safe and effective medicine Every patient deserves safe and effective therapy

from

However,

in

any

drug

healthcare

development,

facility.

creating

a

an increasing number of medicines. Maintaining balance and ensuring there are little or no drugdrug

/

difficult

drug-disease for

health

interactions

professionals.

gets

If

an

more elderly

patient uses NSAIDs for arthritis but also suffers

new drug with high effectiveness and a wide

from cardiovascular disease, he or she runs the

safety margin doesn’t come so easily. People

risk of having a heart attack or a stroke.

die even from prescription medications either because

of

inappropriate

over-prescription

use.

Americans

died

painkillers.

For

In

from this

2017, taking reason,

over

or 17,000

prescription healthcare

providers ought to pay close attention when prescribing

administering

and effective a lot of drugs can be. For instance, grapefruit actions

juice

of

metabolism. juice,

it

is

liver When

inhibits

known

to

enzymes a

interfere involved

person

CYP3A4

with

takes (a

in

the

drug

grapefruit

liver

enzyme

responsible for the metabolism of many drugs)

patients to maximize safety. Different factors

leading to increased accumulation of the drug in

affect drug safety and effectiveness.

the person’s system.

IPSF-AfRO Newsletter 13

medicines

Food has a significant impact on how safe

to

20

and

Diet:

Drug Safety and Effectiveness: Big Deal?

his accumulation is similar to taking too high a

Medicines optimization:

dose which can lead to toxic reactions.

On the

centred

other

a

medicines

hand,

some

foods

may

induce

liver

approach use,

to

to

This safe

ensure

is

a

and

people

personeffective

get

the

best

enzyme causing increased metabolism of a drug.

possible outcomes from their medicines. It is the

This

process by which healthcare providers connect

makes

the

drug

concentrations

to

be

available

leading

to

in

lower

decreased

with

individual

patients

and

understand

convictions,

their

effectiveness of

perspectives,

the drug.

share their medical knowledge so the most fitting

Medication errors:

opinions

to

and

to

evidence-based therapy for every individual can Medication

errors

range

be decided and, where suitable, to discuss this

from the inaccurate filling of a prescription to

with

giving one patient another patient’s medications.

important

This

medicines as intended. An essential part of this

can

be

a

result

of

different

factors

like

other

inadequate knowledge (of the prescriber), failure

approach

to

decisions

follow

systems

and

protocols,

interruptions

healthcare

to

is

ensure

shared

are

a

professionals. patient

decision

made

is

taking

making.

in

This

This

is

their

way,

partnership

with

(during prescribing, administration or dispensing),

healthcare providers rather than the healthcare

staff

providers alone.

competency,

poor

instruction,

and

poor

communication.

The role of the patient:

As

the

patient

is

involved, as much as they wish to, in the decision making

for

their

therapy,

there

are

different

things expected of the patent. A patient needs to give a comprehensive medical history to their healthcare provider. This guides the healthcare provider in making certain decisions about their therapy. Some relevant questions should also be asked by the patient to avoid any misunderstanding and they should be willing to answer questions asked by A

report

commissioned

by

the

Department

of

Health in the United Kingdom, Exploring the costs of

unsafe

(NHS),

care

found

in

the

that

5%

National to

8%

Health of

Service

unplanned

hospital admissions are due to medication issues.

This

report

focused

on

preventable

the healthcare provider. Lastly, the patient is expected to open the bag after a prescription has been filled to confirm that the medications

they’ve

received

are

actually

for

them and if they’ve been filled accurately.

adverse

events which can be attributed to a specific error or errors.

At any given time, the patient’s safety should be the priority of the healthcare provider. They must be protected from avoidable harm. A little more

Providing safe and effective medicines for all

The

primary

the

and a little less distraction during prescribing and

medication a patient is using does not cause

administration can go a long way in ensuring the

harm.

safety

The

goal

is

healthcare

to

ensure

provider

that

attention, a little more knowledge and expertise

is

charged

with the duty of safeguarding patient safety through reduction

appropriate of

medicines

medication

errors.

use

and

There

are

and

effectiveness

of

any

drug-based

therapy.

several ways this can be achieved:

IPSF-AfRO Newsletter 13

21

Medicines for Universal Health Coverage

Medicines for Universal Health Coverage

By Oluwatoyin Tella, PANS, Nigeria

While interning with a community pharmacy as

a

pharmacy

student,

I

encountered

a

woman who came to get a cough syrup for her baby. When I told her the price, 230 naira (equivalent to about 0.64USD), her face fell. I saw

her

ransack

her

purse

for

every

naira

Apart from prescription drugs, several over-thecounter medicines are needed by people all over the

world.

mentions

The

Alma

provision

component

of

of

Ata

declaration

essential

primary

also

medicines

healthcare.

Hence,

as

a

it

is

evident that everybody needs and should have access to medicines.

note she could find. She looked up at me, obviously trying to hold back tears, and said, ‘I have only 200 naira’. She could not get the needed medicine.

However, that is not the reality. In 2012, two FIP (International Pharmaceutical Federation) office bearers, has

The

World

how

global

medicines

challenge.

shortage

Their

article

revealed that several countries are affected by a

describes universal health coverage (UHC) as

variety of supply problems. Noteworthy it is that

when

countries of all income are affected.

people

Organization

about

a

(WHO)

all

Health

wrote

become

and

communities

can

use

effective healthcare services for promotion, prevention, cure, rehabilitation and palliation,

Factors

without being exposed to financial hardship.

shortage

It

capacity

has

been

affirmed

that

healthcare

is

a

fundamental human right and not just a mere

causing of

medicines

raw

shortage

include

materials,

manufacturing

industry

consolidation,

problems,

marketing practices and procurement and supply chainmanagement. Measures have been put in

luxury.

place to address this problem and efforts are still being

Medicines are a vital part of healthcare. This is

reflected

in

the

definition

of

drugs

as

chemical substances used in the prevention, management, diseases

in

cure

humans

and and

mitigation animals.

of

Without

medicines, UHC cannot be achieved. Mayo Clinic has found out that nearly 70 percent of Americans

take

at

least

one

prescription

drug. This is a reflection of what is obtainable globally.

22

IPSF-AfRO Newsletter 13

made.

The

World

Health

resolutions

to

Notification

systems

Assembly

address

in

2016

medicines

should

be

put

made

shortages. in

place

to

allow remedial measures to avoid shortages. Best practices

should

be

adopted

for

procurement

and distribution of medicines and vaccines.

Medicines for Universal Health Coverage

Monitoring and evaluation systems should be developed

and

strengthened

for

medicines

demand and supply. Institutional capacities and

financial

wherewithal

should

be

strengthened to address funding issues. Also,

Regulatory

bodies,

governments,

pharmacists,

health workers and stakeholders should continue to

implement

medicines

measures

being

to

dispensed

ensure at

end

that user

the

levels

meet specified standards.

in situations of shortages, triaging should be done so that those who need it most would get the available medicines while efforts are being made to procure more.

In addition to efforts to maintain the availability of quality medicines for all, counterfeit medicines should

be

circulation

detected as

well.

and

eliminated

While

putting

in

from good

medicines, efforts should be made to take out the

Assuming shortage

that

has

everyone,

the

been

problem

of

completely

everywhere

now

medicines

solved,

have

and

access

available

medicines

are

not

safe

and

effective, the purpose has been defeated. It is as bad as, if not worse than, when there are no medicines available. This is where we talk about safety, effectiveness and quality.

Global

standards

biological, products.

UHC

It

that

have

been

set

for

food,

pharmaceutical

and

is

objectives

a

crucial

reliable

to

the

system

of

encouraged, to detect counterfeit medicines.

to

the medicines and vaccines that they need, if the

bad ones. Innovative start-ups like RxAll should be

similar of

medicines

Not only that, but antimicrobial resistance should also be addressed. If a drug meets standards but is still rendered ineffective due to superbugs, safe and

effective

medicines

for

all

has

not

practice rational drug use. Healthcare financing should also be improved, especially in developing countries. Health insurance schemes could also partner

with

community

pharmacies;

the

people

like

the

recommendations assurance

and

manufacturing published

as

made

numerous

relevant

to

control.

practices

as

to

get

the

medicines

for

Pharmaceutical

guidelines

manufacturers

able

in

every country. The WHO Expert Committee on

has

be

mentioned

themselves, their children and their families.

Preparations

will

woman

introduction

for

same

way they partner with private hospitals. So that

quality control be brought within the reach of

Specifications

been

achieved. Prescribers and dispensers should also

Also,

(GMP) for

well

quality good

have

Everyone, financial

everywhere,

status,

race,

irrespective

gender

or

of

age,

their

deserve

safe and effective medicines.

been

pharmaceutical as

for

herbal

medicines. GMP covers guidelines for the raw materials, milieu,

the

the

production guidelines

production

equipment, facility.

for

as

personnel, well

Furthermore,

inspection

of

as

there

the the are

manufacturers

and distribution channels.

IPSF-AfRO Newsletter 13

23

Safe and Effective Medicines for All

Safe and Effective Medicines for All

By Melody Okereke. PANS, Nigeria

Before the discovery of modern medicines, man used

a

mixture

of

animal

faeces,

droppings

As

the

third

healthcare

largest

and

professionals

most in

accessible

the

world,

and/or random leaves found in his environs to

pharmacists are an integral part of primary health

treat

care because they are often the first point of

this

diseases was

a

and

result

certain of

medical

man’s

conditions;

perception.

These

contact with the health system in many countries

lifestyles were not safe and absolutely effective

and

(although

equitable access and rational use of medicines

most

of

them

worked

due

to

the

they

are

central

safe

of

effective for the benefit of all- a key objective of

However,

the universal health coverage.

transformed

are

goal

they had on man’s health and standards of living. have

medicines

the

ensuring

medicines

these

attaining

placebo effect) because of the significant risk

modern

that

to

and

the manner in which diseases are managed and controlled. effective

The

and

selection safest

and

use

medicine(s)

of

the

best,

To further promote and advocate for the role of

for

a

given

the pharmacist in improving health in every corner

individual out of the many choices available thus

of

requires

Federation

considerable

prescribing

skill

practitioner

on like

behalf the

of

the

doctors,

pharmacists and general medical practitioners.

the

world,

medicines

the

(FIP) for

Pharmacists

International tagged

all’

day,

as

the

2019.

Pharmaceutical

‘safe theme

This

and of

helps

effective the

to

World

promote

pharmacists’ crucial role in safeguarding patient safety

through

improving

reducing medication errors.

24

IPSF-AfRO Newsletter 13

medicines

use

and

Safe and Effective Medicines for All

In his speech, the president of the International Pharmaceutical

Federation

“Pharmacists

that

the

their

and

effective medicines is the shortage of qualified

unique expertise to ensure that people get the

and skilled personnel, low salaries, the scarcity of

best from their medicines. We ensure access to

trained

medicines

professionals,

use

and

their

stated

For many countries, the main problem affecting

broad

knowledge

appropriate

use,

improve

provision

and

distribution

pharmaceutical shortage

and of

of

safe

other

training

and

essential

institutions,

adherence, co-ordinate care transitions and so

inflexible recruitment procedures, lack of career

much more. Today, more than ever, pharmacists

structures and incentives, and the “brain drain” all

are charged with the responsibility to ensure that

contribute to the difficulties. It is very necessary

when a patient uses a medicine, it will not cause

to

harm”.

maximum output in healthcare delivery.

Undeviatingly, poor

quality,

therapeutic

the

use

harmful failure,

of

unsafe,

medicines

ineffective,

can

exacerbation

result

of

in

disease,

tackle

these

problems

effectively

to

obtain

As pharmacists, we must be responsive to the needs of the general public, and effective and efficient

in

Any

decision-making

may

also

systems,

enable harmful medicines to reach the market or

pharmaceutical

lead to shortages of vital medicines, endangering

health

in

professionals,

health

manufacturers and distributors. Money spent on ineffective,

poor

quality

medicines

is

wasted

in

duties.

deficiency

confidence

delay

their

resistance to medicines and sometimes death. It undermines

or

discharging

lives.

–

whether by consumers or governments. The key elements

for

distribution

of

ensuring safe

the

regulation

medicines

have

and been

identified as strong political will and commitment, strong

public

purpose,

support,

comprehensive

a

clear

mission

medicines

and

legislation,

appropriate organizational structure, appropriate distribution

of

responsibilities,

adequate

and

sustainable human resources.

IPSF-AfRO Newsletter 13

25

Safe and Effective Medicines for All Begins with the Right Prescription

Safe and Effective Medicines for All Begins with the Right Prescription

By Soyebo AbdulAhmed, PANS, Nigeria

By now, it would have been the third time she

I was stunned and for some reasons could not

has gone and returned to the pharmacy. She has

move

a

Pharmacist collected the paper and told her it

prescription

paper

now.

I

felt

relieved

and

over

of

she has undergone. As she left a feeling of pity

active

ingredient

is

a

forged

prescription

paper,'

the

to

understand

Same day. date

and

the

inscription

'dispensed'

are

pointers. Look at it. Tell her we can't dispense the drug, ' the Pharmacist instructed.

IPSF-AfRO Newsletter 13

the

dividing

emotion and Pharmacy ethics.

Pharmacist said on looking through.

'The

something

still resided in me but I knew it was because I was yet

'This

mumbled

the

which made me feel a kind of pity for the stress

the

customer

Noticing,

was

Bromazepam.

26

customer.

(Pharm. Tawakalt). She wanted Lexotan, a brand containing

The

the

showed her prescription paper to the Pharmacist

medicine

forged.

to

line

between

Safe and Effective Medicines for All Begins with the Right Prescription

A gentleman walked in and handed me a paper —not even a prescription paper. The drug written on it was a brand I was yet to come across. So the Pharmacist came around.

The two scenarios recounted above happened during

my

first

Industrial

Training

(IT)

as

a

pharmacy student at the end of our third year in pharmacy school. Although, in our second year in pharmacy school we learnt various ways by which prescriptions could be forged, I had never come across a case of forged prescription or a demand by

a

patient

to

obtain

a

Prescription

Only

Medicine without a proper prescription paper. It was during this training that I finally came across a number of cases and, Pharmacist Tawakalt, my supervisor, displayed ethically how to handle such scenarios.

'It is a Prescription Only Medicine, sir. You need a doctor's prescription before we can dispense,' the Pharmacist said.

'Oh, but it is grandma who uses it and, today being sunday, the doctors won't be around,' the customer replied.

'I am sorry sir; you'll have to wait till tomorrow before you can get it. There is nothing we can Forging a prescription is one method of illegally

do.' the Pharmacist said.

acquiring pharmaceutical drugs for personal use or

The man left.

profit.

It

is

otherwise

called

Prescription

Medication Fraud. It is especially common with Few moments later, Pharmacist Tawakalt hinted

drug users. People who misuse prescription drugs

that the drug and the strength he had wanted

most commonly seek prescriptions for opioids and

were

benzodiazepines. Lacking any medical advice on

exactly

what

ladies

took

to

abort,

so

it

could have been that the man didn't tell the trut

the

— no grandma needed it, that is. Hearing this, I

drugs, drug users tend to administer these drugs

felt really taken aback. For, the man had looked

in overdose. And, according to a report by the

so

Centers

caring

health.

and

concerned

about

'grandma's'

dosage,

about

for

side

effects

Disease

15,000

people

and

Control die

safety

and each

of

these

Prevention, year

from

prescription medicine overdoses. And overdoses lead to an additional 1.2 million emergency room visits each year.

IPSF-AfRO Newsletter 13

27

Safe and Effective Medicines for All Begins with the Right Prescription

There are various means by which people seek to obtain

drugs

without

a

proper

prescription.

Furthermore, patients

who

prescription come

Pharmacists and Pharmacists-in-the-making need

prescription

to

pharmacist-in-charge.

keep

abreast

of

them.

Obtaining

drugs

by

must

to

be

papers

buy

drugs

well If

brought or

fill

checked

any

by

their

by

the

inconsistency

is

forging prescription is not only illegal; it violates a

observed, the pharmacist should ask the patient

majority

questions

of

the

Six

Rights

of

Medication

to

ascertain

if

the

prescription

was

Administration — right patient, right medication,

forged or not. By carrying out this analysis, the

right indication for use, right dose, right time and

pharmacist will not only know whether it is a case

right

route.

medication

The

overall

fraud

is

effect

such

that

of

prescription-

of prescription-medication fraud but also arrive

it

impedes

at some clues as to the personality of the patient.

our

quest for safe and effective medicines for all.

As a way forward, first and foremost, the place of ethical dispensing cannot be overemphasized in pharmacy practice. A pharmacist should under no

circumstances

dispense

a

Prescription

Only

Medicine without a proper prescription paper.

Depending

on

the

legal

scope

of

practice,

pharmacists may contribute to prescribing as an independent

prescriber

–

someone

able

to

access

to

medicines

and

their

appropriate use is one key goal of the Pharmacy

or as a supplementary prescriber, which means

profession.

someone

medicines for all, as pharmacists, we must bear in

able

accordance

with

to a

prescribe pre-agreed

medicines care

plan

in that

has been drawn up between a doctor and their patient.

28

Ensuring

prescribe medicines under their own initiative —

IPSF-AfRO Newsletter 13

mind

that

To

it

prescription.

promote

begins

with

safe

the

and

right

effective

and

proper

Local Associations Celebrate #WPD2019

Local Associations Celebrate #WPD2019

Pharmacy Students' Association of Kenya (KEPhSA)

Zimbabwe Pharmaceutical Students Association (ZPSA)

IPSF-AfRO Newsletter 13

29

Local Associations Celebrate #WPD2019

National Association of Pharmaceutical Students - Sierra Leone (NAPS-SL)

Tanzania Pharmaceutical Students Association (TAPSA)

30

IPSF-AfRO Newsletter 13

Local Associations Celebrate #WPD2019

Ghana Pharmaceutical Students Association (GPSA)

Pharmaceutical Association of Nigeria Students (PANS)

Rwanda Pharmaceutical Students Association (RPSA)

IPSF-AfRO Newsletter 13

31

IPSF-AfRO in Abu Dhabi

IPSF-AfRO in Abu Dhabi

32

IPSF-AfRO Newsletter 13

#IAmYourPharmacist Online Campaign

#IAmYourPharmacist Online Campaign

By Elton Vidal Francis Decker, IPSF-AfRO RMPO

Social media is exceedingly evolving and it is

the

most

powerful

tool

that

promotes

It has a set of rules of competing on the respective platforms and so far, we have

networking and connectivity. It has such a

seen

grip

brilliant

on

the

millennials

that

it

is

quickly

becoming both the go-to relaxation corner,

creativity

at

pharmacy

its

very

best

students

and

-

from young

graduates.

and information encyclopedia.

The goal of the campaign is to showcase IPSF African Region, like the other regions,

the

is seizing this opportunity to promote and

and inspire young students to develop and

discuss areas of pharmacy career interest

learn

and the IPSF details.

health of their communities and the region.

The

#IAmYourPharmacist

online and

competition Instagram,

on

Facebook,

using

#IAmYourPharmacist

Campaign

the

is

an

Twitter

diversity

in

the

pharmacy

profession,

the trending skills to improving the

I am confident that we will reach our target goals.

hashtags and

#MyPatientMyConcern.

IPSF-AfRO Newsletter 13

33

#IAmYourPharmacist Online Campaign

34

IPSF-AfRO Newsletter 13

/IPSFAfRO

WWW.

AFRO.IPSF.ORG