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
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