In JK, clinical pharmacy is in its infancy and the concept of pharmaceutical care is completely new in health circles
World Pharmacist Day is celebrated every year on September 25th worldwide under the aegis of International Pharmaceutical Federation (FIP) which is an international body representing over four million pharmacists, educators and pharmaceutical scientists. FIP is a non-governmental organization that was established on this day in 1912 and has been having an official tie-up with the World Health Organization since 1948. This year’s theme for the day has been chosen to be “Transforming Global Health”. While describing the main aim behind these celebrations, President of FIP, Dominique Jordan has stated that: “We aim to show how pharmacists contribute to a world where everyone benefits from access to safe, effective, quality and affordable medicines and health technologies, as well as from pharmaceutical care services”.
The purpose of World Pharmacists Day, which was brought to life at the FIP Council 2009 in Istanbul, was to encourage activities that promote and advocate the role of the pharmacist in improving health in every corner of the world. Main objective of the World Pharmacist Day campaign is to raise awareness about the professional activities of a qualified pharmacist and to educate the public on their significant role and crucial responsibilities in healthcare system and also to inculcate a sense of pride, solidarity and awareness among the pharmacy professionals on a global level. Pharmacists represent the third largest healthcare professional group in the world and India too is home to more than ten lakh registered pharmacists. After bringing out Pharmaceutical Workforce Development Goals in 2016, FIP has unveiled its “FIP Development Goals” this year on September 21 outlining measures needed to develop this profession in consonance with Sustainable Development Goals of the United Nations.
Over the past few decades there has been a trend for pharmacy profession to move away from its original focus on medicine supply towards a more inclusive focus on patient care. The role of the pharmacist has evolved from that of a compounder and supplier of pharmaceutical products towards that of a provider of services and information and ultimately that of a provider of patient care. Number of medication options have also multiplied manifold thus raising the complexity of therapies. Pharmacists have a unique role to play in evaluating these options and utilize their knowledge and skills to prevent, detect, monitor and resolve any medicine related problems. The concept of the seven-star pharmacist, introduced by World Health Organisation (WHO) and taken up by FIP in 2000 in its policy statement on Good Pharmacy Practice, sees the pharmacist as a caregiver, communicator, decision-maker, teacher, life-long learner, leader and manager.
However, the involvement of qualified pharmacists in Jammu and Kashmir in this regard has remained abysmally low, contrary to trends in other Indian states and developed countries. While seeking medical help, people think of a doctor or a nurse or a compounder, but seldom does a pharmacist come to mind probably because even a matriculate was eligible till recent times to be registered as a pharmacist here and anybody can get a license to sell medicines irrespective of his educational and technical background. Amidst all the mess prevailing in Jammu and Kashmir, people holding degrees in pharmaceutical sciences are jobless and have been left to lurch to fend for themselves. All this needs correction by introducing professional services of Clinical Pharmacy alongwith a novel concept of “Pharmaceutical Care”.
Pharmaceutical Care is a patient-centered, outcome-oriented pharmacy practice that requires the qualified pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease and to make sure that drug therapy regimens are safe and effective. Professional Clinical Pharmacy services offered by trained personnel holding graduate and post-graduate degrees in Pharmaceutical Sciences can help a great deal in identifying potential and actual drug-related problems; addressing needs and resolving actual drug related problems; preventing potential drug-related problems and optimizing patient therapy outcomes. It is a practice in which the pharmacy practitioner assures that all of a patient's drug therapy is used appropriately for each medical condition; the most effective drug therapy available is used; the safest drug therapy possible is used, and the patient is able and willing to take the medication as intended. Patients in our part of the globe have not been able to avail such professional pharmaceutical care services so far as a result of which there is large scale dissatisfaction and disillusionment among them since they largely remain uninformed about various lab investigations conducted upon them and about the necessity for various drug therapies prescribed.
Clinical Pharmacy on the whole is in its infancy in the state of Jammu and Kashmir and the concept of Pharmaceutical Care is completely new to most of the physicians, nurses and even pharmacists presently working at the government health facilities. As a result of the patient overload of physicians and some other reasons, they are not in a position to offer detailed counseling, patient education and pharmaceutical care services on individual basis to all their patients. Therefore it is for the trained pharmacy practitioners to step in and fill the void by offering such services with a view to achieve definite therapeutic outcomes that improve a patient’s quality of life. Overall goal of professional Clinical Pharmacy services is to optimize the therapeutic outcome management and decrease the burden of five D’s viz, death, disease, disability, discomfort and dissatisfaction among patients. Clinical, economic and humanistic outcomes will also shift towards the positive side as a result of these integrated and seamless healthcare services rendered by a trained pharmacy practitioner. With these aims and objectives, University of Kashmir started a post-graduate programme in Pharmacy Practice ten years back at its Department of Pharmaceutical Sciences. The course includes mandatory practical internship training for one year in a hospital besides a year-long research work in hospital, clinical or community pharmacy that culminates with compilation and submission of a dissertation.
Overall scenario in relation to professional pharmacy services in the entire state of J&K is very dismal where we have mostly unqualified people working as pharmacists in retail pharmacies and dispensing medicines to patients without any technical know-how about the same and without providing any basic information to the patients about the use and possible side-effects of medicines. In government sector too, pharmacies within hospitals, primary health centres and sub-centres are manned by people who have not undergone any formal training as required under norms, specifically in pharmacy. We don’t have any positions available for pharmacy graduates and post-graduates at any level in our government sector. In fact their applications are not accepted for Junior Pharmacist posts advertised by the Directorate of Health and Family Welfare on the pretext of being ‘over-qualified’ for the job.
Consequently, the services of qualified pharmacists remain completely unutilized in the state, depriving patients of precious information about the use of drugs. In order to keep pace with fast changing times and global trends, trained and qualified pharmacy practitioners should be a part and parcel of the medical team during ward rounds and their assistance must be sought in prescribing best possible drug therapy to the patients. Every major hospital in our state needs to have a full-fledged Department of Clinical Pharmacy Practice with adequate infrastructure, manpower, equipments and funding. Since that is already well stipulated in the approved drug policy of our state, government needs to start working in that direction in its right earnest. Having qualified clinical pharmacists in all hospitals of Jammu and Kashmir will serve the best healthcare interests of our patient population.
Author teaches at Department of Pharmaceutical Sciences, University of Kashmir