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‘Poor pharmaceutical care responsible for Nigeria’s low health index’

By Editor
23 September 2021   |   2:55 am
Ahead of World Pharmacists Day (WPD), pharmacists under the aegis of Clinical Pharmacists Association of Nigeria (CPAN) have said, “lack of adequate pharmaceutical care

[FILES] Pharmacist

CPAN says pharmacies should be used as immunisation centres as seen in countries with better sector performance like UK, Ghana

Ahead of World Pharmacists Day (WPD), pharmacists under the aegis of Clinical Pharmacists Association of Nigeria (CPAN) have said, “lack of adequate pharmaceutical care in health facilities is partly if not majorly responsible for Nigeria’s low health index.”

The theme of the celebration is “Pharmaceutical Care is The Right of Every Nigerian”.

WPD is celebrated on September 25th of every year.

National Chairman, CPAN, Dr. Joseph Madu, told The Guardian: “It is indisputable that majority of patients/clients who visit healthcare facilities do receive drugs, but sadly enough they do not receive the expected accompanying pharmaceutical care.

“This is like someone going for a motor vehicle and given or told he can take the engine without the body of the car. Scientifically speaking, pharmaceutical care is not, and never optional inpatient care. Rather it is the right of every patient or client if we considered the potentially dangerous nature of drugs (so-called medicines).

“An example is the fact that a simple way to poison or damage the kidneys is to take common pain killers (NSAIDs) simultaneously with water pills (diuretics).

“An untrained personnel may not be aware of this potentially dangerous drug interaction during dispensing. All they know is that they can give pain killers to relieve pain and diuretics to increase water loss from the body.”

Madu said there are several documented reports from developed societies indicating that deaths due to drug therapy problems are now ranked third, after fatalities due to cancer and heart disease. He said the striking thing is that these reports are gotten from developed climes where drugs and other pharmaceutical products are strictly used under the supervision of pharmacists, while prescriptions emanate from physicians or other non-physician healthcare providers who are trained and licensed to prescribe.

The clinical pharmacist said this means that in a developing country such as Nigeria, where there is often neglect or disregard for laws guiding drug handling, deaths due to drug therapy or medication-related problems may even be the highest risk factor, followed by cancer and heart disease etc. “This may also be hugely part of the reason why life expectancy is very low in Nigeria (about 54), compared to countries such as the United Kingdom (UK) and United States (US) with life expectancies of about 97 and 98 respectively,” he said.

Madu said drugs are the most commonly used singular agent in the treatment of health problems and even in some local Nigerian languages hospitals are christened with names to which are directly interpreted as the
home of drugs.

But why has Nigerian healthcare system given very little attention to the offer of pharmaceutical care and clinical pharmacy services, which are aspects not toyed within many countries as they specifically concern the safe, appropriate and effective use of drugs in direct patient care? Why are Nigerians allowed to receive low level and sometimes absent Pharmaceutical Care in our healthcare settings? Is it that Nigeria’s healthcare administrators are ignorant or that they deliberately kill health-seeking Nigerians by denying them access to quality pharmaceutical care? Madu said health administrators need to provide a conducive environment for health-seeking Nigerians to enjoy pharmaceutical care and community pharmacies should be used as immunisation and vaccination centres as seen in countries with better health indices like UK and Ghana.

The clinical pharmacist said Nigerian lawmakers should make laws that grant prescribing powers to pharmacists, nurses, optometrists etc.

Madu said some of the questions above need answers even as many countries have used the lessons of the COVID-19 era to positively reform their health sector. He said another documented report from the United States shows that a patient is ten times more prone to the risk of suffering bodily damage from medication-related problems than from Road Traffic Accidents.

The clinical pharmacist said the big question again is, who has the medication-related problem records for Nigeria, where it is common scene to see medications being handled by unprofessionals such as traders, illiterates, school dropouts etc.? Are Nigerian pharmacists incompetent? Are they really unwilling to provide pharmaceutical care services to patients and clients? If not, where lies the problem? Why should our people continue to die as a result of drugs misuse and abuse? Despite the fact that we have over 20 universities where Pharmacists are trained with taxpayers’ money, why are Nigerians not reaping the dividends? Why not employ enough pharmacists including clinical pharmacists in our health institutions?

Madu called the attention of policymakers, Federal Government and all Nigerians to the fact that every Nigerian deserves quality pharmaceutical care as a right and not an option.

He said the pharmacist is the only health care professional trained to excel on knowledge of drug action and offer of pharmaceutical care and the government should embrace using pharmacists to offer pharmaceutical care just as is the norm globally and stop using pharmaceutically untrained people in our health institutions to do the work of pharmacists, as that is very dangerous to the health of the citizenry.

Madu said other health care professionals such as physicians; nurses, pharmacy technicians and Community Health Workers (CHEWs) cannot be substituted to do the job of pharmacists, just as pharmacists cannot be substituted to do theirs.

He said apart from traditional drug dispensing, basic pharmaceutical care, manufacturing and counseling by pharmacists, clinical pharmacists can also offer advanced pharmaceutical care and be involved in such elements as preventing, detecting, categorisation and resolution of potential or actual drug therapy problems at the patient’s bedside or in community pharmacies thereby making drug therapy highly safe for Nigerians.

Madu said pharmaceutical care is designed to promote health and wellness, prevent disease, initiate or modify medication use to ensure that drug therapy regimens are safe, effective and appropriate. “That is the culture of health care around the globe and in line with international best practices,” he said.

The clinical pharmacist said Nigerians should be availed of their rights of pharmaceutical care in health institutions.