I am sure a pharmacist has attended to you at one point or the other. They have dispensed your medications, told you how to take it, counselled you about your health in general amongst other things. However, what you might not know is that your pharmacist can be of great service to you. Especially if you are managing a chronic condition like, hypertension, diabetes, high cholesterol, cancers, arthritis, which usually require continuous medication use.
In Nigeria, statistics have shown that chronic diseases account for 24% of all deaths.1 The increasing incidence of chronic diseases and their complications has led to the need for the provision of effective pharmaceutical care.
"Pharmaceutical care is a patient centered, outcomes oriented pharmacy practice that requires the pharmacist to work with the patient and other healthcare professionals to promote health, prevent disease and ensure medication use is safe and effective."
When implemented, pharmaceutical care has resulted in improved health outcomes and quality of life of individuals managing chronic conditions.
Who provides pharmaceutical care?
Pharmacists are the healthcare professionals charged with the duty of providing pharmaceutical care.
From time immemorial, there has been an incomplete perception by the public about who a pharmacist is. Pharmacists are commonly seen as just sellers of drugs, or more colloquially, counters of drugs. Quite truly, the blame can be placed on the pharmacists as most of us have neglected our roles of being patient-oriented and focused on the product aspect.
It is the essence of this article to inform you in as many ways as we can, about the roles pharmacists can play in the healthcare team; and the benefits all clients can get from consulting a pharmacist.
It is worthy of note that some of the roles overlap across different healthcare professionals, for example with your physician. However, this is a good thing, as it improves efficiency of healthcare delivery. Since patients tend to be more comfortable and open when speaking to a pharmacist, it increases the chances that your pharmacist might pick up something your doctor didn’t.
The roles of pharmacists in fulfillment of pharmaceutical care practice can be highlighted as follows4. They provide:
- Medication Therapy Management
- Medication reconciliation
- Preventive care services
- Educational and behavioural counselling
Medication Therapy Management (MTM)
Medication Therapy Management (MTM) is a distinct service or group of services, usually provided by a pharmacist that ensures that you get the best out of your medications, i.e. it ensures that they are effective, safe and cost-effective. MTM is provided in collaboration with yourself and your physician.
Several evidences have shown that accurate provision of MTM is very beneficial to every patient, especially those suffering from chronic health conditions. Some of the benefits of receiving MTM include:
- better managed health conditions, which reduces the risk of developing complications
- safer use of medications.
- saves cost both short and long term. Short term saving can be through discontinuation of unnecessary medications or switch to a more cost-effective brand of a medication. The long term saving are the bigger savings, reducing your risk of developing complications and the associated costs.
The use of medications comes with the risk of medication related problems. It is through MTM that a pharmacist detects, resolves and prevents these problems. They include:
- Over- and under-dose
- Wrong drug
- Drug interactions
- Need for additional drug therapy
- Unnecessary drug therapy
- Adverse drug reaction
- Inappropriate compliance
All these, if not prevented and resolved, have led to poor disease management, hospital admissions and re-admissions, increased cost of treatment and in some cases death.
In providing MTM, your pharmacist also provides you with a comprehensive list of all your medications. The list contains:
- Why you are using it
- How many and how often to use it
- Special instructions on its usage
- Common and more serious side effects to look out for
Medication Reconciliation
This can occur independently but is more common under Medication Therapy Management briefly explained above. Your pharmacist compares your most recently prescribed medications and previous medication regimen, to ensure that ,
- you are not using more than one of the same medication,
- taking any unnecessary medication or
- taking medications that are not to be used together.
This is commonly done when there is transition of care, between different physicians, or between the hospital and your home or if you added non-prescription medications to your drugs.
Preventive Care Services
Screening helps detect potential or already occurring health issues early, allowing you to take action. As with most health conditions, early management is key towards overcoming them. It saves you the physical, psychological and financial burden of managing the condition if it had gotten more serious. It can even save your life!
Your pharmacist provides screening services and also serves as a platform for public health initiatives. Examples of screening services include body mass index (to check if you are overweight), blood pressure, blood glucose checks and malaria tests.
Gladly, testing of common diseases has been made easy, through the use of easy-to-understand testing kits and monitoring devices. Your pharmacists can also order some laboratory tests, if the need arises or you are due for one, such as kidney function test, HbA1c (to check your glucose control over the past two to three months), cholesterol levels and so on.
Educational and Behavioural Counselling
Pharmacists are equally equipped to provide accurate and comprehensive educational and behavioural counselling. Your pharmacist can provide you with information you need concerning your condition and treatment regimen. This information is useful to you in the following ways:
- It can help you become more compliant with your treatment regimen, because you understand why you need to follow the treatment plan. They can help you understand how it works, probable side effects and any other questions you might have.
- It can help keep you safe, because you know the do’s and don’ts associated with your treatment plan.
There are many examples of cases in which the engagement of the service of a pharmacist resulted in great improvement in the quality of life of the individuals. In a recent study, pharmacists involvement in the management of patients with elevated blood pressure, glucose and cholesterol, lead to a significant reduction in these parameters. There was also a 20% reduction in the number of smokers involved in the study.5
As pharmacists they were in a position to help identify those with high risk of heart attack and stroke through test screening and were able to achieve these brilliant results by:
- providing MTM.
- helping the patients adhere to their medications.
- counselling and educating them on their conditions and treatment plan.
- counselling on diet, exercise, lifestyle modifications and smoking cessation.5
Optimal healthcare involves a team of healthcare professionals which should include a pharmacist. The improvement in health outcomes and quality of life when a pharmacist is included on the team is invaluable. It is therefore paramount that you…
This is indeed an eye.opener concerning the roles of Pharmacists in ensuring that patients' health is improved through optimal use of their drugs. Thank you for keeping people informred!