E-DRUG: Clinical pharmacy in Pakistan
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In most of the developing Asian countries the clinical aspect of medicine and treatment have become the main prerogative of the medical profession, partly because of history (pharmacy as a field of institutional learning and the regulatory frame work for drugs at least in India, was a later event, much after the medical councils), and partly because the physician is regarded to be on a much higher plane, at least by the common man. This has almost relegated retail pharmacy as a trading profession.
I think WHO should intervene and do the needful in this regard, as otherwise merely learning western models of clinical pharmacy in developing countries, without any practical application in the country of learning may lead only to fill the gap of manpower requirements of the west, which may again cause perpetual migration problems internationally.
chandrasekar kalyanram
CK Aiyer, faculty
iihmr, Jaipur, India.
chandrarobert@yahoo.com.au
E-DRUG: Different models of pharmacy
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I am involved with the FIP Pharmacy Education Taskforce http://www.fip.org/www/?page=pharmacy_education. During a session on
Pharmacy Education Country Case studies at FIP Basel this year, there
was a plea for the design of an African model to inform the training
of pharmacists. The motivation was to ensure that the competency
priorities and the focus of training was aimed at country specific
needs. This would also ensure that students were not trained for the
international job market.
I would be very interested to hear the view of members on this topic.
Should there be only one set of competencies that are necessary for
entry into the pharmacy profession?
Or should there be two models - one for developing countries and one
for developed countries? Perhaps fine tuned for country/ regional needs?
Or should there be a hierarchy of training - e.g. pharmacy assistant,
pharmacy technician, pharmacist - followed by specialization - e.g.
clinical, manufacturing, drug supply management etc?
Or are their regional/ cultural differences that are so great that a
continental model should be developed e.g. African, Asian, European,
North American?
I am sure that most members have taken part / continue to take part in
this debate on a regular basis. I would be keen to benefit from the
wisdom that you have developed, either through this list or direct to
me at b.futter@ru.ac.za.
Thank you
Billy
WT Futter M Comm. ACIS. PGDHE.
Associate Professor
Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
b.futter@ru.ac.za
E-DRUG: Different models of pharmacy (4)
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Dear Billy
The situation in the Pacific Region illustrates the enormous diversity
of competency needs for pharmacy training.
There are 22 Pacific Island countries (PICs) with poulations ranging
from a few thousand to almost 1 million (except Papua New Guinea with a
population of around 5.5. million).
Pharmacy workers are challenged by enormous isolation, distances and no
economy of scale. Countries are separated by many thousands of
kilometres and the populations within are dispersed thorughout islands
separated by many thousands of kilometres. For example the Kirbati
population of 90,000 is across 30 islands spread 5000 km east to west
and 2000 km north to south. In most counries there are only one or two
pharmacists. The bulk of the 'pharmacy work' is done by assistants,
technicians and nurses. The pharmacists are the managers of the whole
country's system.
Formal courses do not cover the needs of these countries' pharmacists,
nor do they cover the needs of all the others working throughout the
system. Therefore PICs are developing (with the help of WHO WPRO Suva)
appropriate training for all aspects of work in PICs. Even in the PICs
there needs to be adaptation for local needs in different countries.
I believe the diversity in Africa, where I have worked in Horn of Africa
countries, would definitely warrant a huge range of competencies as
well. The FIP material is useful for reference but can (I think) only
be useful in a limited sense in developing countries where the
competency needs are much wider and more varied.
best wishes
Beverley
--
*Beverley Snell*
*Senior Fellow*
*Centre for International Health*
*Macfarlane Burnet Institute for Medical Research & Public Health *
*GPO Box 2284, Melbourne 3001 Australia*
*http://www.burnet.edu.au/home/cih*
*Telephone 613 9282 2115 / 9282 2275*
*Fax 61 3 9282 2144 or 9282 2100*
*Time zone: 11 hours ahead of GMT.*
*email <bev@burnet.edu.au>*
*Site: Alfred Medical Research & Education Precinct (AMREP),*
*85 Commercial Road, Prahran 3181*
E-DRUG: Different models of pharmacy (2)
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I believe that, as is the case across the globe, pharmacists serve several
different roles within the public and private sector. Having experienced
working in a rural African setting, I see great need for the input of
pharmacists from a clinical point of view. As has been the case in developed countries, it will take time for the roles of clinical pharmacists to evolve.
Should the model of training not cover all roles of pharmacy with the option of future specializing? This would enable practitioners to cater to the needs of the organization they are working with, without limiting their
skill base to supply chain management functions only.
Either way, an essential competency for all pharmacists is the ability to
problem solve; which I think is a skill that is often forgotten in the
developing setting.
Danielle Deidun
Pharmacist
St Michael's Community Hospital Guilleme
PO Box 230
Magawa
Mchinji
Malawi
Phone: +265 5618054
danielle.deidun@gmail.com
E-DRUG: Different models of pharmacy (5)
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I beg to differ on this issue of different models of pharmacy training for different localities.In Ghana sometime ago a state official suggested that since well trained doctors were leaving the country for greener pastures elsewhere,the Medical schools should produce half baked doctors who would be good enough for only Ghana.This created a massive furore and it never took off. Let water find its' level..I particularly think that african pharmacists are equally capable of providing very useful services like our counterparts elsewhere...maybe given similar environment and challenge.
We need to move away from the confines of our dispensaries to the wards,where there are so many opportunities to intervene and optimize outcomes in patient care. Training models should aim at empowering the professional pharmacist to be confident, innovative, assertive and be responsible for our actions and inactions.We need attitudinal commitment to patient oriented care and not products. In most African countries, we are not involved in the clinical care of patients living with Hiv/Aids but happy with managing the logistics...meanwhile adherence counselling is a perfect operating terrain for pharmacists....who else can encourage and motivate 100% compliance through concordance???
Raymond Tetteh
Specialist Clinical Pharmacist
Korle Bu Teaching Hospital
Accra, Ghana.
r_niiatetteh@yahoo.com
E-DRUG: Different models of pharmacy (7)
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Thank you to all five respondents to this issue who have given a rich
perspective of the conflicting issues and realities with which we need
to come to terms.
The purpose of my response is not to limit further comment, but to
encourage it. If you know someone who has strong views on this topic,
please encourage them to respond. It is my intention to produce a
report after considering all responses, a report that I will make
available to this list. So please submit your point of view.
On a point of clarification, there is no suggestion that any one model
would be superior to the others. For example, an African model would
have to take into account the realities of the region ? such as
logistic and regulatory challenges, specific clinical competencies
related to HIV/AIDS, TB, malaria etc., priority compounding,
formulation, manufacturing knowledge and skills. It would also have
to take into consideration the prior learning of students, the
capacity to train, etc.
In other words, the focus would be on producing a pharmacist who was
ideally qualified to meet the needs/priorities of the region with the
resources available. Some might consider this to be a superior rather
than an inferior model.
The step/wise or hierarchy model envisaged could be simply granting
recognition for specific competencies en route to the final
qualification. This would also encourage recognition of prior
learning for mature students who want to move up the competency
ladder. Similarly, it would provide a platform for the development of
specialist competencies after the basic pharmacy competency training
has been reached.
E-DRUG: Different models of pharmacy (6)
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I beg to differ on this issue of different models of pharmacy training for different localities. In Ghana sometime ago a state official suggested that since well trained doctors were leaving the country for greener pastures elsewhere,the Medical schools should produce half baked doctors who would be good enough for only Ghana. This created a massive furore and it never took off. Let water find its' level.. I particularly think that african pharmacists are equally capable of providing very useful services like our counterparts elsewhere...maybe given similar environment and challenge.> We need to move away from the confines of our dispensaries to the wards,where there are so many opportunities to intervene and optimize outcomes in patient care. Training models should aim at empowering the professional pharmacist to be confident, innovative, assertive and be responsible for our actions and inactions.We need attitudinal commitment to patient oriented care and not products. In most African countries, we are not involved in the clinical care of patients living with Hiv/Aids but happy with managing the logistics...meanwhile adherence counselling is a perfect operating terrain for pharmacists....who else can encourage and motivate 100% compliance through concordance???>