E-DRUG: the Global Village and essential drugs (contd)
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Wilbert,
If we agree that a drug is "a chemical product with information" we
may have to analyse the situation about who is supposed to prescribe
and dispense these products? And why became the situation of
prescribing and dispensing "we do what we want" and "do not bother
me, I am a doctor and I am right"? with all the consequences of
irrational drug use in the broadest sense, including delivery and
administration.
I may propose that we have to include the training of the two
health professionals in our Global Village Approach. I keep it
simple:
Medical Schools are supposed to train professionals for proper
diagnosing of health conditions and to inform the patient about his
identified health problem(s). Schools of Pharmacy are supposed to
train professionals for correct and rational prescribing/dispensing
AND drug information.
Unfortunately, for decades, the pharmacy profession is mainly seen as
drug suppliers, persons who provide medicines over the shop counter,
full stop. Let's say a business person. The ironic fact is that
during the pharmacy study, hardly any business subject/topic is
included in the undergraduate curriculum.
This incorrect view of the pharmacist as the drug supplier,
is changing. The pharmacist at community and hospital level is
recognised more and more as the supplier of adequate and proper
drug information to patients AND other health professionals, beside
his business role.
The pharmacist who was for many years excluded from the health care
team, is now appearing as a valuable team member and the role of the
pharmacist is being recognised (Vancouver meeting, August 1998).
The main issue is the patient in our Global Village, a person in
need for appropriate health care. A person who seeks information
about his health situation/condition as well as medical advise from
a qualified medical professional and then will seek treatment AND
information for his condition from a pharmacist (a qualified
pharmaceutical professional).
The relationship "Medical Professional - Pharmacist" is crucial for
right diagnosis - appropriate treatment AND information.
As long as this relationship is not identified, accepted and
established (public and individual) patient care including
pharmaceutical care is in danger.
An example, employment of pharmacists on wards in NHS hospitals in
Scotland has proved that by recognising the pharmacist as a member
of the health care team, dramatic improvements have been made in
medical and pharmaceutical care of individual patients by more correct
and rational prescribing of medicines (treatment agreed between
medical doctor and ward pharmacist), better patient compliance
resulting in higher patient satisfaction. Moreover, less prescribing
mistakes were made and less drugs were wasted which lead to
considerable savings in the hospital drug expenditures. (Most of the
hospitals in Scotland work with drug formularies (limited drug lists,
the majority of the drugs are essential drugs) and treatment guidelines
which are used by pharmacists and medical doctors).
I may conclude that the pharmacist is the professional who is the
qualified provider of relevant and appropriate drug information.
The Global Village should include the review of the roles of the two
health professionals, medical doctor and pharmacist, and that general
perception and common practice have to be modified to respond
adequately to the health needs of the patients.
Marthe M. Everard
Manager of WHO Collaborating Centre
The Robert Gordon University
School of Pharmacy
Schoolhill
Aberdeen AB10 1FR
Scotland
United Kingdom
Tel: #44-1224-262533
Fax: #44-1224-262555
E-mail address: m.everard@rgu.ac.uk
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