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EPN biennial forum 2018 in Kampala

In Kampala (Uganda), from 15th-18th May 2018, the Ecumenical Pharmaceutical Network (EPN) biennial forum was held.

The theme of this forum meeting was Medication Safety.

As a member of EPN GIMS was represented by it’s chairman and performed as a speaker, did a poster presentation about the GIMS model and contributed with 3 articles in the EPN electronic magazine Pharmalink.

Valuable contacts were made and follow up activities are investigated.

Link to the articles:

EPN-Poster-GIMS Kampala 2018

GIMS model article EPN forum 2018 v1

EPN article medication safety medication programs

EPN article Sellin-Vanslobbe

 

Tokyo declaration on Patient Safety

On the 14th till 17th of April 2018 a high level meeting took place in Tokyo.

“The Tokyo Declaration on Patient Safety is founded on the policies articulated in World Health Assembly resolution WHA55.18 (2002), which urged Member States to “pay the closest possible attention to the problem of patient safety and establish and strengthen science-based systems, necessary for improving patient safety and the quality of health care”.

“Recognizing that patient safety is one of the most important components of health care delivery which is essential to achieve Universal Health Coverage (UHC), and moving towards UN Sustainable Development Goals (SDGs); and that patient safety systems and practices need to be established in all countries as one of the critical health care standards for achieving UHC on a sustainable basis;” 

GIMS wants to/can contribute through developing and implementing pharmaceutical IT-tools.

Whole text of Tokyo declaration:  Tokyo declaration

NIA presentation

At a NIA-meeting (Dutch Industry Pharmacists Association) a presentation was given about GIMS foundation.

The theme of much needed improvements in Medication Safety in LMIC’s was picked up well.

Medication Safety in Resource-Limited Settings?

Beneath a fine abstract from a presentation at the Second Global Ministerial Summit on Patient Safety :

Medication Safety in Resource-limited Settings

Priyadarshani Galappatthy, Prof. Dr., Faculty of Medicine, University of Colombo, Professor and Head Department of Pharmacology, Sri Lanka

Abstract: Medication safety is a major concern contributing to patient safety particularly in resource-limited settings (RLS). Absence of reliable estimates of prevalence of adverse drug events, costs involved, causes of medication errors and evidence of effective interventions in RLS is a major limiting factor for ensuring medication safety in RLS.

Although there are nearly five times as many people living in Lower and Middle Income Countries (LMICs), the number of annual adverse drugs events calculated (6 million) is almost equal to the number of adverse drug events occurring in high income countries (5.8 million). Some key problems identified include lack of reliable data, safety culture, reporting systems, poor reporting, poor legibility of hand written prescriptions, absence of electronic support systems, limited number of healthcare professionals to serve the large numbers of patients, lack of clinical pharmacists services, higher prevalence of counterfeit and substandard medicines (up to 20-30% in some LMIC countries), availability of large numbers of generics of the same drug, lack of stringent drug regulatory mechanisms, poor medication literacy and absence of patient support mechanisms.

Possible interventions include identification of the baseline situation on epidemiology and causes of adverse drug events in RLS, the drugs involved in RLS, their severity, amenability of drug events to prevention, implementing routine quality testing of drugs throughout the drug supply chain, implementing successful national drug regulation, increasing the capacity of regulators and providing technological support and expertise for detecting and managing drug related issues.

Expected outcomes would be establishing the baseline on the epidemiology of medication incidents in RLS, implementing systems and practices for medication safety and significant reduction in medication errors (e.g. up to 50%) in the next 5 years. Future direction is towards a multidisciplinary approach with active involvement of all stakeholders in preventing medication incidents. Developing and implementing an individualized action plan for each country for the problems identified based on local data would be the key to ensuring medication safety in RLS.

Keywords: medication safety, medication errors, resource limited settings, lower-middle income countries, prevention

Speaker Information: Priyadarshani Galappatthy is a consultant physician, professor in Pharmacology and Head, Department of Pharmacology, Faculty of Medicine, University of Colombo, Sri Lanka.

For the complete document use link:

Abstracts_and_Speakers_Patient_Safety Ministers Summit 2017

 

‘GIMS Pro’

As GIMS foundation we have a focus on the improvement of Medication Safety in LMIC’s.  IT is one of the ways to help pharmaceutical professionals to be able to perform these tasks towards their community.  That is why we are in the process of creating ‘GIMS Pro’.

Goal:

Create (locally customized and serviced) open source IT products (software and a national product database) focussed upon pharmaceutical professionals which will be able to help to enhance Medication Safety for the general public in LMIC’s.

These IT products require nationally organized supporting entities for education, technical support, maintenance and further national development.

Ideally these entities are, or will be, incorporated in a national Professional Pharmaceutical Society, or likewise, so the professionals themselves can direct the desired functional IT- and organisational goals/destination, and shall have no commercial goals.

Path:

-The specific national situation (technical, judicial, economical, safety and professional attitude) is sufficiently adequate to start the process.

-GIMS foundation operates as the party which supplies the licence (free of charge) for the standardized IT-products.

-GIMS foundation delivers the corresponding consultancy in the process of realising the nationally desired versions and entities.

-The national entities are, for their territory, the owner of the nationally developed ‘GIMS Pro’-versions.

-GIMS foundation functions after national implementation as a GIMS-family in which users are connected and further developments are guided.

Technical:

-Internet based,

-open source software,

-both a product database and corresponding software is needed,

-product data base derived from the Dutch ‘G-standaard’ and adepted to local situation,

-ideally a patient file database is possible,

-the software should be very flexible in the desired/operational functionalities,

Technical:

-Internet based,

-open source software,

-both a product database and corresponding software is needed,

-product data base derived from the Dutch ‘G-standaard’ and adepted to local situation,

-ideally a patient file database is possible,

-the software should be very flexible in the desired/operational functionalities,

-functionalities can be:

*Dosage control (age and sex dependent)

*Checks on Interactions between co-used medicines

*Checks on Contra-indications:

#Diabetes

#High blood pressure

#Asthma

#HIV, TB, Malaria

#Pregnancy

#Intolerances

#Kidney function

*(pro-)active searches in case of the availability of adequate patient files

 

What say others about GIMS?

“I would like to recommend the importance of the GIMS-Foundation initiative. In general there is a focus on accessability, affordability and quality of the medication in low and middle income countries, but the actual consumption of medication poses new and other questions. Questions wether the right person uses the right medicine, in the right dose, for the right amount of time, in compliance with the advises. The use of medication is always a balance between the expected benefits and the potential side-effects. Lack of balance threatens the patient. Disregarding the medication safety undermines the benefits, is a potential hazard, and is a waste of money. Monitoring medication safety is a key element in the work of health care professionals. The World Health Organization stimulates countries all over the world to establish national bodies for rational use of medicine in particular to find a balance between quality, safety and costs of the actual use of medication. The GIMS Foundation contributes to this balance by stimulating initiatives to guarantee the medication safety and is a partner for local, regional and national organizations. The Dutch Institute for Rational Use of Medicine (IVM) has been very successful in the last 20 years to create the best benefit/risk ratio in the use of medicines in the Netherlands, leading to for example an optimal use of antibiotics and therefore the lowest level of antibiotic resistance in the world. We achieved this in close cooperation with general practitionars, specialists and pharmacists. We thus support the work of the GIMS Foundation and we are willing to cooperate in every possible way.”

Drs. Ruud Coolen van Brakel, director IVM, Dutch Institute for Rational Use of Medicine

Electronic prescription is a must have

In a just relased Dutch Health Inspectorate Investigational  Report titled,  in translation,  ‘Safe prescription must (be) better’ it is stated as an absolute demand that, in order to minimize errors etc, the prescription must be electronical.

veilig-voorschrijven-moet-beter 2017

LMIC’s should also be able to implement some form of electronic prescribing (and dispensing) system in order to help prevent health care risks, from the unsafe prescription/dispensing and use of medicines, for their populations. At the GIMS foundation we are currently working on such a (broadly applicable) IT-tool.

Universal Health Care Program and Medication Safety

Within Universal Health Care programs an important role is defined for Medicines Benefit programs.

MSH is a very active organisation in that theme: MSH: managing medicines_benefits_making_universal_health_coverage_a_reality (29-02-216)

Conclusion of the MSH publication: “The objective is to create awareness of the key considerations for designing a sustainable medicines benefit program in LMICs. Ultimately, if people can better incorporate medicines in their [universal health coverage] programs, then we will be meeting the objective [of universal health coverage], which is to reduce out of pocket payments and ensure equitable access to quality care.’

At the GIMS office we think; besides the needed Medicines Benefits Program  a parallel Medication Safety Program should be created!