In Middle-income country Mongolia pharmacy business is economically booming and therefor also the number of pharmacies and pharmacists. But is the health of the Mongolians themselves also booming?
After a personal working visit the following conclusions could be made:
- Pharmacies function primarly as a logistic service for the general public and just use ICT for logistics and financial administration.
- Professional patient pharmaceutical counseling (e.g. controls on dosage, interactions, contra-indications) is very, very limited.
- Both policy makers, academia as well as pharmaceutical professionals realise that progress (both in education as well as ICT-tools) is necessary in the theme of Medication Safety in order to protect the general public from health risks originating from medication .
Mongolia is a place where GIMS can/should be of help.
Since considerable time big medicine distribution programs (mainly on HIV and TB) have been enrolled by entities like WHO and the Global Fund.
How is the aspect of Medication Safety covered in these programs? Both policy wise and practically?
Utrecht University student Christiaan van Bommel BSc Pharm, and almost graduated as MSc Pharm, will look into this more deeply.
Results are to be expected by the end of July 2016.
As stated in January, Aradhana Kohli, BSc Pharmacy will do her MSc research project at GIMS.
Research project The GIMS model definitive
1) Create a theoretical research framework, i.e. a (international applicable) screening and rating model of all structures, processes, actors, factors and the corresponding critical dynamics (Attitude, Knowledge, Tools) between them, concerning Medication Safety in a country (to be called the ‘GIMS model’).
2) Evaluate and adapt the screening model.
3) Produce an article, e.g. for the Pharmaceutical Weekly, international scientific magazines.
On the 11th of April the ‘Universities Allied for Essential Medicines‘ (UAEM) organised a debate in Maastricht.
GIMS was invited as a speaker and was also possible to make the point that ‘better acces to medicines ALSO means better safety measures are necessary’.
Utrecht University MSc-student Aradhana Kohli starts this month at GIMS for her MSc-theses. In preparation for her research project she made a summary of the two BSc-theses which where conducted in 2015 year at GIMS.
Summary BSc-theses 2016
Based on this research there are large differences found in regulations and legislation, prescription and delivery, availability and access to medicines among the countries studied. Factors such as education, war, government, culture and religion and economic state of a country have a significant impact on both regulating and monitoring these rules. The level of passive awareness among the healthcare specialists was high for nearly all the studied critical dynamics for all the countries. However the level of active awareness (in a way that one sees, or participates actively in, progress) was low in especially low and middle income countries.
This study didn’t provide hard outcomes, but can certainly provide a basis for a follow-up study in the field of global medication safety. Especially firstly in the analysis of the obstructions for increasing the active awareness of healthcare professionals.
Medicines are by their nature always ‘poisons’ as they can influence (drastically) the fysiology of an organism.
So let’s turn around the general idea that medicines can have negative side effects and correct it into;
only by carefull prescription and use the patient can benefit from the positive side effects of potential ‘poisons’.
That’s why at GIMS we use this back side on our business cards.
In the ever intensifying discussions about the cost of new, and very expensive (oncology) drugs, a widely heared argument from industry is that they are ‘obliged’ to their shareholders to perform financially this well. Otherwise they would not be able to attract investors and therefor their output of innovative medicines will be endangered.
An interesting development is that there is building up more pressure from big investors, like pension funds and ‘society sensitive’ banks, to also consider the effects on society as a whole of the strict financial focus Big Pharma feels it has to oblige to.
Can activistic share holders alter the direction of the developments?
Then they might also take in consideration that ‘inviting’ or pushing , Big Pharma to take active co-responsibilty for the Medication Safety related issues is a desirable societal goal aswell. GIMS can help!
From the PGEU website:
‘Community pharmacists have been working in the development of processes and tools to ensure Patient Safety in community pharmacies, but it is important that both community pharmacists and health policy makers realise the synergies that can arise from integrating those processes in the Patient Safety path.
Moreover, community pharmacy practice is becoming patient centred and process oriented. Dispensing the appropriate medicine and providing the relevant information and care, to the right person, at the right time is central in the community pharmacist’s daily practice. All pharmacists’ daily activities are one way or another linked to Patient Safety. That is why it is not possible to identify single initiatives towards ensuring Patient Safety in community pharmacies without contextualizing them in the community pharmacy setting, the distribution chain and the continuum of care.
However, medication safety is certainly an area where pharmacists’ expertise are of vital importance.’
MSH (Managements Sciences for Health) published it’s MDS-3 , 2014, (Managing Access to Medicines and Health Technologies) in which clear statements are made about medication safety risks which are likely to exist in low- and middle income countries.
From summary chapter 35:
‘Poor product quality, adverse drug reactions and medication errors greatly influence health care systems by negatively affecting patient care and increasing costs. Most of the statistics documenting the issues and highlightening the importance of pharmacovigilance come from developed countries, therefor low- and middle income countries likely have greater problems because of the poorer state of their health system infrastructure, the unreliable supply and quality of medicines, the lack of adequately trained essential health care staff, and their limited access to communication and information technology.’
In co-production with Dr. Jennifer Sellin (Lecturer Dept. of International & European Law Faculty of Law, Maastricht University), an article is in preparation.
In this upcoming article a logical link will be made between the human right to Health, and therefor an access to medicines and hence ALSO to be able to use the medicines safely.