Written by Ijeoma UKAZU

Reducing risk of medication errors and improving patient’s safety

Prescribed medication is the most frequent treatment provided to patients in the health care delivery system.

Professionals who are involved in medicine management are governed by a legal and professional accountability to follow best practice when prescribing and administering medication as this is essential in the provision of safe and effective patient care.

However, one of the recommendations to reduce medication errors and harm is to use the "five rights" as these rights guard against effects from wrong prescription.

In the views of Pharmaceutical Society of Nigeria, PSN, patients are advised to be fully aware of their rights to quality health which must be followed before a medication safety could be assured in order to achieve improved healthcare for all.

Revealing this to journalists recently in Lagos at an event to commemorate World Pharmacist's Day, the President of PSN, Pharm. Sam Ohuabunwa stated patient's right to include; Right to the right dosage, medication, being administered to the right patient, at the right time and by the right route.

Ohuabunwa stressed that, "I am sure everyone here has consumed medicines, we would find out whether he has consumed the right dose, of the right drug, was it administered to the right person, at the right time by the right route.

"It is important that we ask these questions continuously and we begin to see how people adhere to taking their medications."

The president further explained, "for instance, if you suppose to take your medication six hourly, and you take them eight hourly, you are already in medication error and the drug will not work at its optimum. If you are supposed to take a drug ones a day and you take it twice a day, you have caused problems for yourself. It is important for us all to understand the five rights."

He said that the patients should understand these rights as they may appear simple, but are personalised for each patient since they are modified by demography, health condition, physiological status and possible allergies.

Ohuabunwa said that world over, the role of the pharmacist is immeasurable in the health care delivery system of every nation, hence the adoption of the theme for this year as: "Safe and Effective Medicines for All."

The PSN Boss added that the theme is targeted to narrow gaps in the delivery of quality pharmaceutical care as well as products which has huge impact on achieving the Sustainable Development Goals, SDGs.

In line with the International Pharmaceutical Federation, FIP, the PSN president noted that the theme aims to highlight the key role that pharmacists play in assuring patients’ safety through improved medicines use and reduced medication errors.

Medication error is an adverse drug event that occurs when exposure to a medication results in harm, Ohuabunwa explained.

The pharmacist pointed out safety roles played by pharmacists and how it affect patient's safety to include the following; Ensuring access to medication, supplying medication information, evaluating medication appropriateness and improving medication adherence.

Others are; providing health and wellness services, medication management, and assessing health status of patients.

Ohuabunwa however added that, pharmacists have continued to perform their traditional role of drug production and dispensing, but the paradigm shift towards a more patient-oriented practice has necessitated the adoption of pharmaceutical care by all settings of the pharmacy practice.

The patient-oriented practice should range from drug formulation to production, analysis, distribution and dispensing, Ohuabunwa said, stressing that pharmacists must be intricately involved in all of these for the integrity of the system to be guaranteed.

Reiterating the skills by pharmacists, he said; "They use their specialised skills to affect the health outcome of patients. Effective medicines will be able to produce the intended or expected outcome when responsibly provided."

The industrial pharmacists pointed out that a number of areas need to be taken seriously to ensure safe and effective medicines for all, including, pharmaceutical care, control, regulation of pharmacy practice, education/training, infrastructure, and reward/remuneration.

Explaining further he said, that pharmaceutical care; must be promoted wholly by the health policymakers, applied by all pharmacists and embraced by all stakeholders.

He added that the lack of support for pharmaceutical care by policymakers and cooperation by other healthcare professionals has continued to widen the gap in quality of healthcare provision between Nigeria and other countries, including those in same level of development.

In the area of control, he stated, that, ethical and psychotropic drugs must be taken away from the streets, thus the need to pass the Pharmacy Bill into law.

The PSN president further observed that, the control of dangerous drugs and everyday medications goes beyond forming of committees, adding that the existing laws are archaic and offenders leverage on this to promote the illicit circulation of these silent weapons of mass destruction.

Ohuabunwa lamented that, "the National Drug Distribution Guidelines, NDDG, was conceptualised about seven years ago which would have addressed the Open Drug Market, ODM, and reduce irresponsible access to medication and counterfeiting to tolerable level, stating that, "it is unfortunate that this proposition is yet to see the light of day."

For regulation of pharmacy practice, he said that regulation of medicines must be total as drugs are potential poisons and need to be handled with adequate knowledge.

Ohuabunwa added that the PSN is working assiduously with the regulatory bodies to ensure the Pharmacy space is opened up for more practitioners, to guarantee access to medication for the Nigerian public through the establishment of satellite pharmacies as this again can only happen with the signing of the Pharmacy Bill into law.

On education and training, he said, "Health is dynamic and pharmacists need training and retraining to retool for emerging and reemerging health problems. There is very little of government support towards Pharmacists Post graduate studies. Pharmacists bear the full brunt of the cost of their residency/Consultancy programme. The government should grant scholarships for postgraduate and postdoctoral training abroad, especially for the new and emerging areas of Intensive Care, IC, and emergency care pharmacy for transfer of technology and skill to the Nigerian Pharmacists.

"For infrastructure, improvement in transportation and electricity will have a big effect on the delivery of safe and effective medicines to Nigerians through timely delivery of pharmaceutical products and adequate storage temperature, especially for cold chain products, like vaccines and other heat sensitive products.”

Remuneration, he said that pharmacists in Nigeria are not adequately remunerated given the tasking and sensitive role they play in healthcare delivery. Recently the migration of pharmacists to countries with better opportunities for professional development and reward is worrisome. The Western world has continued to welcome them as part of the highly skilled team needed in the developmental plan and architecture of their health care system.

In line with this, he added that, on September 25, 2019, in Abu-dhabi, UAE, the Royal Pharmaceutical Society, RPS, of Great Britain and the PSN signed a Memorandum of Understanding towards partnership for greater impact on global health.

 

This will especially benefit the Nigerian pharmacists through the exchange of ideas, technology and skills for the better outcome of health care seeking patients, he observed.

He said, PSN will continue to encourage pharmacists, through capacity building and professional development to provide safe and effective medicines to Nigerians.

Also speaking at the event, the Chairman, 2019 World Pharmacists Day Committee, Pharm. Sir Daniel Egwu, said that in the committee, "I and my team were charged to do advocacy, create awareness and sensitise Nigerians on the role of pharmacists.

Egwu regretted that, "Nigerians do not appreciate the work and worth of the pharmacist. By mobilisation and sensitization, we were to reach out to all the pharmacist all over the country."

He said a lot of Nigerians see the pharmacist as a quack, a non-professional who is called to do the bidding of a patient forgetting that medicines are drugs and as well as poisons, stressing that people should see the pharmacist as a professional.

Highlighting the theme for this year’s event, "Safe and Effective Medicines for All," Pharm. Egwu said "Right from the manufacturing of drugs to the retail outlet down to the distribution, pharmacists are in charge. Also, the pharmacist takes the lead in the storage requirement to keep the drug effective,

To encourage students study pharmacy in the university and to avoid dearth in the profession, a challenge was thrown open to write an essay, Egwu said.

The pharmacist said, two winners emerged from the challenge, the winner, Uzor Onwukwe Daniel, Maryland Comprehensive Secondary School and Agbayi Emmanuel, Igbobi College Yaba, Lagos as first runner up.

The highlight of the event was the award of cash prize to the students and the school while cash prize was also given to the winner, Bassey Victor Israel from Port Harcourt on the online challenge with the highest likes (7,000) on the best picture of "my pharmacist and I".

 runner up of the secondary school essay writing competition with some personalities at the event to commemorate World Pharmacist's Day 2019 recently in Lagos.

 

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