Needed: Qualified Pharmacists

Lionel Wijesiri

I recently had a conversation with a friend of mine who is an experienced pharmacist. He had a grievance over an issue he believed is not just right. “What do patients think we are?” he asked, “Do they think that a pharmacy is nothing more than a “warehouse for drugs” and a pharmacist is merely “a shipping clerk who must dutifully and unquestioningly obey the written orders of omniscient physicians?”

He added, “We have the ability to do more than just pour tablets from one bottle to another.

We are not mere clerks - we are the final link in the patient safety net. Maybe, we cannot warn of all side effects and cannot catch every prescriber error, but we can warn of the common, severe side effects and we can catch some prescriber errors. Sometimes, I wish the public understood what we are and what we can do.”

I believe he has a valid point. If you are like most common people, you will see your pharmacist at least ten times as often as you see your physician annually. By getting to know your pharmacist, you can gain a valuable ally - one who will help you get the full value of both your prescriptions and over-the-counter medications.

Unqualified

But something has gone wrong today. Take a stroll in the streets of any city in Sri Lanka: no one can fail to notice the multitude of retail shops selling medicines.

These retailers are aplenty, and telling authentic pharmacists from fake ones proves a hard task. Over the years, the Government Medical Officers Association has expressed its concern over the unregistered pharmacies coming up like mushrooms all over the country and has urged the Health Ministry to take immediate measures to check on such pharmacies, located especially in the rural areas.

According to regulations, registered pharmacies must employ at least one qualified pharmacist, who must be physically present during business hours in their drug outlets. However, many are those who simply choose to ‘buy’ the license thanks to some unscrupulous pharmacists.

They display the name of that graduate on their storefront for a fee, without any involvement of any sort on the part of the latter in the business of the so-called pharmacy.

Demand

Surveys have found out that out of 9,000 pharmacies in the country, only 2,300 have been registered with the Drug Regulatory Authority. As a result, there is a huge demand for pharmacists in the country, which has also led to crisis in the pharmaceutical service.

Another important aspect to consider is the dispensing of prescriptions by semi or unqualified pharmacists employed by most pharmacies in the country.

Some of the individuals, who can barely communicate in English, could very well misread prescriptions unwittingly endangering unsuspecting patients. Given this scenario, should it not be the primary concern of the public to lobby for an effective method to have all medicines dispensed only by qualified Pharmacists?

Virtually everyone in Sri Lanka takes medication, ranging from occasional use of non prescription medicines to long term use of a number of prescription medicines simultaneously. Almost all medicines have the capacity to injure or kill. Many medicines provoke adverse reactions. Some medicines are incompatible with one and other.

Medication errors are a significant source of harm to the patients. Even where medicines are taken safely, they are not always taken in such a way as to maximize their therapeutic effect.

Poor adherence to medicines is a vast and generally underestimated cost to our health systems, both in terms of wasted medicines and worse health outcomes. The professional role and mission of the pharmacist is to minimize all these sources of danger, harm and reduced effect.

Action

Its time the Health Ministry declare all-out war on all untrained and unqualified pharmacists in the country and severely deal with pharmacy owners who do not comply with the regulations. Healthcare and Nutrition Minister Nimal Siripala de Silva said recently that the government had advised pharmacies to stop employing unqualified pharmacists and had warned them that the government would institute legal proceedings against such pharmacies.

Another issue needs consideration. The lack of graduate pharmacists in Sri Lanka has created immense problems in the drug management system especially in areas such as hospital and community pharmacy, drug administration and quality assurance.

In 2006, the University of Sri Jayewardenepura commenced the first ever B. Pharm program with the intake of 20 students. In addition to this, we have the pharmacists’ examination conducted by the Medical College Council. We need\more Institutes to conduct such courses to meet with the demand. The Health Ministry needs to address the issue also as part of the overall campaign on justice for patients.

The future of health care depends on a close collaboration among physicians, patients and pharmacists. In order to avoid duplication of effort, confusion and conflict, a health care team needs a point person.

As the leading health care authority on medication, the pharmacist is the most logical member of the health care team to gauge the usage and efficacy of prescription drugs. The pharmacist’s accessibility also allows him/her to find out what is working, what is not, and to intervene when necessary.

Today’s pharmacists are moving from behind the counter to play a vital role in patient care management. In a sense, this new approach is really a return to days gone by, when a pharmacist had time to form a one-on-one relationship with each patient.