hydeka: Here is another long but necessary 'epistle' on the ongoing struggle in the health sector.

Did you know that over 80 percent of health conditions are treated with drugs and other pharmaceutical products? It is a well known fact by all health professionals that medications play a significant role in patients care.

Are you aware that there are over 25,000 prescription products available in the World today compared to 650 prescription products available in 1960’s? According to United States Food and Drug Administration (USFDA), there are over 25,000 registered prescription products as of June, 2014.
Did you know that over 50 percent of patients with chronic illnesses are non-compliant with their medications?
Are you aware that lack of compliance by patients, drug interactions, drug misuse, drug abuse, failing interaction in the health services and prescription errors contributed to over 80 per cent of treatment failures? In a research conducted by Farup PG et al, the cumulative of these factors contributed 84 percent to treatment failure.
Did you know that in Nigeria there are over 10,000 Nigerians to one pharmacist far above World Health Organization recommendation of one pharmacist to a 1000 of the population? According to Mrs Gloria Ebumere, the Acting Registrar of Pharmacists Council of Nigeria, there are 16,970 registered Pharmacists as of May 2012 (Punch Newspaper).
Are you aware that in over 30 states of the United States, physicians enter into agreements with pharmacists to jointly manage patients’ drug therapy?
Did you know that the ONLY health care professional that has comprehensive, exclusive and expert knowledge about drugs, cosmetics and other pharmaceutical products are pharmacists? Are you aware that one of the most trusted, accessible and reliable professionals (not just in the health care sector but in all professions) in the World are Pharmacists? In an annual poll conducted by Gallup In 2013, pharmacists placed second among the professions listed, with 75% of respondents expressing a high or very high opinion of their honesty and ethical standards. Pharmacists retain a spot in the top 3 for the tenth consecutive year.

Who are Pharmacists? According to Wikipedia, Pharmacists are health care professionals, who practice in pharmacy, the field of health science focusing on the safe and effective medication use. A pharmacist is a member of the health care team directly involved in patient care. Pharmacists undergo university-level education to understand biochemical mechanisms of the action of drugs, drug uses, and therapeutic roles, side effects, potent drug interactions and monitoring parameters. This is mated to anatomy, physiology and pathophysiology. Pharmacists interpret and communicate this specialized knowledge to patients, medical practitioners and other health care providers. Pharmacists are involved in every aspect of the preparation and use of medicines, from research and development to eventual supply to a patient. In a nutshell, pharmacists are drug experts.

Who are Consultant Pharmacists? According to America Society of Consultant Pharmacists, a Consultant Pharmacist is a Pharmacist who is paid to provide expert advice on the use of medication by individuals or within institutions, or on the provision of pharmacy services to the institution. Consultant Pharmacists ensure that their patients’ medication is the most appropriate, most effective, most cost-effective, the safest possible, and are used correctly. They are saddled with the responsibility to identify, resolve and prevent medication-related problems. They accomplish this through a comprehensive consultation that provides a thorough, one-on-one review of all your medications;prescription, over-the-counter, herbal and nutritional. A Consultant Pharmacist has studied and acquired extensive knowledge and experience in observing and properly assessing the health of patient, advocating healthy living practices and diseases prevention for patients, identifying medication-related problems that can cause, aggravate or contribute to common patient problems, making it easier for patient to take their medications properly by labeling, packaging and organizing prescription drugs better and understanding the role of care giver, the financial challenges that patients can face, and the importance of choosing appropriate care.

IMPROVING YOUR QUALITY OF LIFE
In addendum to possessing skills specifically tailored to individual patient’s need, Consultant Pharmacists have a different perspective from most Doctors to dispense medication for a patient. A consultant Pharmacist would first look if the symptoms might itself be a side effect of a current medication.

For clarity purpose, what does the above statement imply; Does your medication make you drowsy? Do you feel anxious, confused or depressed? Do you sleep poorly at night? Is your thinking foggy? Are you having a severe headache? Do you have dry cough?
All of the above symptoms may be pretty related to taking your medications. For example, a high blood pressure patient taking Agiontensin Converting Enzyme Inhibitors (ACEI) like Ramipril, Lisinopril or Enalapril to mention a few may have dry cough as a side effect. A consultant Pharmacist will evaluate the overall picture of how your medication is affecting your quality of life. This will make a huge difference for you and your loved ones. Consequently, it generally affects the well-being of the society.
In addition, to the above services, a consultant Pharmacist helps to identify and reduce medication related problems such as drug interactions and side effects with his extensive knowledge in Structural Activity Relationship (SAR) and pharmacology. A typical example is when you take your paracetamol with alcohol. Paracetamol, also known as acetaminophen chemical structure contained a benzyl ring with NHCOCHʒ and OH at the Para positions. In other words, it is a phenolic group (alcoholic group), which when used with any other type of alcohol increases the work load of the liver, therefore causing increased liver metabolism which can subsequently lead to liver diseases. Consultant Pharmacists help to eliminate unnecessary medication due to poly pharmacy, simplify the system of taking medication therefore eliminating complex medication, reduce medications cost, serve as your advocate with your Doctor to ensure the use of most appropriate medications, promote wellness and help in identifying untreated problems.
For hundreds of millions of people across the world, especially in America with chronic illnesses, Consultant Pharmacists play a vital role in ensuring optimal drug therapy thereby improving patients’ quality of life. In their role as medication therapy experts, consultant pharmacists take responsibility for their patients medication-related needs, they ensure that they receive the optimal care.

AN ATMOSPHERE OF MISCONCEPTION!
Let me also use this medium to clear the air on those people who believe that 80 per cent of people who eventually studied pharmacy failed to gain admission to study medicine. Consultant Pharmacist and the current President of the Pharmaceutical Society of Nigeria, Pharmacist Olumide Akintayo gave an insightful and factual response in an interview with Punch Newspaper on October 26, 2013, “The fourth estate of the realm (The Press) has a sacred responsibility to report and put issues in their right perspective. Your question is an obvious fall-out of deliberate propaganda orchestrated by some stakeholders in healthcare. At the First Doctors Summit in Asaba, Prof. Wole Atoyebi, a past President of the Nigerian Medical Association submitted that part of the problems in health care was that people who could not gain admission for medicine settled for other courses in health care and now want to enjoy the benefit of what they could not attain as students. Graciously they allowed me to participate at that session and in the full glare of the over 1,000 delegates from across the country, I submitted that the entry point for pharmacy was higher in the great University of Ife (now OAU) than any other course in the university system. Ife is the best rated in this country and despite all hiccups, it is still highly rated both in the Commonwealth and Africa.
I openly challenged the delegates at the conference like I am still doing even now to controvert evidence that the entry point for pharmacy is not one of the top five in any Nigerian university that it is offered. In my days, the entry point for direct entry students was a minimum of 12 points in physics, chemistry and biology. You may want to find out, no student is admitted into a pharmacy faculty except pharmacy is the course of first choice. So, the chance of opting for pharmacy if you cannot study medicine does not even arise most times. As prelim students in Ife, when pharmacy students take courses in mathematics and excel because you are not allowed to carry over, medical students took courses in sociology and economics because they were failing mathematics in numbers.
These are verifiable facts. Do find out what it takes to study pharmacy in our universities and I can boldly confirm to you that the rigour is second to none. Just find out from any neutral person who passed through a university where pharmacy is offered. This is why a pharmacist who is worth his salt cannot be consumed by a persecution complex or siege mentality. Why else do you think pharmacists excel in all sectors? Go to the telecoms and check out the number of pharmacists who are at the top echelon at MTN, Airtel, Glo and Etisalat. In banking, pharmacists are directors and vice presidents and so on. Do find out how many pharmacists are in charge of oil and gas companies in Nigeria.”

NIGERIANS HEALTH ARE IN THEIR HANDS
I firmly believe with every fibre of my being that discerning Nigerians of all ages, tribes and regions who are keen about improved quality of life for all Nigerians regardless of the geographical location will key in to the necessity of having consultant Pharmacists in Nigerian hospitals. Barrister Tosin Ayo, in his wisdom gave us a better clue on the meaning of consultancy when he wrote, “The word ‘Consultant’ is derived from the Latin word: ‘consultare’ meaning “to discuss”. A consultant is thus a professional who has a wide knowledge of a subject matter and who provides professional and expert advice in a particular area such as security (electronic or physical), management, accountancy, law, human resources, marketing, public relations, finance, health, media practice and journalism, engineering, science or any of many other specialised fields.
From the foregoing definition, it means any health professional can be a Consultant in his/her own field so long as the medical doctors are not only also made Consultants but remain the traditional Administrative heads of medical institutions.” There is wisdom in the words of Albert Einstein when he opined, “In matters of truth and justice, there is no difference between large and small problems, for issues concerning the treatment of people are all the same.”

Pharm. Sesan Kareem is a young Nigerian Pharmacist and Author. He writes from Lagos.