Importance of Pharm. D study in Nepal
-
Rabin Chudal-
If
any Query Please feel free to contact as following
Pharm.
D is an abbreviation for Doctor of Pharmacy degree, a doctorate level degree
obtained in the pharmacy school/ college by prospective pharmacists. The doctor
of pharmacy is a professional degree not a graduate degree. The Pharm.D curriculum
is designed to produce a scientifically and technically competent pharmacist
who can apply this education in such manner as to provide maximum health care
services to patients. Students are provided with the opportunity to gain
greater experience in patients close cooperative relationships with health
practioners. It is the goal of all pharmacy schools to prepare pharmacists who
can assume expanded responsibilities in the care of patients and assure the
provision of rational drugs therapy
Pharm.D degree
curriculum is different than that of B.Pharm, it includes extensive didactic
clinical preparation and a full year of hands on practice experience.
In 1990, the American
Association of colleges of pharmacy (AACP) mandated that a doctor of pharmacy
degree would be the new first professional degree.
Currently all
accreditation schools and colleges of pharmacy in the united states offer the
Pharm.D degree national association of boards of pharmacy is now permitting
students with five years like Pharm d for FPGEE eligibility.
Many other countries
like Canada, Spain, France, Slovenia, Hungary, Italy, Netherland, Pakistan, Jamaica,
Egypt, Iran, Jordan, Qatar, south Arabia, United Arab emirates, Nigeria etc
have started Pharm.D programs India has started Pharm.D program from 2008.
In some countries, it
is the first professional degree and a prerequisite for licensing to exercise
the profession of pharmacist.
The first Pharm.D
program was established at the University of southern California school of
pharmacy in Los Angeles California in 1950.
SOME
COUNTRIES WHERE THERE IS A PHARM D COURSE:
1.
North America
Canada
United
States
2.
South America
Brazil
Chile
3.
Europe
·
Czech republic and Slovakia
·
France
·
Hungary
·
Italy
·
Netherland
·
Portugal
·
Spain
4.
Middle east
·
Iran
·
Jordan
·
Lebnan
·
Qatar
·
Saudi
Arabia
·
United Arab Emirates
5.
Asia
·
Pakistan
·
India
·
Nepal
·
Philippines
·
Thailand
·
Bangladesh
6.
Africa
·
Morocco
·
Ghana
·
Kenya
·
Nigeria
·
South Africa
·
Tunisia
·
Algeria
ROLES
AND RESPONSIBILITIES OF A QUALIFIED PHARM D PHARMACISTS:
1. Drug distribution and dispensing
Pharmacists
assess legitimacy of prescriptions, eligibility for coverage, appropriates and
safety of the medication for the treatment of patient.
2. Patient safety
Promote
rational drug therapy by conducting drug therapy by conducting drug utilization
reviews, identifying potential prescription
related problems such as drug- drug interaction, duplications of drugs,
known allergies, under or overdosing or inappropriate therapy, prior
authorization, monitoring therapy, pharmacokinetic dosing of drugs, quality
assurance program
3. Clinical program development
Use
evidence-based clinical and research data due to create disease management programs.
Evaluate scientific evidence in order to select appropriate drugs for a patient
population through a pharmacy and therapeutics committee. Design and conduct
outcomes based research in order to help patient’s achieve the desired result
from their drug therapy.
4. Communication with patients,
prescribers and pharmacists
Helps
prescribers choose drugs that will meet patients needs and quality for coverage
provides and educate patients about their individual prescription history
provide a dispensing pharmacist with a patients drug profile in order to
identify potential adverse drug reactions or duplicate therapies.
5. Drug benefit design
Determining
if a formulary should be used and whether it should be restricted or open and
the use of patient’s cost-sharing structure for generic covered brand name
drugs and non formulary drugs. To determine if a participating pharmacy network
should be established and what the criteria for QA would be to determine
criteria and procedures for drug utilization
Pharm.D
can start their career in a limitless number of professional areas that range
from community pharmacies, drug development, fundamental or applied research,
biotechnology to areas such as forensic sciences, toxicology, regulatory
affairs, clinical analysis, law enforcement (scientific police), Bromatology,
Drug Marketing, Regulatory, Authorities , University Teachers, Executive Managers
(pharmaceutical and biotechnology companies and governmental institutions etc.
Large
numbers of pharmaceutical companies are opting for clinical trials and the
spending in four types of trials represented about 7.8 billion in 2007 and is
projected to grow to $ 17.2 billion in 2013 pharm.D graduate will be the best
suited for clinical research and related jobs across the globe.
LENGTH OF STUDY
Country
wise the course of the study is different. For instance, in Pakistan it is 5
years course while in India it is a 5 year course with 1 year of hospital
internship which means total 6 years. Similarly, Pharm.D (Post Baccalaureate) after
B Pharm is of three years. These posts Baccalaureate Pharm D program have been
teaching in Kathmandu University Nepal.
In
south Asia, if we talk about India, Pharm D program was launched in 2008. In
2008, the first batch of Pharm.D took admission to the course. Pharm D is the
professional pharmacy doctoral program. In india, it is total six years program
after 10+2 or D.Pharm (Diploma in Pharmacy).
It
includes five years of academic study and one year internship.
It
is slightly different than M. Pharm.
|
Pharm D
Direct after 10+2/D Pharm
|
Pharm D
(Post Baccaulurate)
|
M.Pharm
|
Duration of
course
|
6 years
|
B.pharm
(4 years)+3
years
|
B.Pharm
(4
years)+2 years
|
Project thesis
work
|
6 months
|
6 months
|
1 year
|
Internship
|
Yes(1
year)
|
1
year
|
No
|
Prefix
“D”
(doctor)
after course
|
Yes
|
Yes
|
No
|
The
academic study includes the same subjects such as B.Pharm, in addition the
pharmacy components are emphasized such as hospital pharmacy, community
pharmacy, Pharmacotherapeutics, clinical pharmacy, biostatistics and research
methodology, clinical toxicology, clinical research, Pharmacoepidemiology,
Pharmacoeconomics, clinical Pharmacokinetics and Pharmacotherapeutic drug
monitoring.
Furthers
to add, in the fifth year of the course the candidate had to perform a project
work for six months.
Some
unique features of Pharm.D include eligibility to register for Ph.D prefix ‘Dr’
to name and a registrable qualification after completion of course.
The
pharmacists can provide the clinical pharmacy services. Out of the services
patient medication counseling is considered to be the most important part from
a patient’s point of view. The information that may be discussed while a
counseling session purpose, expected action storage, method of administration
of drug and medical devices overall skills required to provide better clinical
pharmacy services are up to date knowledge of clinical aspects of drugs and
good communication skills.
ROLES
OF CLINICAL PHARMACISTS:
(Pharm.D)
candidates in hospital
Activity
|
Role
|
Medication history interview
participation in ward round and meetings
|
·
To ask the patient about his medication history to
optimize the further therapy.
·
To enable prescribing to be influence at the time
of decision making
·
To contribute to patients care through the
provision of drug information and promotion of rational drug therapy.
|
Provision of drug/poison information
|
·
To provide accurate and relevant information on
drug related matters (generally clinical aspects of drugs, eg: use
administration) verbally or in written form to persons involved in
prescribing, administration, monitoring and use of medicines.
·
To prepare specific drug related resources such as
protocols and patients information leafieps.
·
To provide poison information to physicians.
|
Prevention,
assessment and management of drug interactions.
|
·
To review the medications order for the adverse
drug interaction.
·
To identify patients at risk of adverse drug
interaction.
·
To suggest suitable method of management for the
interaction
·
To take appropriate steps
·
To avoid recurrence of interaction with adverse
sequlae
·
To ensure early reorganization of drug interaction
to prevent adverse sequlae.
|
Adverse
drug reaction(ADR) management medication order review
|
·
To detect, assess and correlate, manage, document
and to prevent ADRs
·
To encourage nursing and medical staff as well as
patients, to report ADRs
·
To ensure patients receives most appropriate drug,
dose, dosage form
·
To minimize drug related problems.
|
Clinical
review
|
·
To determine the priorities of the treatment with
reference to therapeutics outcomes desired by the patients
·
To evaluate and monitor patients therapy
·
To review the outcomes of the treatment.
|
Therapeutic drug monitoring(TDM)
selection of drug therapy
|
·
To optimize therapy for the drugs for which there
is know relationship between therapeutic effect and measured concentrations.
·
To identify the desired therapeutic outcomes.
·
To ensure the drug selection follows local
guidelines, formulary and availability limitations where applicable.
·
To promote quality use of medicines.
·
To optimize the clinical outcomes and quality of
patients care.
|
Patients
medication counseling
|
·
To provide the information directed at encouraging
safe and appropriate use of medication for the enhancement of better
therapeutic outcomes.
·
To monitor new dosage and medications.
|
Liaison with
community services
|
·
To communicate concerning special problems.
·
Provisions of medication aids.
·
To encourage the patient to contact to their
hospital pharmacists.
|
After completion and
during the course pharm. D candidate may provide the clinical pharmacy services
in the hospitals work in the areas clinical research organization (CRO),
Pharmacovigilance, pharmaco economics, community services, research and
academics.
We know, it will take time to get it
will established pharm D. candidates need to work hard and get recognized in
the society for patients care by clinical pharmacy services.
They have to create a rapport with other
health care providers such as physicians, nurses and also with patients.
Pharm D candidates have to generate the
need the clinical pharmacy services in the society and prove its importance.
As the Pharm D is
mostly patient centered curriculum, therefore patients will be able to know all
the information about their disease, drugs and life style modifications for the
diseases in future which would definitely increase prognosis of the patients.
The clinical pharmacy services would also minimize the work load of physicians
from their busy schedule as well as it would decrease the load on the health
care system.
Medicine are chemical substances that
are meant to change the way the body deals with an illness or injury or to
maintain your health and well being no matter where you get them from herbal
medicines like vitamins, minerals, nutritional supplements are all medicines.
They are called complementary medicine.
Medicine is a drug that
can help if the among of medicine is right people take medicine because they
want to get better if they have illness they want to feel relieved of their
pain even for temporary.
Different medicines do different things.
Some are meant to treat illness or injuries. Some are meant to prevent
illnesses or maintain health and well being. Others are meant to ease the
problems caused by an illness or injury.
We
get medicine from the pharmacists with a prescription from a doctor/dentist/physician/medical practitioner.
Also we get some OTC medicine without prescription. Pharmacist’s role is vital
in health care system through the medicine and information they provide.
Major responsibility include range of
care of patients from dispensing medication to monitoring patients, from
dispensing medication to monitoring patients health’s and progress to maximize
their response to the medication.
Pharmacists also educate consumer and
patients on the use of prescription and over the counter and advice physician,
nurse and other health preffessional on drug decision.
In united states, ACPE (Aceredition
Council for Pharmacy Education) accredited doctorate of pharmacy (Pharm D ) is
currently the only degree accepted by the national associate of boards of
pharmacy (NABP) to be eligible to sit for the north America pharmacists.
Licensure examination (NAPLEX) previously the United States has a five years bachelor’s
degree in pharmacy.
SOME DIFFERENCE S IN PHARM D AND M
PHARM
Pharm D:
doctor degree which is highly integrated in depth course in clinical pharmacy.
Work
areas:
Ø Hospital
Ø Health
care industries
Ø Retail
outlets
Ø Consulting
Major work
functional area:
Ø Patient
counseling.
Ø Consulting.
Ø Patient
history and record keeping.
Ø Maintain
records of medicine and its after effects.
Ø Advise
safe usage of administration of drugs etc.
M.Pharm
Master
in pharmacy is specific subject like Pharmacology, Chemistry, analysis etc
Work
areas:
Ø Pharmaceutical
manufacturing.
Ø Biotec
industries.
Ø Medical
instrument making.
Ø FDA
Major
work function areas:
Ø Analysis
and testing.
Ø Quality
control.
Ø Quality
assurance.
Ø Sales
and marketing.
Ø Clinical
research etc.
In
context of Nepal, Pharm D is a new course. Kathmandu University have started 3
years course (post Baccalaureate) Pharm D.
In
Nepal there is no any 6 years Pharm D course till now.
In
context of giving authority (adhikarikta)
by Nepal pharmacy council a diploma pharmacy to assistant pharmacist, bachelor’s
pharmacy to pharmacists and master in pharmacist to sr. pharmacist, how Nepal pharmacy
council would take the Pharm. D course?
How
Nepal government will establish Pharm.D course? Where and how Nepal government
will create the environment of employment?
How
government and private medical college and teaching hostital will give Pharm D
course an permanency (istayetwo)?
One
good thing, MMIHS which is a part of NEHCO Nepal had open the job vacancy for Pharm
D. NEHCO Nepal might be the first organization which welcome Pharm D in such a
way.
Mr.
Chiranjibi Chudal
9851018545
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