Importance of Pharm. D study in Nepal

                                         - Rabin Chudal-

 

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.

 If any Query Please feel free to contact as following

Mr. Chiranjibi Chudal

9851018545