Drug-related deaths rank 3rd after cancer, heart disease – CPAN boss

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Dr. Joseph Madu, is the National Chairman, Clinical Pharmacists Association of Nigeria (CPAN). In this interview, he highlights the dangers from drug abuse and misuse, the role of professional pharmacists in handling medicines, challenges clients face from lack of pharmaceutical care, among others, reports APPOLONIA ADEYEMI

Types of care

Globally speaking, there are three major types of care in clinical settings namely: nursing care, medical care and pharmaceutical care. However in Nigeria, nursing and medical care are usually commonly administered on patients while the patients are denied pharmaceutical care in a good number of cases. It is indisputable that majority of patients/clients who visit healthcare facilities do receive drugs, but sadly enough they do not receive the expected accompanying pharmaceutical care. This is like someone going for a motor vehicle and given or told he can take the engine without the body of the car. Scientifically speaking, pharmaceutical care is not, and never optional in patient care. Rather it is the right of every patient or client if we considered the potentially dangerous nature of drugs ( so-called medicines). An example is the fact that a simple way to poison or damage the kidneys is to take common painkillers, the non-steroidal anti inflammatory drugs (NSAIDs) simultaneously with water pills (diuretics). An untrained personnel may not be aware of this potentially dangerous drug interaction during dispensing. All they know is that they can give painkillers to relieve pain and diuretics to increase water loss from the body. The lack of adequate pharmaceutical care in our health facilities is partly if not majorly responsible for Nigeria’s low health index. Nigeria is on position 189 out of 191 on the World Health Organisation (WHO) score of countries.

Tragedy from drug problems

Today, there are several documented reports from developed societies indicating that deaths due to drug therapy problems are now ranked third, after fatalities due to cancer and heart disease. The striking thing is that these reports are got from developed climes where drugs and other pharmaceutical products are strictly used under the supervision of pharmacists, while prescriptions emanate from physicians or other non-physician healthcare providers who are trained and licensed to prescribe. This means that in a developing country such as Nigeria, where deaths due to drug therapy or medication related problems may even be the highest risk factor, followed by cancer and heart disease, etc. This may also be hugely part of the reason why life expectancy is very low in Nigeria (about 54), compared to countries such as the United Kingdom (UK) and United States (US) with life expectancies of about 97 and 98 respectively. Drugs are the most commonly used singular agent in the treatment of health problems. Even in some local Nigerian languages hospitals are christened with names to which are directly interpreted as home of drugs. But why has Nigerian healthcare system given very little attention to offer of pharmaceutical care and clinical pharmacy services, which are aspects not toyed with in many countries as they specifically concern the safe, appropriate and effective use of drugs in direct patient care? There is often neglect or disregard for laws guiding drug handling,

Near absence of pharmaceutical care

Why are Nigerians allowed to receive low level and sometimes absent pharmaceutical care in our healthcare settings?

Is it that Nigeria’s healthcare administrators are ignorant or that they deliberately kill health seeking Nigerians by denying them access to quality pharmaceutical care? Health administrators need to provide the conducive environment for health seeking Nigerians to enjoy pharmaceutical care.

Also , Nigerian community pharmacies should be used as immunisation and vaccination centres as seen in countries with better health indices like UK and Ghana. Our law makers should make laws that grant prescribing powers to our pharmacists, nurses, optometrists, etc. Some of the questions above need answers even as many countries have used the lessons of the COVID-19 era to positively reform their health sector. Another documented report from the USA shows that a patient is ten times more prone to the risk of suffering bodily damage from medication-related problems than from road traffic accidents. The big question again is: “who has the medication-related problem records for Nigeria; where it is common scene to see medications being handled by unprofessionals such as traders, illiterates, school drop outs, etc?” Are Nigerian pharmacists incompetent? Are they really unwilling to provide pharmaceutical care services to patients and clients? If not, where lies the problem? Why deaths from drug misuse persists Why should our people continue to die as a result of drugs misuse and abuse? Despite the fact that we have over 20 universities where pharmacists are trained with tax payers money, why are Nigerians not reaping the dividends? Why not employ enough pharmacists including clinical pharmacists in our health institutions? This author wishes to use this medium to call the attention of our policy makers, Federal Government and all Nigerians to the fact that every Nigerian deserves quality pharmaceutical care as a right and not an option. The pharmacist is the only health care professional trained to excel on knowledge of drug action and offer of pharmaceutical care. The government should embrace using pharmacists to offer pharmaceutical care just as is the norm globally and and stop using pharmaceutically untrained people in our health institutions to do the work of pharmacists, as that is very dangerous to the health of the citizenry.

Limiting professionals to their core area

Other health care professionals such as physicians, nurses, pharmacy technicians, community health extension workers (CHEWS) etc, cannot be substituted to do the job of pharmacists, just as pharmacists cannot be substituted to do theirs. Apart from traditional drug dispensing, basic pharmaceutical care, manufacturing and counseling by pharmacists, clinical pharmacists can also offer advanced pharmaceutical care and be involved in such elements as preventing, detecting, categorisation and resolution of potential or actual drug therapy problems at the patient’s bedside or in community pharmacies thereby making drug therapy highly safe for our people.

Why pharmaceutical care

Pharmaceutical care is designed to promote health and wellness, prevent disease, initiate or modify medication use to ensure that drug therapy regimens are safe, effective and appropriate. That is the culture of health care around the globe and in line with international best practices. Nigerians should be availed of their rights of pharmaceutical care in our health institutions.

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