Department of Pharmaceutical Sciences,
University of Kashmir is the only educational institution in the entire Jammu
and Kashmir that has been offering an under-graduate degree programme in
Pharmacy over the past thirty five years. In 2009 post-graduate degree
programmes in five different specializations of Pharmaceutical Sciences
including Pharmacy Practice were started after getting necessary approval from
the University Grants Commission, New Delhi for offering the same as an
innovative programme. Masters degree programme in Pharmacy Practice was aimed
at orienting the pharmacy education in J&K towards hospital and clinical
pharmacy, enhancing competency and
clinical skills of pharmacy graduates and capacity building of pharmacists for making them an integral part of the health care team who
could assist in providing optimal evidence-based
care to the patients.
A decade of education and research in
this specialization has been completed last year at the University of Kashmir.
It has been quite a rewarding and exciting journey over the past ten years for
the faculty as well as students of this programme. This write-up is an attempt
to apprise the common masses about the aims, objectives, progress and outcome
of this programme with a view to reinvigorate ourselves for another lap with
greater resolve, commitment and conviction so as to make qualified and trained
workforce available for the healthcare system who could assist in delivering
better pharmaceutical care services to the patients of the valley in times to
come. This programme is essentially aimed at carving a niche for the qualified
pharmacists of J&K and establishing them as an inherent part of the healthcare team that so far comprised of only
doctors and nurses.
Overall goal of professional Clinical
Pharmacy services is to optimize the therapeutic outcome management and
decrease the burden of five D’s viz, death, disease, disability, discomfort and
dissatisfaction among patients. Clinical, economic and humanistic outcomes will
also shift towards the positive side as a result of these integrated and
seamless healthcare services rendered by a trained pharmacy practitioner.
Post-graduate programme in Pharmacy Practice is being offered over the past ten
years with these very objectives. The course includes mandatory practical
internship training for one year in a hospital besides a year-long research
work in hospital, clinical or community pharmacy that culminates with
compilation and submission of a research dissertation. Two year rigorous
training of clinical pharmacists fully gears up the trainees to accept full
responsibility of the patient’s medication management and suggest
modifications, if required in his drug regimen.
While the aim of pharmacy practice
education has been to create a qualified and trained workforce that is
well-equipped to address pharmaceutical care, patient counseling and other
clinical pharmacy needs of the patients visiting out-patient and in-patient
departments of our government hospitals, objectives of the pharmacy practice
research have been to assess adverse drug reaction monitoring, pharmacovigilance
and pharmaceutical care services; evaluate access to essential medicines that
includes their availability, affordability and acceptability; evaluation of
drug utilization and prescribing practices; estimation of economic burden of
the treatment of various chronic ailments like diabetes, PCOS, hypertension,
cancer etc; assessment of hospital pharmacy and medicines management services
at our government health centres. In spite of some difficulties faced in
running the programme smoothly, Department of Pharmaceutical Sciences has been
relentlessly marching ahead over the past ten years towards establishment of Clinical Pharmacy Practice
as a full-fledged and well recognized profession in J&K.
Post-graduates in Pharmacy Practice who
have passed out from the University of Kashmir have worked on 15 different
research projects. All the three core areas of Pharmacy Practice viz.,
hospital, community and clinical pharmacy practice have been addressed while
formulating the research design in this programme. Care has been taken to
accord top priority to the most intriguing issues facing patient care in the
region and the outcome of research has so far been not only interesting and
encouraging but thought-provoking too. Research findings of these projects have
been published in peer-reviewed, national and international journals of repute
thereby presenting a snapshot of the overall drug use and prescribing patterns among
Kashmiri population and revealing the gross situation of availability, affordability,
effectiveness and safety of essential medicines in various districts of the
valley. All these studies were the first of their kind in this region that
could be of great help in devising policies and setting achievable targets in
ensuring availability and affordability of safe, effective and good quality
medicines all across Jammu and Kashmir. For instance one of the doctoral
research studies was undertaken to design and develop a medicines management
policy framework for tertiary care hospitals that lays out a scientific and
systematically organized framework for selection, quantification, demand
estimation, procurement, distribution and use of medicines in tertiary care
hospitals which if adopted and implemented well can help ensure availability of
quality medicines in sufficient quantities throughout the year and prevent drug
shortages in our tertiary care hospitals.
Professional Clinical Pharmacy services
offered by trained personnel holding post-graduate degrees in Pharmacy Practice
can help a great deal in identifying potential and actual drug-related
problems; addressing needs and resolving actual drug related problems;
preventing potential drug-related problems and optimizing patient therapy
outcomes. It is a practice in which the pharmacy practitioner
assures that all of a patient's drug therapy is used appropriately for each
medical condition; the most effective drug therapy available is used; the
safest drug therapy possible is used, and the patient is able and willing to
take the medication as intended. Patients in our part of the world have not
been able to avail such professional pharmaceutical care services so far as a
result of which there is large scale dissatisfaction and disillusionment among
them since they largely remain uninformed about various lab investigations
conducted upon them and about the necessity for various drug therapies
prescribed. As a result of the patient overload of physicians and some other
reasons, they are not in a position to offer detailed counseling, patient
education and drug information services on individual basis to all their
patients. Therefore it is for the trained pharmacy practitioners to step in and
fill the void by offering such services with a view to achieve definite
therapeutic outcomes that improve a patient’s quality of life.
In spite of this modest attempt by the Department,
Clinical Pharmacy Practice on the whole is in its infancy in Jammu and Kashmir
and the concept of Pharmaceutical Care is completely new to most of the
physicians, nurses and even pharmacists presently working at the government
health facilities. Overall scenario in relation to professional pharmacy
services in Jammu and Kashmir is very dismal where we have mostly unqualified
people working as pharmacists in retail pharmacies and dispensing medicines to
patients without any technical know-how about the same and without providing
any basic information to the patients about the use and possible side-effects
of medicines. In government sector too, pharmacies within hospitals, primary
health centres and sub-centres are manned by Medical Assistants who have not
undergone any formal training as required under norms, specifically in
pharmacy. We don’t have any positions available for pharmacy graduates and
post-graduates at any level in our government sector at present. Consequently
the services of qualified pharmacists remain completely unutilized in J&K,
depriving patients of precious information about the use of drugs.
In order to keep pace with fast changing
times and global trends, trained and qualified pharmacy practitioners should be
a part and parcel of the medical team during ward rounds and their assistance
must be sought in prescribing best possible drug therapy to the patients. Every
major hospital in J&K needs to have a full-fledged Department of Pharmacy
Practice with adequate infrastructure, manpower, equipments and funding. Government
of Jammu and Kashmir needs to adopt Pharmacy Practice Regulations of 2015 that
are in vogue throughout the country at present. If J&K fails to adopt and
implement these regulations even after five years of their promulgation in the
country, we shall be failing our patients and depriving them of life-saving
pharmaceutical care and clinical pharmacy services. Further since all these
prepositions are already well stipulated in the approved drug policy of
J&K, government needs to start working in that direction in its right
earnest.
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