Role of Pharmacist

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• Role of Pharmacist
• in
• Malaria Control

15th Roll Back Malaria Partnership Board Meeting
New Delhi
Mrs Manjiri S Gharat Hon. Secretary, Community
Pharmacy Division, Indian Pharmaceutical
Association
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Role of Pharmacist African ExperienceMalaria
Fact Card Project (Year 2001-2004)

• Project of Commonwealth Pharmaceutical
  Association (CPA), International Pharmaceutical
  Federation (FIP) World Health Organisation
  (WHO)
• Aimed to disseminate reliable and relevant
  consumer information through community pharmacies
  on the prevention and early treatment of malaria
  in various malaria-endemic regions- Zimbabwe
  ,Tanzania Ghana
• Pharmacists were provided with the training and
  resources to develop, produce and implement
  intervention strategies

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Malaria Fact Card Project (Year 2001-2004)

• Malaria Fact Card-Consumer Education tool - easy
  to understand ,in local language
• Focused on prevention, treatment complied with
  Malaria Control Strategies in each country
• Training of pharmacists in use of Fact Card as
  Counseling tool
• Focused Group discussion for evaluation of
  project

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Project Outcome

• Fact Card had increased awareness of the
  prevention and early treatment of malaria in more
  than 60 of survey respondents in the target
  groups
• Increased pharmacist/patient interaction not only
  informed patients but also promoted the potential
  for real change in consumer behaviour
• Project was successful in achieving its
  objectives

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Typical Indian Retail Pharmacy
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(No Transcript)
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Pharmacists participating in Tuberculosis (TB)
Control
TB Fact Card Project

• Objectives
• To involve community
• pharmacists in
• Promoting community awareness of TB
• Monitoring TB treatment prescribed by private
  physicians
• Providing patient support

Implemented through 50 trained community
pharmacists in Mumbai Navi Mumbai
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Special Achievements
Rise of Concept of DOTS Pharmacist
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DOTS Provider pharmacist with TB patient
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Positive experiences of TB Fact Card project in
Indian Settings Malaria Fact Card in African
settings suggest
Pharmacist has potential in participation of
various health programmes of Governments
It has been (pharmacist services) mostly untapped
potential till date
Pharmacists can add to trained workforce with
their involvement there could be wider outreach
of malaria control programme
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Advantages of using Community Pharmacy Services

• Pharmacist-first port of call health professional
  
• Easy accessibility of pharmacies
• Pharmacist skills in communication
• Friendly relation with consumers
• Knowledge about medicines
• Better patient care support
• Provision of free advice

500,000 (half a million ) community pharmacies
in the country
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Malaria Control Issues to be addressed

• Shortage of trained manpower
• Drug use problems at community level
• Insufficient awareness in the community leading
  to high morbidity mortality in certain States

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Observations by pharmacists
Informal discussion with experienced community
pharmacists brought up following points

• Incorrect use of medicines by patients
  (incomplete treatment, wrong timings of dosages
  ,fear of side effects etc)
• Suggests-Scope to improve the situation-Role of
  pharmacist
• Low level of awareness concern about vector
  control, especially in rural areas
• Suggests-Scope to improve the situation-Role of
  pharmacist
• Variations in treatment seen in prescriptions
  (deviations from standard guidelines?)

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Envisioned Role of pharmacist

• Early Case Detection and Prompt Referral for
  Treatment
• Identifying symptomatic cases directing
  suspected cases for medical check up
• Referring to diagnostic centers, Drug
  Distribution Centers (DDCs) and Fever Treatment
  Depots (FTDs) in the rural areas
• Counseling
• Community awareness about causes, preventive
  measures ,symptoms, diagnosis (emphasis on
  importance of blood smear examination), treatment
  
• Rational use of prescribed medicines
• Counseling to improve Community Participation by
  sensitizing and involving the community for
  detection of Anopheles breeding places and their
  elimination
• Sensitizing consumers for various ways of vector
  control emphasizing personal prophylactic
  measures

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Envisioned Role of pharmacist contd

• Presumptive treatment in high transmission areas?
• Pharmacovigilance reporting of ADRs
• Participation in Evaluation of prescriptions/Presc
  ription audits
• Counseling for Travelers malaria
• World Malaria Day IEC campaigns

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Way ahead Pharmacist centric model for Malaria
control

• Consumer health information other IEC material
  on malaria in compliance with National malaria
  control policies ,for distribution/display
  through pharmacies
• Disseminate the information about planned project
  to pharmacists
• Selection of willing pharmacists
• Training of pharmacists about disease use of
  Information tools
• Follow up monitoring of the activities
• Evaluation

Pilot project in one District of any high disease
burden State then nation wide implementation
after refining the model
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Possible collaborations-Public-Private Mix
activity

• Collaborating organizations at national, regional
  local level
• National Pharmaceutical Association (Indian
  Pharmaceutical Association)
• Chemist Associations
• Government Vector Borne Disease Control
  Department
• WHO ??
• Challenges
• Capacity building for training of pharmacists
• Funding support (sustainability )

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To summarise
Counseling
Community awareness
Case detection referral
With appropriate training supervision,
community pharmacists can complement and
supplement the government efforts to make a
significant dent in the malaria burden
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Acknowledgements

• CPA Secretariat,London
• Prafull D Sheth,Vice-President ,FIP

Thank You