PhD Studies IPSF Pharmacy Education Newsletter | July 2013
FIPEd-IPSF Student Learning Experience Questionnaire Integration of Pharmacy and Public Health
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Since establishment in 1949, IPSF now represents more than 270 000 pharmacy students and recent graduates in over 70 countries worldwide. IPSF is the leading international advocacy organisation of pharmacy students promoting improved public health through provision of information, education, networking, and a range of publication and professional activities.
Mr. Fahmi Fuady
PhD Studies Page 3
Pharmacy and Public Health Page 4
The 12th APPS Page 6
Pharmacist and HIV Patients Page 8
Issue #6, July 2013
Design & Layout
Ms.IPSFAlexandra Marques Chairperson of Media and Publications Front Cover photo
Back Cover photo
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Ms. Yuqian Liu [Editor-in-Chief] Ms. Neo E-on Ms. Hannah Svedlund Mr. Jason Hong Ms. Sheena Patel Chairperson of Media and Publications firstname.lastname@example.org Editor-in-Chief email@example.com
It it with great pleasure that I present you with another issue of Pharmacy Education Newsletter. In this issue, I’d like to highlight Ms. Naoko Arakawa’s article which shows the importance of your participation in FIPEd-IPSF Student Learning Experience Questionnaire. Please remember to submit your survey results if you haven’t. We have two articles from two veteran IPSF’ers. Firstly, Mr. Juha Mönkäre with his article about Ph.D. studies and how it differs from undergraduate ones. Secondly, Ms. Neveen Abdulghani and her valuable experience in dealing with drug resistant tuberculosis cases during her practice in South Africa. We will be continuing the series that we started in the last edition where Ms. Junna Kiriyama will give us some information about the theme of APPS 2013 and a speaker they’ve invited for the event. Last but not least, Mr. Mohan Shrestha, IPSF HIV/AIDS Awareness Campaign Coordinator, will tell us about the important role of pharmacists in the treatment of HIV patients.
Your comments, suggestions, ideas, and questions regarding PEN are very valuable to us to make future issues of PEN even better. Please address them to firstname.lastname@example.org. As always, I’d like to thank Alexandra and the editorial board for their job in designing and proofreading this newsletter. Enjoy reading, viva la pharmacie!
Ms. Naoko Arakawa, FIP Pharmacy Education Taskforce Member
FIPEd-IPSF Student Learning Experience Questionnaire Needs your voice for evidence-based advancement of global pharmacy education! Dear Pharmacy Students, There is a global interest in quality and standards of professional pharmacy education as health policy world-wide becomes more focussed on extending the roles of pharmacists to provide more effective medicines-related health services. To achieve higher and equitable quality, the global infrastructure for pharmacy education needs to be mapped to the required competencies of pharmacists in order to meet the given health needs in any country. As students are at the centre of pre-service education, their input is important in the development of educational policies and practices. It is of global interest and relevance to survey the student learning experience. FIP Education Initiatives (FIPEd) and IPSF are now implementing a global survey that aims to collect data: To identify the key demographic variables of students; To measure and map global patterns of the learning experiences in pharmacy programmes, and; 2
To measure and map attributes of the quality of learning of students in pharmacy programmes across the nations. Data collected will provide key evidence for education advancement. Your participation in this survey is vital to provide to a better evidence of current pharmacy students learning experiences, and will assist in the development of global pharmacy education policy recommendations. The “FIPEd – IPSF Student Learning Experience Questionnaire” is an on-line survey in 7 different languages (Arabic, English, French, Japanese, Mandarin-Chinese, Portuguese, and Spanish). Please click on the survey link (http://www.codegnet.org.uk/moII_2013/) and answer in the language that best suits you. This questionnaire should take no more than 15 minutes of your time. If you have any enquiries about this survey, please contact Naoko Arakawa (email@example.com) or Marouen Ben Guebila (firstname.lastname@example.org). Remember that your voice is the best evidence to inform the future of pharmacy. Tell us how you feel about your learning experiences and become changemakers.
Mr. Juha Mönkäre, IPSF Treasurer 2005-08 and HLM
“Both parties have their own justified views on the development of pharmacy education.” Pharmacy students are at the receiver compartment of the pharmacy education, but PhD students are at the to the donor compartment. Although PhD programs vary widely in different countries and universities, they contain some teaching and supervising components of undergraduate students. This offers not only new challenges but another perspective on pharmacy education. When we are students, we always wonder and question about methods and arrangements of teaching. That is naturally a positive aspect that facilitates the further development of the educational process. However, when we stand in the shoes of an educator, or even the coordinator of some courses, we get a new perspective on issues we previously have encountered from the other side. Maybe there are some good and logical reasons for strange course schedules or why the content is divided to certain blocks. Of course, it is also possible that we find some ugly truths behind the problems. One of them being the fact that teachers also have lots of other
another view on pharmacy education
things to do than only that one course or thesis work the student is working on. While teaching or supervising someone’s bachelor or master thesis, the teacher might have other additional and relative important tasks. For example, performing important experiment at the lab, writing grant proposal or even being engaging in other teaching activities. Therefore, it might be that a student is not immediately receiving the feedback on the returned work or answer to their e-mail. Everyone who is teaching was once upon a time a student. It is always important to remember this so we treat our students the way we would have wanted to be treatment. However, during the years, those memories fade, and may become more selective. Thus, it is important that there is a working and open dialogue between students and teachers when developing pharmacy education. Both parties have their own justified views on the development of pharmacy education. Teachers need to remember to listen to students and try to pick working suggestions while students need to remember that we do not live in an ideal world. All good ideas do not necessarily work in reality but without suggesting any improvements, pharmacy education will stop to develop.
Ms. Neveen Abdelghani, IPSF Chairperson of Public Relations 2007-08
Integration of Pharmacy and Public Health An Example from South Africa
“Public health and pharmacy go hand-in-hand and that pharmacists are responsible for the protection of the public’s health.” The integral role that pharmacists play in the healthcare system has paved the way for an expansion of the pharmacist’s scope of practice into areas including health policy research, supply chain management, and humanitarian work. A desire to effect positive changes in health care policy related to medications and the expansion of medication access led me to undertake a 6-month global health practice with CAPRISA, the Centre for the AIDS Program of Research in South Africa. At King Dinuzulu Hospital, formerly George V Hospital (KGVH), KwaZulu-Natal’s designated provincial “Centre of Excellence” for the specialized treatment of drug resistant tuberculosis (DR-TB), I joined a team of clinicians that is on the front lines for one of the world’s most severe HIV and TB joint epidemics. Drug therapy for this especially vulnerable co-infected population is complicated by a number of issues, including a wide range of drug-drug interactions and clinical co-morbidities, alongside greater
health system related problems such as drug supply shortages and socio-economic divisions that have contributed to increased patient defaulting and the consequent spread of drug resistance. In the second half of 2011, the South African National Department of Health issued an update to its treatment policy guidelines for the management of multidrug resistant tuberculosis (MDR-TB). The new guidelines discouraged the concurrent use of tenofovir and aminoglycoside/polypeptide antibiotics in co-infected patients due to the increased potential for renal toxicity. Many of the patients that come through KGVH are already failing first-line and even second-line therapies for HIV and TB, and with such a heavy pill burden have poor drug adherence. There is an increasing number of extensively drug resistant tuberculosis (XDR-TB) cases that is also especially alarming. The concurrent use of tenofovir and kanamycin/capreomycin in these co-infected patients cannot always be avoided; in fact, the combination may be the last and only line of therapy still available. Key to the operation of any health system is the ability to keep costs under control,
public health professional, I remain steadfast in my conviction that medication access must be expanded, that universal access is a fundamental human right. Public health and pharmacy go hand-in-hand and that pharmacists are responsible for the protection of the publicâ€™s health. Extending this professional mandate to the policy making arena, pharmacists can affect important changes that may not only bring about universal medication access, but may also revolutionize health care systems long into the future.
while ensuring excellent service and uncompromised quality. What is especially worrisome is the large number of patients failing their treatments. Bed space in the MDR-TB wards at KGVH is scarce and the large majority of co-infected patients may spend only a short-time inpatient before they must be discharged and continue therapy as outpatients. It is oftentimes hard to ensure 100% medication adherence even in the wards, where stories abound of patients hiding pills or otherwise disposing of medications by various means. Once patients are discharged, they may be down-referred into the care of providers at clinics closer to home, but some patients are also lost to follow-up, disappearing altogether and only returning to the hospital for emergency care when it may already be too late. Patients with MDR or XDR-TB who are lost to follow-up are incredibly vulnerable, and the long standing and well documented clinical relationship between HIV and TB co-infection makes the care of these patients very challenging. Just as any external humanitarian assistance program should not supplant a countryâ€™s current emergency response system, so too should efforts to secure expanded medication access not override or do away with local programs already in existence. What works in one local context, may not always work in another and it is these differences that both make international public health work full of invaluable learning experiences, as well as, uniquely challenging problems requiring innovative solutions. As an investigational pharmacist and now
Ms. Junna Kiriyama, Social Events Coordinator of The 12th APPS
Be Your Own Healthcare Partner “Promoting self-medication can lead to improving our health and cut the cost of prescribing.” Our life expectancy is getting longer and people are eager to live their lives healthier. To live healthier, people need to learn to self-manage their health. One of the ways of self-managing health is through selfmedication, which is defined by the World Health Organization as the selection and use of medicines by individuals to treat selfrecognized illnesses or symptoms. However, another definition should also be considered, which is ‘the prevention of non-communicable diseases or chronic diseases by an individual themselves’. Promoting self-medication can lead to improving our health and cut the cost of prescribing. That’s why we decided our theme for APPS 2013 to be “Self-Medication: Be Your Healthcare Partner”. We have invited Mr. Akira Uehara, Chairman and CEO of Taisho Pharmaceutical Co Ltd and Board member of World Self-Medication Industry. At the symposium, he will speak about the following issues: definition and
importance of self-medication; the ways to apply self–medication to our daily lives; the role of pharmacists and other medical staff in self-medication; and pharmacists’ responsibility in supporting self-medication. Moreover, Japan is one of the countries with the highest percentage of older people in the world. This current condition in Japan may reflect what may happen to other countries in the near future. At APPS we also have scientific, educational symposium and various themes for the workshops. We will share the details soon on our homepage. We hope that participants will expand their potential as pharmacists in these symposiums. Hope to see you in Japan!
Mr. Mohan Shrestha, IPSF HIV/AIDS Awareness Coordinator 2012-13
We, As Future Pharmacists, in The Pharmaceutical Care of Patients with HIV “Pharmacists play a crucial role in keeping the adherence of patient who take HAART by providing detailed informations and services related to HIV and the therapy course prescribed to the patient.” If we think about the most available healthcare professional in the community: community pharmacist is probably the answer. As trusted community health advisors, pharmacists can promote the safe use of medications and improve clinical outcome which is a must for the better therapy outcomes in HIV. In addition, the role of pharmacists is crucial in the hospital as well. Pharmacists are the one at the end of the healthcare team who go through all the prescription and provide the appropriate drug as prescribed, avoiding all medication errors. In the pharmaceutical care of patients with HIV, Pharmacists play a crucial role in keeping the adherence of patient who take Highly Active Anti-Retroviral Therapy (HAART) by providing detailed informations and services related to HIV and the therapy course prescribed to the patient.
Adherence to an Anti-Retroviral treatment (ART) regimen involves taking all pills in the correctly prescribed doses, at the right time, and in the right way. Non-adherence to drug can adversely affect HIV outcomes in the form of increasing the chances of viral drug resistance, the rate of progression to an AIDSdefining illness and even HIV-related mortality. So, adherence to Anti-Retroviral Therapy is a principal predictor for the success of HIV treatment and remains a major challenge to HIV care. Adherence means a more collaborative process between the patient and healthcare provider, which in this case is the pharmacists. The role of pharmacist is crucial for maintaining the adherence of the patients by providing pharmaceutical care service to the patients in the community setting. The Pharmacist’s responsibility and duty is to optimize the patient’s medication therapy by reviewing the medication profile and making sure the patient fully understand what each medication is for, how to take it, when to take it, side effects, drug-drug interactions and drug-food interactions. The pharmacist should always be available to answer the questions. During counseling, pharmacist should counsel
Side effects and toxicity to ART are common and vary from person to person even if the patient is adherent. In case of any dosage adjustments, formulation changes and drug substitution, pharmacists should review these changes with the patient’s prescriber, in order to reduce medication error.
It takes a long time to build up a good image but a couple of mistakes can bring it down. So, it is extremely important for the pharmacist to be committed towards the community. The pharmacist should also get involved in local events, activities in the community level and at local AIDS support organizations so that the role of pharmacist in the community will be clear.
in the preferable language of the community respecting their culture so that the patient can easily understand and remember everything said by their pharmacist. We should offer adherence tools, such as pill boxes, beepers and reminder phone calls to the patients. We are in a position to assess patients’ adherence by enquiring them about the number of doses taken and missed in the past days and past week. If the patients became non-adherent, it is important for pharmacists to consult the patients’ physician and take the best course of action according to the patient’s condition.
As a conclusion, the complexity of pharmaceutical care for patients with HIV infection presents special challenges and opportunities for pharmacists interested in developing a specialized knowledge base about HIV treatment. Reference: http://www.thebody.com/content/70262/10-steps-tochoosing-the-pharmacy-thats-right-for-.html?ic=700100 http://www.hivguidelines.org/clinical-guidelines/hiv-andpharmacy/pharmacists-partners-in-health-care-for-hivinfected-patients/
The important aspect that each pharmacist must not fail to remember is the confidentiality of the patient. The counseling must be so private that the issues not shared with other family members. To provide all these services to the patient, it is extremely important to be HIV sensitive. We have to be non-judgmental, non-homophobic and non-AIDS-phobic. The medication therapy last for patient’s lifetime. Thus, pharmacists should also provide ideas regarding insurance companies and help contact physicians to discuss the situation of the patient and substitute/switch the medication that is suitable to the patient’s condition. IPSF Newsletter
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