"Health ministry launches pilot project to ensure patient safety by containing medical errors", "Several prescription drugs to come under pharmacovigilance soon". These are the captions of news items appeared in an issue of 'Pharmabiz' dated 7. 1. 2010. On going through those news items one could not control the 'feeling of pity' of pharmacy profession in India. The said news denotes how the Central government and even a head of a pharmaceutical wing (drugs controller general of India) are forced to assign the job of a clinical pharmacist to others.
Pharmacovigilance and patient safety by containing medical errors are the primary duties of a clinical pharmacist and being performed by him in all the developed counties. Pharmacy students are taught and trained in these aspects even during their under graduate courses and specialising in their master's course [M. Pharm - pharmacy practice]. There are hundreds of these graduates waiting for job opportunities in government hospitals.
As the post of clinical pharmacist and the parent department - Department of Pharmacy Services - are yet to be created in Indian hospitals, their education and training is simply going waste, whereas the government is utilizing the services of non-pharmacy peoples for those works. Time has come to take up the work, we agree, but the manpower produced and ready is not being used! What a pity! Where is the gap? It clearly indicates the failure of authorities concerned, as well as professional pharmacy associations of not apprising the government of availability of such suitable persons for the given job. Then what is the purpose of starting such courses in scores of Indian pharmacy colleges? Is it just to make money by these colleges?
It is our duty to point out that the assigned works cannot be performed satisfactorily by such ad hoc committees or ad hoc measures. When there are peoples specially trained for the work, why give the work to others? These works are of such nature that they must be done by day to day monitoring, observing and testing of patients by sitting near them in the wards of the hospitals. Therapeutic Drug Monitoring (TDM) should be performed by conducting needed tests of the body fluids, at an appropriate time, in an appropriate manner by the clinical pharmacists and recorded. Only the data collected from such records will be useful, reliable and serve the purpose of the government and drugs controller general of India.
Adverse drug reactions
Ignoring all these fundamental and scientific aspects how one can confirm Adverse Drug Reactions (ADRs), Drug interactions and other problems faced by the patients? How and who is going to find out medical errors and ensure patient safety? Do you expect the treating physician himself find out his error and report to the authorities?
It is common sense that a doctor who prescribed the drug which caused the Adverse Drug Reactions may not like to reveal it. It is human nature to avoid embarrassing situations as nobody want to be in bad light. It is doubly so in medical practice which entirely depends on good name from the public. So don't expect straight forward reports of truth from private hospitals or clinics, also they have no facilities for confirming Adverse Drug Reactions etc, even if they wish. Hence, pharmacovigilance and Therapeutic Drug Monitoring can be carried out effectively only in government hospitals set up that too only when the work is assigned to the people specially educated and trained for the purpose.
Without considering all these things, if a committee submits its report, obviously, it cannot be worth acting upon. It could be at best yet another report of a yet another government. committee! If the government is serious about the job it should organize it in a proper manner. It is time for all pharmacy associations especially IPA, IPGA, IHPA, and AIDCOC to wake up, arise and act. Even Pharmacy Council of India can do whatever it can in this matter of importance.
Hence, as demanded in these columns earlier, Department of Pharmacy Services should be started in all big government hospitals with clinical pharmacists appointed in them in sufficient numbers. Necessary laboratory facilities should be provided in each of the above hospital and then start pharmacovigilance and other programmes. Assigning the work to existing infrastructure will not serve any purpose. People, if given additional workload or unknown work will simply cook-up the work and provide the government with false data. By believing and acting upon it authorities are going to end up in fool's paradise! Hence, for God's sake don't take ad hoc actions without studying how the work is carried out in other countries.
Our ministers and higher officials are very much interested in 'study tour' abroad to learn and implement new things in India. It is golden opportunity for them to go to USA, UK, Australia and other developed countries where clinical pharmacy services are provided. Our learned drugs controller general of India should make efforts on this and let the government representatives know it with first hand information and then implement it in India.
Will the pharmacy professional associations wake up and act?
(The author is Ex. President, Indian Pharmacy Graduates Association, Madurai, Tamil Nadu)