Proposal: Drug Management Approaches in Scarcity and Recession, Nigeria in Focus

Preamble

Medication therapy is critical in treating and preventing diseases  and is an integral part of everyday life for many Nigerians. However, the current economic recession has unleashed untold hardship not only in the area of obtaining good quality medications but also in all spheres of life.

Thus, many Nigerians have to an extent become good managers of the little resources in their hands. People are becoming thrifty, provident and better decision makers in things to eat and buy for pleasure; places to go for leisure.

THE CURRENT QUAGMIRE

 It is a well known fact that currently, there is shortage of foreign exchange in the country. This has created stress not only in the process of importation of such specialized products as medications, but also pharmaceutical grade raw materials required for the manufacture of drugs.

Consequently, this has resulted in:

  • drug shortages and
  • hike in prices of available medications

Drug shortage simply means that for a particular medication, there is insufficient supply to meet currently existing demand.

In addition, the American Society of Health System Pharmacists (ASHP) considers a drug to be in shortage when supply issues affect how a Pharmacy prepares or dispenses a drug product or influence patient care when prescribers must use an alternative therapy.

This situation if it lingers can impact negatively on the health of Nigerians viz a viz  lack of good quality drugs and proliferation of fake/substandard drugs.

THE WAY FORWARD

Drug shortages are a concern to Pharmacists and significant resources are required for managing them. A successful program for managing drug shortages involves a number of key elements namely: a good understanding of the reasons behind the shortages, a proven system for involving the entire health care organization quickly, and clear channels for communicating information and plans with all those involved especially prescribers.

The need to ensure that our patients/clients get the standard treatment using good quality drugs cannot be overemphasized. In view of this, the following are ways in which the available resources; drugs in this case, can be managed such that our patients get the necessary therapy /treatment:

  • Communication between Pharmacists and doctors is key.  A team approach between Pharmacists and doctors will ensure that a strong and consistent message is delivered to patients.  Such a good working relationship will facilitate a patient focused thorough assessment of potential consequences of drug unavailability and development of contingency plans that meet a patient’s drug related needs.
  • Identification of alternative drugs or therapeutic equivalents by Pharmacists. Such decisions regarding alternative agents should be made in collaboration with the medical team. This step will go a long way in ensuring that out-of-stock syndrome is minimized or eliminated in the face of the current acute drug shortages.
  • Prescribing within the Essential Drug List of the Hospital( as much as possible)
  • Utilization of Standard Treatment Guidelines (STGs), other established protocols or hospital-specific treatment guidelines.
  • Prescribing for the shortest duration as much as possible. Whenever indicated and where necessary, duration of therapy should be limited to the specifications of STGs, other established treatment protocols or hospital-specific treatment guidelines.
  • Definitive prescribing of antibiotics. As much as possible, antibiotics should be prescribed definitively (and not empirically) following microscopy, culture and sensitivity tests.
  • Generic prescribing is strongly advocated.
  • Limiting Polypharmacy.  As much as possible, the practice of Polypharmacy should be reduced to the barest minimum.
  • Preparation of Extemporaneous products. Pharmacy departments of Hospitals should be empowered to prepare certain extemporaneous preparations for use within hospitals whenever indicated.

CONCLUSION   

One cannot really predict how long the current economic recession will last. Hence, the need for pragmatic approach in the management of available drugs.  This is to ensure that in the area of healthcare delivery, patients’ drug-related needs are adequately met

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