Hospital Pharmacy in Bangladesh

(Mohammed Younus): In Bangladesh hospital pharmacy services of both the government and private institutions are very much barren and overlooked for their perfections. Anyone can find our hospital pharmacies in the same arrangement as mere dispensaries to stock and hand over the drug products to the patients on the prescriptions.

Currently, it is the main and the only sphere of the professional deliveries of our hospital pharmacies. I am sure that this is very much shocking to observe and accept by our graduate and post-graduate Pharmacists. Graduate and postgraduate Pharmacists have been placing their wholeheartedness to participate in interdisciplinary health care professionals’ teams in hospitals to develop the standard and usefulness of our hospital pharmacy and to brew the quality and standard of our health care system. It is very much painful to note that no government in the last 37 years of our country’s independence has thought about and taken any lead to upgrade the standard and shape of pharmacy services of our hospitals for the health-keeping interests of our people. Very recently the span of our hospital pharmacy practice has got variations through the rationale employment of graduate Pharmacists in a few of our private hospitals.

The variations are not perceptible to the mass because of the very fewer number of working graduate Hospital Pharmacists in a very fewer number of private hospitals. Still then, as a graduate Pharmacist, I would like to admit they led the way to transform the backward and less useful mode of hospital pharmacy services into the very useful pattern of modern hospital pharmacy in our country. To me, this will remain a milestone in the advancement of the standard of our hospital pharmacy practices and the health care system. Getting delivery of appropriate quality health care is one of the most important basic human rights of our people.

No one of the health professionals can sit idle paying no attention to the quality of our health care deliveries. So, we the Pharmacists can not overlook the matter and can not stay silent, but demand for our professional right to work to provide pharmaceutical care to the people through our active involvement in the health care system. No one can ignore or prevent us from getting such a prerogative and professional right to serve the people through our pharmaceutical specialties and skills. The health care system requires coordinated efforts of mainly four kinds of health professionals; namely- doctors, pharmacists, nurses, and diagnostic professionals. The competence of the professionals directly affects the overall quality of the health care deliveries to the people.

It is pleasant to note that the professional competence of three of the stated professionals of our health care system is quite satisfactory excluding the presently available quality of the services of the pharmacists. This is due to the reason that a good number of specialist and consultant professionals of those three professions are available at the service points. Only the present quality of the pharmacy services is of low standard due to nonexistence of the specialist pharmacy professional (viz. graduate and postgraduate Pharmacists) at the delivery points of the health care system. This is due to the reason that the Ministry of Health and Family Welfare of our country has not made it mandatory to employ specialist Pharmacists at the hospital pharmacies and other service points of the healthcare delivery system of our country.

This sort of Pharmacy professionals deficiency is greatly affecting the trials and quality of the health care deliveries of three other professionals to our people and finally causing a bad impact on our economy loss. No kind of professionals but graduate and postgraduate Pharmacists are the skilled professionals to ensure good quality pharmacy services in the healthcare delivery system. It is one of the major requirements for the health institutions of all countries of the world that registered graduate and postgraduate Pharmacists are to be employed in hospital pharmacies etc for providing necessary quality and standard of pharmacy services to the patients. So, why should it not be regarded and followed in our country also? Our government has to incorporate, encourage and support an inter-professional approach in hospitals and other healthcare institutions; and that graduate and postgraduate pharmacists are positioned as integral members of the interdisciplinary healthcare professionals’ team in hospitals and that Pharmacists are authorized to be actively involved in designing the institution’s medication use and medication management activities. Hospitals are the main surge points of health care service delivery to the people. The employment of a sufficient number of graduate and postgraduate Pharmacists in our hospital pharmacies will definitely and quickly improve the required quality of our hospital pharmacies.

As Pharmacists, it is our satisfaction to note that we are producing high-quality pharmaceuticals in our pharmaceutical industries and exporting that to 67 countries of the world. Therefore, I am confident that if graduate and postgraduate Pharmacists are employed in our hospitals, they will sharply improve the quality and standard of the pharmacy services of our hospitals and that will finally synchronize positive impact to the coordinated efforts of the healthcare professionals to ensure better quality health care to our people. It is pleasing to note that more than twenty universities (both public and private) are now producing high-quality graduate Pharmacists in our country. Thus, by this time, in this country, we have enough graduate and postgraduate Pharmacists who are available and are worthy to be employed in hospital pharmacies to upgrade the quality and standard of pharmacy services. Graduate and postgraduate Pharmacists keep good academic knowledge to share institutional care with patients in coordination with other professionals of the health care team of the hospitals. Pharmacists are well educated on infection prevention and control, correction of medication-related problems, rational utilization of drugs, checking and monitoring drug interactions, controlling adverse drug reactions, checking for contraindications, performing patient counseling, provision of clinical pharmacy for drug and disease management and for the provision of pharmaceutical care to the patients and the people.

Graduate pharmacists can participate in health-oriented educational programs of hospitals for patients and allied health members. Pharmacists educate patients on the safe use of drugs and poison-prevention measures. Pharmacists can initiate or participate in research activities in hospitals for the advancement of medical knowledge against disease & its treatment and investigational drugs. Pharmacists can provide unbiased and dependable drug information for all health professionals in hospitals. Pharmacists can carry on pharmacokinetic studies involving individualization of drug dosing in patients, biopharmaceutical studies of drug products and radiopharmaceutical dosage formulations, and pharmacoeconomic studies, as well as administrative and professional studies on drug-distribution systems and drug-utilization review studies.

Our graduate and postgraduate Pharmacists will also be competent in delivering those services and can also manufacture all kinds of dosage forms including total intravenous nutrients and safer intravenous admixture responsibilities dependably in the hospitals, obviously through designing and building appropriate setup in the manufacturing area of the hospital pharmacy departments. Thus, through the appointment of graduate and postgraduate hospital Pharmacists, we can have total pharmacy care in our hospitals. And thereby our hospitals will be always self-reliant in respect of the supply of good quality drugs and their appropriate utilization to ascertain better quality of health care to our people through interdisciplinary health professionals’ endeavors.

(Writer: Mohammed Younus, B.Pharm (Hon’s), PGT (HIV/AIDS) Harvard, PGT (Paed. HIV/AIDS) Baylor.)

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