|7 February 2014
THE menace of non-communicable diseases (NCD) in Malaysia, such as diabetes and hypertension, is alarming and multi-disciplinary health intervention is needed.
Data from the National Health and Morbidity Survey conducted in 2011, showed that 20.8 per cent of our population had diabetes.
As the prevalence of these disease increases, it will put a tremendous pressure on the healthcare expenditure and psychosocial aspect of the wellbeing of individuals and health providers.
Within the context of managing these diseases, majority of the patients will be put on medication to control their diseases and a good outcome of disease control can only be achieved if the patient diligently adheres to the treatment prescribed.
I congratulate the Ministry of Health for coming up with various programmes to prevent and overcome diabetes and hypertension.
Based on our research at Universiti Sains Malaysia, the majority of patients who get their treatment either from public or private practitioners are having problems managing their medication in their homes.
There is also a lot of medication wastage due to non-adherence to the prescribed therapy.
In a home medication review study conducted in Negri Sembilan among non-controlled hypertensive patients, we found that on an average a patient wastes RM50 of hypertensive medicines a month due to non-adherence.
There is no doubt that in some public hospitals there are the “pharmacist-led medication adherence clinics” in place, but the challenge is how to get the services to other small centres and in a private setting.
In private hospitals for example, the clinical pharmacy service is almost non-existent and in the majority of cases they only employ one pharmacist to run the show.
I personally had this experience when one of my friends, who was recently diagnosed with hypertension and diabetes, was discharged without being advised on the medication that was prescribed to him.
As the treatment of these diseases can be complex, it is vital to include a pharmacist in the overall patient care.
Furthermore, community pharmacists should be engaged to provide medication counselling services as well.
Over the years, community pharmacists’ image in this country has been tainted by a business model that drives high volume, price war and profiteering with little regard for quality use of medicines.
There are dedicated pharmacists in the community but because of the tainted image of their profession, their role in patient care is undervalued.
The main reason is that they are not given the avenue to show what they can do for the benefit of patients.
I know that some dedicated community pharmacists are providing free home-based counselling to patients and some collaborate closely with general medical practitioners to help improve patients’ therapeutic outcomes.
As changes in pharmacy education had transformed the extended service delivery of pharmacists in health promotion and public health, there must exist a standard practice model to enhance mutual collaboration between pharmacists and physicians in the private sector.
Assoc Prof Dr Mohamed Azmi Ahmad Hassali, Deputy Dean (Student Affairs & Networking), School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang
This article was first published in www.nst.com.my on 26th July 2013.