1. Access to pharmacists is access to health

2. I My Pharmacist!

3. Introduction
 World Pharmacists Day (HBD FIP@102!)
 Aptness of Theme (Access to Pharmacists is Access to
Health)
 Pharmacy in Healthcare
 Linkages of Pharmacy to Nigerian National Healthcare
 Timelines/Evolution in Pharmacy
 Issues in Pharmacy
 Emerging Opportunities
 Focus on Ondo State
 A Gaze into the Crystal Ball
 Summary
 Conclusion

4. Key Considerations in Effective
Healthcare Delivery
 Access
 Quality
 Affordability

5. Pharmacy in Healthcare
 Role of Pharmacy in Healthcare
 Traditionally..
 regarded as a transitional discipline
between the health and chemical sciences
 Seen as a profession charged with ensuring
the safe use of medication

6. Pharmacy in Healthcare
 Role of Pharmacy in Healthcare
 Traditionally..
 Some aspects of the profession have been
constant, unchanged over centuries –
 the focus on helping patients deal with
maladies,
 the ability to apply contemporary
understanding of science and technology to
health-related issues, and
 the ethical mandate to place the patient at the
center of all we do as pharmacists.

7. Pharmacy in Healthcare
 Role of Pharmacy in Healthcare
 Contemporary..
 Pharmacists are currently recognized as drug
experts whose role is to work in collaboration
with patients, physicians and other health care
professionals to optimize medication management
to produce positive health outcomes.
 Pharmaceutical Care embodies a patient-centered,
outcomes-oriented practice of
pharmacy. This practice model promotes the
Pharmacist as a key member of the
healthcare team, with responsibility for the
outcomes of medication therapy.

8. Pharmacy in Healthcare
 Role of Pharmacy in Healthcare
 Contemporary..
 The ability of pharmacists to provide true
"pharmaceutical care“ hinges on:
 the redesign of the traditional pharmacy environment and
services,
 "revolutionary changes" such as private consulting areas in
pharmacies
 "adding value" to the pharmacist license via expanded
patient services.
 Immunization clinics, emergency contraceptives, and
collaborative practice provisions for optimal medication
therapy management.

9. Pharmacy in Healthcare
 Role of Pharmacy in Healthcare
 Contemporary..
 Need to raise the profile of the
Pharmacist from a quiet but valuable
member of the Healthcare team to a
more visible and vital component of
patient care.

10. Pharmacy in Healthcare
 Linkages through the National Health Policy
(NHP)
 Goal of NHP: Comprehensive Healthcare System
based on Primary Healthcare (PHC)-Promotive,
Protective, Preventive, Restorative & Rehabilitative
 Key PHC Elements:
 Education about prevailing Health problems
and methods of prevention/control
 Prevention and Control of locally endemic
and epidemic diseases
 Provision of Essential Drugs and Supplies

11. Pharmacy in Healthcare
 Linkages through the National Drug Policy
(NDP)
 Goals of NDP:
 Improve Quality of Healthcare through the Rational Use of
Drugs
 Make available (Access) at all times, Drugs which are
Effective, Affordable, Safe and of Good Quality throughout
the Healthcare System
 Key Success Factor For NDP:
 Qualified & Duly Registered Pharmacists in
ALL Community Pharmacies &
Hospital/Health Systems

12. Pharmacy in Healthcare
 Linkages through the National Health
Insurance Scheme (NHIS)
 Goal of NHIS:
 Improve the Health of All Nigerians at an
Affordable Cost
 Key Success Factor For NHIS:
 Re-Classify Pharmacist as Primary
Healthcare Providers with direct payment
from NHIS for Services Rendered

13. Time-lines in Pharmacy Practice
 Early 1900s- Pharmacists fulfilled the
role of Apothecary
 —preparing drug products secundum artem
(according to the art) for medicinal use.
 At a point there was an Apothecary-General
 By the 1950s,
 Large-scale manufacturing of medicinal products
 Introduction of prescription-only legal status for most
therapeutic agents
 Consequence: limited the role of Pharmacists to
compounding, dispensing and labelling prefabricated
products.”

14. Time-lines in Pharmacy Practice
 Mid-1960s- Clinical Pharmacy:
Evolution toward a more patient-oriented
practice
 rapid transition characterized by an
expansion and integration of professional
functions,
 increased professional diversity and
closer interaction with physicians and
other health care

15. Time-lines in Pharmacy
 Early 1990s - Pharmaceutical Care Model
 adopted to emphasize that the role of the
Pharmacist involves “the responsible
provision of drug therapy for the
purpose of achieving definite outcomes
that improve a patient's quality of life.”

16. Evolution in Nomenclature
 Apothecaries: Dates back to 1600’s. legally ratified
members of the medical profession, able to prescribe as
well as dispense medicines.
 Still in use in USA
 Pharmaceutical Chemist/Chemist
 in Australia, New Zealand, and the UK, a pharmacy is
often referred to as “the chemist.” 19th Century.
 Druggist
 A druggist was a pharmacist who owned a pharmacy,
 Pharmacist: Dates back to 18th Century in UK

17. Pharmacy Training
 Apprenticeship
 Pharmacy Extern
 Pharmacy Intern
 Academic
 Diploma
 Degree
 B.Sc
 B.Pharm
 Pharm. D
 Specialisation
 Continuing Professional Education

18. Evolution in Training
 Apprenticeship
 an aspiring apothecary, would work side-by-
side with the established professional
practitioner,
 learning by observing and doing
medication-related activities
 under the tutelage of the master
craftsman or “master”

19. Evolution in
Training…Apprenticeship
 Student Pharmacist required to complete
a period of practical experience under a
Practitioner approved by the Pharmacy
Board
 “Pharmacy Extern”: hours, usually
totalling nearly a year overall, could be
completed during the summers between
terms of enrollment in classes.
 “Pharmacy Intern”: Total hours
completed following graduation.

20. Evolution in Training…University
Degree USA
 1820’s to 1860’s: Private Pharmacy
Schools operating as Independent
Colleges were the Pioneers of University
Education for Pharmacists
 1940s (WW2 era): Schools/Colleges
became affiliated with Universities (many
of which were Public Uni’s)
 academic health centres began to
emerge at U.S. universities as clusters of
schools of the health professions
assembled with a university hospital

21. Evolution in Training…University
Degree USA
 1820’s to 1860’s: Private Pharmacy
Schools/Colleges
 1940s (WW2 era): Schools/Colleges
became affiliated with Universities
 Academic Health Centres (schools of the
health professions assembled with a
university hospital)
 providing patient care
 educating future professionals. Many of
these operations included colleges of
pharmacy.

22. Evolution in Training…University
Degree USA
 1821: First college to train Pharmacists
in the U.S.-Philadelphia College of
Pharmacy.
 1823: Second college was the
Massachusetts College of Pharmacy,
now the Massachusetts College of
Pharmacy and Health Sciences
 1860’s: First Pharmacy program in a
public institution at the University of
Michigan

23. Evolution in Training…University
Degree USA: Curriculum (1)
 In the 1800s,
 colleges of pharmacy offered the
academic degree Graduate in Pharmacy
(Ph.G.).
 For an additional year of study the
student would be awarded the degree
Pharmaceutical Chemist (Ph.C.)
 even further study could earn the
student the degree Doctor of Pharmacy
(Phar.D.).

24. Evolution in Training…University
Degree USA: Curriculum (2)
 1940s: B.Sc (4 years)
 B.S.Pharm (5 years) Professional Degree
 1990s: Pharm.D (6 years)
 Nigeria
 Diploma
 B.Sc
 B.Pharm
 Pharm.D??

25. Evolution in Training…University
Degree USA: Focus
 1800s: Chemistry- Prepare & Dispense
Medications
 Early 1900’s: Prepare & Dispense Medications +
Clinical Chemistry eg Urinalysis
 1960’s: The Chemical focus gradually
transferred over to a biological focus during the
with increasing emphasis on pharmacology
 1970’s: A Clinical focus moving the emphasis
from the product to the patient.
 1990’s: Pharmaceutical care- A new philosophy
of Pharmacy Practice was advanced by Helper
and Strand.

26. Evolution in Training: Licensure
 USA: Exams designed to assess whether the
licensure applicant possesses the minimum
competence to be admitted to practice as well
as to assess the licensure candidate’s
knowledge in the areas of Pharmacy Laws.
 Nigeria: No Exams. Only completion of a 12
month period of internship required.
 Once licensed the Pharmacist has a
Professional, Ethical and Legal obligation to
maintain competence to practice.

27. Pharmacy Schools in Nigeria
 1 Faculty of Pharmacy, University of Ibadan, lbadan. OyO State
 2 Faculty of Pharmacy, University of Lagos, Lagos, Lagos State
 3 Faculty of Pharmaceutical Sciences, Ahmadu Bello University.
Zaria.
 4 FacuIty of Pharmaceutical Sciences, University of Nsukka.
 5 Faculty of Pharmaceutical Sciences, University of Jos, Jos, Plateau
State
 6 Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife,
Osun State
 7 Faculty of Pharmacy, Olabisi Onabanjo University, .Sagamu. Ogun
State
 8 Faculty of Pharmacy, University of Uyo, UyO, Akwa Ibom State
 9 Facultv of Pharmacy, University of Benin, Benin City, Edo State

28. Pharmacy Schools in Nigeria
 10 Faculty of Pharmacy, Niger Delta University. Wilberforce Island
Bayelsa
 11 Facultv of Pharmacy, Madonna University of Elele, Rivers State
 I2 Faculty of Pharmacy, University of Maduguri, Maiduguri, borno
State
 13 Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University,
Awka
 14 Faculty of Pharmacy, Igbinedion University, Okada Edo State
 15 Faculty of Pharmaceutical Sciences, Unveristy of Port-Harcourt,
 Port-Harcourt, River State
 16 Faculty of Pharmaceutical Sciences, Usmanu Danfodiyo
University

29. Issues
 Rapid Change in Healthcare Delivery
 Significant Growth & Development
Opportunities for Pharmacy
 Expansion of the scope of Pharmacy
Practice and,
 in some jurisdictions, the assumption of the
authority to prescribe medications in
defined situations.
 Considerable Ambiguity & Uncertainty by
Outsiders

30. Issues
 Rapid Change in Healthcare Delivery
 Significant Growth & Development
Opportunities for Pharmacy
 Assumption of the authority to prescribe
medications in defined situations.
 USA: Collaborative Drug Therapy Management
by Pharmacists
 UK: Independent & Dependent Prescribing
Rights for Pharmacists
 Canada: Alberta—“adapting a prescription”— &
“initiating/managing drug therapy.”
 Nigeria: National Prescription Drug Policy (work
in progress) to include Pharmacists as
Prescribers of “Safe Medicines” (20 Categories)

31. Issues
 Prominence in Community
 Health Systems Pharmacy vs Hospital
Pharmacy
 IT in Pharmacy
 E-Prescribing
 E-Patient Health Records
 E-Dispensing
 Veterinary Pharmacy

32. Emerging Opportunities
 Public Health and Chronic Conditions
 Pharmacist-Initiated Prescription
 Ondo State Govt Positive Disposition
to Pharmacists
 Reference OSPHCDB
 Career Pathway for Govt Pharmacists
 NDDC/SDDC PPP with Pharmacists
 Ambulance Services Pharmacist

33. Change Management for New
Laws/Regulations/Guidelines
Vision
Success
Sysytems
Neccesity
Capabilities Structures

34. New Drug Distribution Guidelines
 Introduced in March 2011
 Sanctions for Non-Compliance expected to
commence with effect from 12th July 2012, Now
shifted till 2015.
 Does it pass the test?
 Necessity & Vision? A resounding YES.
 Are the necessary Structures, Capabilities &
Systems in place to ensure Success? A big NO!
 What should be the right spirit? Create
Awareness, Interest and Participation of major
stakeholders. Address Concerns raised. Run a
Pilot Scheme in a few locations.

35. Public health and chronic
conditions
 Resources to help with health
promotion,
 preventing disease and
 supporting people with chronic
conditions

36. Public health and chronic
conditions
 Alcohol use disorders
 Asthma: Supporting patients with
asthma
 Bowel cancer
 Chronic obstructive pulmonary
disease (COPD): Supporting patients
with COPD
 Dementia: Pharmacy & the call-to-action
resources

37. Public health and chronic
conditions
 Diabetes (blood glucose and
cholesterol screenings)
 Hygiene & Infectious Diseases
(EBOLA)
 Immunization/Vaccines
 Lung cancer
 Mental health
 Obesity and weight management

38. Public health and chronic
conditions
 Sexual health
 Smoking cessation
 Supporting patients on oral anti-coagulants

39. Services you can get from your
Pharmacist in Nigeria (ACPN):
Counselling
Medication Therapy Management (MTM)
Disease prevention strategies erms
Immunization
Rapid tests (Cholesterol, Blood Pressure,
Sugar, Malaria, Hepatitis, etc.)
HIV counselling and testing
Family planning

40. Services you can get from your
Pharmacist in Nigeria (ACPN):
Family wellness
Pharmaceutical care for chronic conditions
like (Hypertension, Diabetes, etc)
Medication Use Review (MUR)
Drug Information (DI)
Documentation of your medical matters for
continuum of care
Online consulting.

41. Services you can get from your
Pharmacist in Nigeria (ACPN):
Home delivery
Home visits
Referral to other Healthcare Providers
Public health Services and Campaign
First Aid kits
Training

42. Ondo State: Leader in Healthcare
Systems Achievements
 Abiye
 Agbebiye
 ORIREWA
 OSPHCDB describes Primary
Healthcare as: “a diverse field which
encompasses a wide range of health
Professionals such as Pharmacists,
Doctors, Nurses, Allied Health
Workers and Dentists.”

43. Ondo State Primary Health Care
Development Board
 • Goal 1: Control preventable diseases
 • Goal 2: Improve access to basic health
services
 • Goal 3: Improve quality of care
 • Goal 4: Strengthen the Institution
 • Goal 5: Develop a high-performing
and empowered health workforce
 • Goal 6: Strengthen partnerships
 • Goal 7: Engage communities

44. Pharmacy Stats: Ondo State
 Number of Pharmacists: 130 (PCN 2012)
 State Population:3,460,877 (2006 Census)
 Pharmacist/Population
Ratio:1/26,222(3.75/100,000)
 National Pharmacist/Population Ratio:1/14,941
(6.69/100,000)
 WHO Pharmacist/Population Ratio:1/2000
(50/100,000). USA: 85/100,000

45. Pharmacy Stats: Ondo State
 Pharmacy Distribution
 Manufacturer: 1 (Tisco)
 Importers: 2 (Ideal Eagles/Silvahill)
 Wholesalers+Distributors: 14+2 (Akure: 8
+2, Ondo: 5 , Igbokoda: 1
 Retailers: 20 (Akure:13, Ondo:3, Ikare:2,
Igbokoda:1, Owo:1)
 Hospital???

46. Healthcare Facilities Stats:
Ondo State
 Primary Healthcare: 769
 Secondary Healthcare: 40
 Tertiary Healthcare: 2
 Total: 811
 Akure-183; Akoko-129; Ondo-88;
Odigbo-76; Idanre-59; Ilaje/Ese-
Odo-58; Owo-43; Okitipupa-40; Ile-
Oluji/Okeigbo-40; Others-95
 Ref: FMOH Directory 2011

47. What does the future look like for
Pharmacy & Pharmacists? (1)
 The future is limited only by the
imaginations and abilities of those entering
and leading the profession.
 Change is a certainty – will you be
positioned to capitalize on opportunities as
they emerge and evolve?
 “It is not the strongest of the species that
survives, nor the most intelligent that
survives, but the one most responsive to
change.” Charles Darwin.

48. What does the future look like for
Pharmacy & Pharmacists? (2)
 Globally
 Bright and Rewarding
 very highly regarded by individual
patients and the public collectively
 Locally
 Community > Hospital
 Need to reposition Pharmacy as Central
to Healthcare by offering more Value
Added Services to the Consumer

49. What does the future look like for
Pharmacy & Pharmacists? (3)
 Do Pharmacists have knowledge and abilities to
provide services valued by others?
 Can their services have a positive impact on
others?
 Are they accessible so people can avail themselves
of these services?
 24/7
 Call Centre
 Can Pharmacists discern emerging trends and
opportunities to advance the profession and
themselves?
 Chain Pharmacies?
 Public Health?

50. What does the future look like for
Pharmacy & Pharmacists? (4)
 “As the leading healthcare authority on
medication, the pharmacist is the most logical
member of a total healthcare management
team to gauge the usage and efficacy of
medication, patients’ medication use patterns
and alternative therapies,”
 Plus, no one is better equipped to keep costly
medication mistakes from happening than
Pharmacists.

51. What does the future look like for
Pharmacy & Pharmacists? (5)
 The potential for a medication error is
particularly high when a patient leaves the
hospital with new medications and has old ones
at home.
 Add to that the mix of prescriptions with over-the-
counter medications and supplements –
often from a variety of doctors:
 It’s a “prescription” for trouble that has a
simple remedy:
 Increased ACCESS to the One Healthcare
Professional overseeing it all:
 The Pharmacist.

52. Summary
 The Future of Pharmacy
 Depends to a great extent on:
 the Pharmacists ability to INNOVATE
 ETHICS, INTEGRITY & PROFESSIONALISM
 Pharmacy’s ability to demonstrate its
RELEVANCE by creating VALUE for
Patients/Consumers/Customers/Chain
members
 ALERTNESS, COHESION, ARTICULATION, &
POLITICAL SAVVY to institute Friendly Laws &
Policies as well as to pre-empt and counteract
unfriendly laws
Remi ADESEUN

53. Conclusion
 “Those that are creative,
entrepreneurial and able to develop a
value-added “Win-Win” approach will
find more opportunities.”
 ACCESS TO PHARMACISTS IS
ACCESS TO HEALTH!

54. What will Success Look Like?
When the Patient/Consumer Says...
I Really Do...

55. Pharmacists: Tested & Trusted!

56. Thank You!
Contact Information:
Remi ADESEUN FPSN, FNAPharm
Chairman
Rodot Group
.Healthcare
.Architecture
.Consulting
08057713769/07065156473
r.adeseun@rodot.org
radeseun@gmail.com