27 September 2015:
On Friday I had the pleasure of participating in the Annual General Meeting (AGM) of the Pharmaceutical Society of Uganda (PSU). This event draws 300-400 of all of the Pharmacists in Uganda (out of a total of 746 pharmacists) to a gathering where they spend 2 days together learning about everything from the State of Pharmacy Practice in the country to new regulations and laws being considered that affect them, to a synopsis of new taxation laws that affect pharmacists and pharmacy owners to issues of Pharmacovigilance (drug safety) and much more. I had attended a small part of this meeting back in 2013 to administer a survey on the state of Pharmaceutical Care (PC) I had developed with the Secretary of the PSU, Sam Opio, and a faculty member at Makerere University, Robert Otto. But this year, I was thrilled to be an invited speaker!
Up until today, the work I’ve been doing along side faculty at Makerere University, with Pharmacists at Mulago National Referral Hospital, and with the Ugandan Pharmacist participants of the 8 week Pharmaceutical Care training Program in the USA was known to only a few handfuls of Pharmacists in Uganda. The wave of interest for advancing Pharmaceutical Care to Improve Safe Medication Use has significantly grown among pharmacists, healthcare administrators, and other healthcare professionals over the past few years in Uganda. PSU asked me to talk about how the PC efforts of the USA and other countries are improving both patient care and the economic use of drug products, the state of implementation of PC in Uganda today, and to offer suggestions on how to strengthen PC in Uganda. From the questioning and comments, it was clear to me the presentation was well received. One of the participants thanked me for motivating them to engage more in PC activities and for giving them a lot of specific examples for how to do this.
I am also happy that I was able to stay within my allotted time frame for this presentation, which was 20 min. Unfortunately because the program started 30-45 minutes late and the morning tea time and the time for questioning of the first few speakers went really long, lunch was delayed and this made the audience a little antsy. This is a pretty common occurrence for the programs I’ve attended here. What ends up happening is that the longer the time past lunch, the less time they give you for your talk, so for example, even if they told you to prepare for 20 minutes, they might, on the spur of the moment, tell you to take only 10min or even less. The final speaker before lunch was talking about a very important topic- Pharmacovigilance. She was Huldah Nassali, the Drug Information Officer for the National Drug Authority, which is like our FDA.
Unfortunately her talk was greatly cut down in time but her worthy goal was to motivate Pharmacists to increase their reporting of Adverse Drug Reactions (ADRs) they see in patients they’ve treated. She had developed a tool to do this to assist them. This is a very important role of a Pharmacist because we are often the last person in the chain to talk with a patient who has had a drug prescribed and the first person they come back to when a bad reaction occurs. Through the tracking of ADRs, we, as pharmacists, can detect serious drug safety issues and improve overall medication safety.
After a delicious lunch buffet of the traditional Ugandan foods we heard presentations on antimicrobial resistance in isolates of Neisseria gonorrhea from infection in male patients at the Mulago Hospital STI clinic, and the Use and Practice of Radiopharmaceuticals in Uganda. Currently there is only 1 Radiopharmaceutical pharmacist at Mulago who is ready to retire so there is a desperate need to encourage some young pharmacists to pursue this training and take his place. Sulah Balikuna, a pharmacy faculty from Makerere University whom I’ve worked with in the past then gave a very interesting talk on Pharmacoeconomic Analyses. This is definitely something that the Pharmacy Administrators need to work on at the government facilities. Currently many of the antibiotics being used at Mulago are likely having high resistance rates yet alternatives would be very much more expensive. A Cost-Effectiveness analysis could help to show that continuing to spend less money on drugs, but on drugs that don’t work and the patients stay sick longer and in the hospital longer, is actually not as economically beneficial as spending a little more on drugs that can cure patients faster and reduce complications and length of hospital stay.
Since the afternoon sessions started late due to the morning late start and a late lunch, all of the speakers times were cut down significantly and what happened to the Pharmacovigilance speaker in the morning also happened to Sulah and then to Cathy Namulindwa, one of the pharmacists who studied with me in the States this summer. She talked about the implementation of Pharmaceutical Care in Uganda from a slightly different perspective but end up being cut off early. I was proud of her as she was sharing some of the information she had learned – this definitely is the start of the positive outcomes from the Pharmaceutical Care Training Program at Wilkes University for Ugandan Pharmacists. Although she didn’t get to finish her talk, I know that both she and Gonsha, the other PC participate this year, will be doing many more training sessions for the Pharmacists to help them increase PC services at their facilities.