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Reducing the risk of medication related deaths in Nigeria

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‘As long as we have clinicians who hide the name of prescribed medication from their patients; the rate of duplication of therapy, adverse drug reactions and drug-drug interactions will continue to increase. Patients have the right to know the medicines prescribed for them’ Adaku Efuribe

As we clamour for universal health coverage and achieving the UN SDG goal3- Ensure healthy lives and promote wellbeing for all at all ages. There is one simple step we could take to help improve the health and well- being of Nigerians; we need to bridge the gap of lack of integrated healthcare and patient centred care using a multidisciplinary team (MDT) approach. We need to put the patient at the centre of care and utilise pharmacist knowledge and input if we must prescribe legally and safely.

The rate of medication related deaths due to overdose, adverse drug reaction, drug- drug interactions can be reduced through medicines reviews and medicines reconciliation.

‘As long as we have clinicians who hide the name of prescribed medication from their patients; the rate of duplication of therapy, adverse drug reactions and drug-drug interactions will continue to increase. Patients have the right to know the medicines prescribed for them’

Medicines reconciliation/review

Medicines reconciliation is a process whereby patients’ medicines are reconciled as they move between different stages of healthcare, from primary – secondary care interface.

Also Read: Meet Mariatheresa S. Kadushi, Founder of M-afya, A Mobile App Providing Health Information In Native Languages In Africa

Pharmacist led medication review tend to be more in-depth ,capturing all the essence of patient centred care as it offers more time for the patient to ask medicines related questions which enhances concordance.

The role of the pharmacist as a ‘drug expert’ is to complete medicines reconciliation and medication reviews especially for patients taking regular medication for long term conditions like Hypertension, Diabetes, Arthritis ,Asthma etc.

In a typical Nigerian Clinical setting (public and private), when a patient has contact with a clinician, most times, the patient does not have any interaction with a pharmacist. Integrated healthcare is a healthcare model where every member of the healthcare team contributes their own quota towards excellent healthcare delivery.

This true-life story about patient X shows the importance of medicines reconciliation:

 Patient X is a 65-year-old man living in Sokoto, with a history of Hypertension; he takes amlodipine 10mg tablets daily. Patient X travelled to Lagos for a business meeting and he suffered a hypertensive crisis, he got admitted in a hospital in Lagos, his blood pressure was adequately controlled and he was discharged with two other antihypertensives. Patient X did not go through the medicines reconciliation process with a pharmacist or another clinician, so when he got back to Sokoto, he continued to take his newly prescribed antihypertensives in addition to the one prescribed by his doctor in Sokoto.Few days later, Patient X suffered hypotension (low blood pressure) and had a fall on the stairway at home, breaking his hip, which made his condition worse.

A consultation with a pharmacist during the discharge /admission process could have prevented duplication of therapy, and patient educated/informed about which medication to stop/continue and also side effects to expect. Medication reviews are needed to highlight issues of blood monitoring, therapeutic drug monitoring for medicines that require special monitoring; like methotrexate, diuretics, digoxin etc. Annual blood tests are routinely checked because if dosage regimens are not adjusted or vital blood checks are not made, this may lead to increased harm to the patient or even death.

Education and support for patients on multiple medicines

Evidence has shown that when patients understand the side effects of the medication they take, they are more likely to comply with the dosage regimen. A lot of work needs to be done in the area of patient education and information provided through medicines use reviews. The gains of patient centred care cannot be overemphasised, all medical needs have to be tailored to the individual patient, considering their personal circumstances, other co-morbidities, and sometimes frailty comes into consideration for some elderly patients as well.

There has been a drive for more social prescribing, motivational counselling and interventions for patients who have suffered medical emergencies or patients with long term conditions. Evidence has shown that non-pharmacological interventions have a major role to play in achieving overall general health and wellbeing.

Integrated health care approach will reduce the risk of medication related deaths in Nigeria as well as enhance delivery of outcomes. Clinicians need to work together to ensure adequate measures are put in place and everyone contributes their own quota for effective healthcare delivery. Pharmacists are part of the MDT and their expertise need to be utilised more across clinical settings in Nigeria to help prevent medication related errors and deaths. The role of the pharmacist in medicines optimisation, medicines reconciliation and patient centred care cannot be overemphasized.

Article by Adaku Efuribe: A clinical pharmacist & UN SDG Advocate, Adaku advocates for better healthcare systems. She is also a health and wellbeing coach.

Health

Airbus and Koniku launch a disruptive biotechnology solutions for aviation security operations

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Koniku Inc.-Airbus Aircraft cabin (credit: Airbus)

Toulouse – Airbus and Koniku Inc. have made a significant step forward in the co-development of a solution for aircraft and airport security operations by extending research activities to include biological hazard detection capabilities, as well as chemical and explosive threats. 

The disruptive biotechnology solution, which was originally focused on the contactless and automated detection, tracking and location of chemicals and explosives on-board aircraft and in airports, is now being adapted in light of the COVID-19 crisis to include the identification of biological hazards.

Based on the power of odor detection and quantification found in nature, the technical solution, developed to meet the rigorous operational regulatory requirements of aircraft and airport security operations, uses genetically engineered odorant receptors that produce an alarm signal when they come into contact with the molecular compounds of the hazard or threat that they have been programmed to detect.  

Airbus and Koniku Inc. entered into a cooperation agreement in 2017, leveraging Airbus’ expertise in sensor integration and knowledge of ground and on-board security operations within the aviation and defense industries, as well as Koniku’s biotechnology know-how for automated and scalable volatile organic compound detection (via their Konikore™ platform).

Also Read: Koniku Appoints Dr. Akintoye Akindele To It’s Board of Directors

With in-situ testing planned for Q4 2020, Airbus is demonstrating its ability to accelerate traditional research cycles in a real-time environment in order to develop and bring to market a game-changing, end-to-end, security solution at convincing scale and speed, thereby contributing to the continuous improvement of security in the air transport ecosystem, while increasing operational efficiency and improving passenger experience.

Visit: Airbus

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Health

Low risk of COVID-19 in SA water systems

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There is no evidence that COVID-19 will contaminate water supplies, but the pandemic has highlighted water challenges putting communities’ health at risk, say industry stakeholders.

Panelists participating in a high-level webinar hosted by Messe Muenchen South Africa, organiser of IFAT Africa, said last week that although international scientists were using COVID-19 RNA in sewage to track the prevalence of the virus in communities, there was no evidence that COVID-19 could pose a risk via drinking water. However, the pandemic was highlighting the health risks up to 30% of the South African population faces through lack of access to piped water.

The virus does not survive waste-water treatment plant processing or the treatment for reuse, the panellists said. 

Hennie Pretorius, Industry Manager Water and Waste Water at Endress + Hauser, said: “There have been concerns that this virus could enter the water supply, but the good news is that with proper disinfection of waste water, we should not see the viruses entering rivers, and proper filtration should eliminate any risk in the drinking water supply.”

“There is no evidence of COVID-19 entering water supply systems at this stage, but even if it did, the technology exists to remove such viruses,” said Henk Smit, MD of Vovani Water Products.

Panellists said the pandemic had highlighted the health risks facing those South Africans who do not have access to treated, piped water, however.  Taking tanks of water to underserved areas raised water quality concerns, while shared taps increased communities’ risk of contracting the virus, they noted.

Also Read: COVID-19 Pandemic disrupting our food supply chain – What Next?

Achim Wurster, Chairman of the Water Institute of South Africa (WISA) said: “There could be some risks in the standpipes in poorer communities, where people congregate and touch the tap – and this is where education comes in. But we are not aware of cases of viable virus coming through treatment processes and infecting people.”

Moderator Benoit Le Roy, CEO of Enviro One, noted: “This crisis is highlighting our deficiencies. Nearly half the water we harvest, treat and convey at great cost is wasted, and we are running out of surface water and ground water. So, some of the obvious measures are to reduce, reuse and augment. But we need the political will, and the financial and risk models to implement that. I believe there is sufficient funding, technology, implementation capability and pedigree to give us water security, so that in times like this, when we have a catastrophe on our hands, we don’t exacerbate the health risks the underserved 30% of the population is exposed to.”

The panellists said that effective implementation of the Department of Water and Sanitation’s Water and Sanitation Master Plan for national water security required stepped up effort and improved public-private collaboration.

“This pandemic has brought our inefficiencies to light, and it will hopefully create more opportunities for government and private sector to sit together and find solutions, drive certain projects and get things done faster,” said Smit.

South Africa’s water supply and treatment challenges, solutions and opportunities will come under discussion at IFAT Africa, the leading trade fair for water, sewage, refuse and recycling, at Gallagher Estate in Johannesburg from July 13 to 15, 2021.

To watch the full webinar discussion, click here

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Envisionit Deep AI launches AI solution to help Radiologists and Doctors fight Coronavirus

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Dr. Jaishree Naidoo, CEO and Co-Founder of Envisionit Deep AI

Established in 2019, Envisionit Deep AI is an innovative medical technology company that utilises AI to streamline and improve medical imaging diagnosis for radiologists. They are guided by their vision to positively impact the lives of people in Africa by using revolutionary technology to democratise access to healthcare for all.

Envisionit Deep AI has just launched an online version of RADIFY, their AI solution for radiologists and medical doctors. RADIFY, in response to the COVID-19 outbreak, has been offered free of charge to support hospitals, doctors and any other public and private organisation using X-ray in the identification and treatment of COVID-19 pneumonia.

RADIFY was primarily developed to enable radiologists to diagnose more images, more consistently and in less time – whilst prioritising care for people who need it most. One of the biggest challenges facing primary healthcare in South Africa, even before COVID-19, was that they were under resourced and over used. The first line of investigation for pneumonia, and likewise COVID pneumonia, is an X-ray to pick up suspicious features that can be prioritised for further testing.

The volume of X-rays, CT scans and MRI’s generated have always outpaced the number of qualified Radiologists on hand to diagnose and generate patient reporting, creating bottlenecks in the system, often unintentionally leaving urgent cases in the queue for hours on end. RADIFY is capable of labelling 20 different pathologies on X-rays at a rate of 2,000 x-rays per minute, which is 2,000 times faster than a human being!

Also Read: These two Africans are helping businesses and individuals spend less time doing expenses with Xpensi

The chest X-Ray is the first line of investigation for COVID pneumonia because it’s the most readily available, quick and cost-effective imaging tool for the diagnosis of pneumonia – the number one killer of patients with COVID-19.  With the impending demand for testing, known shortage of specialists and the costs associated, it’s vital for healthcare to streamline this process. RADIFY can assist healthcare facilities to detect possible COVID-19 pneumonia cases in order of high, intermediate and low probability.

Dr. Jaishree Naidoo, CEO and Co-Founder: Paediatric radiologist who has served the state health care system for 20 years. Pioneered the paediatric radiology subspecialty after becoming the first South African qualified paediatric radiologist in 2010. Previously, head of paediatric radiology at Charlotte Maxeke Johannesburg academic hospital and at Nelson Mandela Children’s Hospital where she commissioned the first paediatric radiology department.

She has chaired the South African Society of Paediatric Imaging (SASPI), the African Society of Paediatric Imaging (AfSPI), serves on the Executive Council of the World Federation of Paediatric Imaging (WFPI) and African Society of Radiology (ASR)

To test the platform, visit https://radify.ai.

Visit: Envisionit Deep AI

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