According to the Royal Pharmaceutical Society ‘Medicines optimisation represents that step change. It is a patient-focused approach to getting the best from investment in and use of medicines that requires a holistic approach, an enhanced level of patient centred professionalism, and partnership between clinical professionals and a patient’.
I believe medicines optimisation is about ensuring that patients receive the right kind of medication at the right time and medicines use review is a step towards the direction in achieving this. It focuses on making patients get the best out of their medicines.
Evidence has shown that a good number of medicines prescribed end up not being taken due to lack of concordance and compliance.
My experience in community pharmacy with patient returned medication has shown that patients who do not understand the rationale for prescribed medication are more likely not to use the medication.
Also medication which are preventative in nature are at a higher risk of non-compliance as patients do not see the immediate benefits of taking such medication.
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 entered 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.
Social prescribing and befriending services can help curb loneliness especially in the elderly as loneliness contributes to depression and could make dementia related symptoms worse.
Outcome in healthcare delivery has seen some improvements when patients have been through some social prescribing when their domestic needs are met and they at least have some form of social life and social activity, this leads to improved wellbeing and mood which in turn contributes remarkably to the disease management outcome.
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.
Factors such as wrong medication formulation could deter a patient from taking their medication; for instance a patient with swallowing difficulties would benefit from having solid medication forms converted to liquid preparations or orodispersible forms where appropriate.
Also the use of multiple dosage eye drops in the case of a glaucoma patient could be impaired if the patient is suffering from Parkinson’s disease or arthritis, as the patient is not able to instil drops into the eye. Such patient would benefit from an eye dropper device or single dose eye drop preparation.
It is during the medication review process that such issues are discussed and problems of non-compliance solved.
In the course of completing a medication review with one of my patients, It came to light why patient’s chronic obstructive pulmonary disease (COPD) was not well managed .This patient happened to be visually impaired and was unable to read the small typed instructions on the dispensing label and so assumed tiotropium capsules needed to be swallowed whole and not inserted into the inhalation device.
After I offered education, guidance and support to this patient, the patient was able to use her inhaler as intended and her COPD symptoms were well controlled eventually. In this case a possible COPD exacerbation or even hospital admission was prevented.
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.
Multidisciplinary team approach is needed where every member of the health care team contributes their expertise in patient centred care.
Integrated health care approach will 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.
The role of the pharmacist in medicines optimisation and patient centred care cannot be overemphasized.
Adaku Efuribe is a Clinical Pharmacist and Independent Prescriber (specialising in pain management and general medicine).She is a United Nations Sustainable Development Goal Advocate and continues to advocate for better healthcare systems for all.
GE Healthcare Launches Versana Ultrasound Machines to Drive Access to Affordable and Quality Healthcare in Uganda
GE Healthcare team displaying the Versana Premier and Versana Essential Ultrasound machines during the Uganda Society for Advancement of Radiology and Imaging Conference (USOFARI).
This innovative system is well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care
KAMPALA, Uganda, November 11, 2019- GE Healthcare has announced the launch of Versana Premier and Versana Essential for the first time in Uganda. The launch was announced during the Uganda Society for Advancement of Radiology and Imaging Conference (USOFARI).
Versana Premier is a world-class ultrasound designed for peace of mind, easy to use and easy to own. The Versana Premier ultrasound system can help deliver high-quality, personalized care, patient after patient, day after busy day. This innovative system is well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care. It also comes with local product and clinical training to help healthcare professionals gain comfort and proficiency with the system to enhance patient care.
Versana Essential is a complete ultrasound solution that healthcare professionals can learn to use quickly and productively. It enables confident clinical decision making for quick referrals and immediate clinical correlation to help scan a wide range of patients. The machine is designed with the growing medical center in mind, to provide the clinical capability and support they want without compromising the quality, reliability, and affordability needed.
Both Versana Premier and Versana Essential are part of the Versana ultrasound family, which comprises of solutions that help to empower care without compromise, balancing capability, affordability, and reliability. These innovative systems found within the GE Healthcare Primary Care Ultrasound Segment are well suited for general practice clinics, physical check-up centers, community health clinics, and other facilities offering basic medical care.
“We are excited to participate in this year’s USOFARI conference together with other private and public partners in an effort to continue providing the latest imaging solutions to enhance early detection of diseases and ultimately the most appropriate treatment for patients,” said Andrew Waititu, General Manager, GE Healthcare East Africa. “The launch of Versana Premier and Versana Essential is a testament of our continuous investment in innovations that help to drive access to affordable and quality healthcare for all across Uganda.”
Also Read Meet Mariatheresa S. Kadushi, Founder of M-afya, A Mobile App Providing Health Information In Native Languages In Africa
Universal Health Coverage (UHC) is part of the United Nations sustainable development goals, to ensure that every person, everywhere, should have access to quality healthcare. As part of its vision 2040 and the health sector development plan, Uganda seeks to accelerate movement towards UHC with among others, essential health and related services needed for promotion of a healthy and productive life.
Understanding Nutrition History For A Healthier Life
Pounded yam with vegetable soup (Image: Simplinatural)
“We are less healthy today than our ancestors. By disregarding traditions, we’ve predisposed ourselves to genetic damage.” Catherine Shanahan M.D author of Deep Nutrition.
It’s the 21st century and the machines, computers, social media and tech drivers are here. Giant strides in medical science, engineering, technology has made life better and easier for us. We were supposed to be a very healthy and wealthy generation but instead we started to get sicker and unhealthier. Over the last 50 years cardiovascular related health issues is the number one killer of men and women worldwide according to a WHO report.
Our diets changed and so did our bodies and health. We deciphered so many hypotheses of what could be the problem. We thought it was inadequate exercise, so we exercised more but nothing changed. Whenever we thought we knew the answer to what was happening to our health decline, we realised we were right back where we started from. We continued to grapple with modern diseases medical science seems unable to mitigate.
What does history have to do with our health?
The year is 1901 and my maternal Grandmother is preparing dinner of Amala and ewedu soup (Yam flour and a vegetable). She prepares the dinner just before sun down and gives her large family to eat. Three times in a week, she prepares the same type of meal. However, unknown to my grandmother was the fact that the fermentation process during yam flour processing had converted the starch present in the yam into more complex nutrients like minerals and vitamins by the help of a bacteria called lactobacilli.
Fermentation converts starch(sugar) to lactic acid leaving by-products like beneficial minerals, vitamins that the gut uses to produce important neurotransmitters like serotonin. Serotonin is responsible for regulating sleep, appetite, moods and pain inhibition in the brain but its production is influenced by the billions of friendly bacteria like lactobacilli in the gut. She knows nothing about the science behind what she prepares for her family but from observation over time along with thousands of other women, she knows that a good meal of amala was easily digestible, filling and kept everyone happy.
It’s the 21st century and we no longer sprout our grains for their beneficial vitamins and minerals but cart them off for processing and our diet high in refined sugar and processed oils have now started to harm our brain. Our cells are weak from oxidative stress and inflammation but we continue to eat these modern diets.
We see a spike in suicide rates and depression amongst young people all over the world with no end in sight. Maybe this is the right time to begin to study nutrition history. What worked in the past? What did our ancestors eat that made them strong and healthy? More evidence in nutritional psychiatry are starting to show a connection between what we eat and how we feel.
A critical look into traditional African diets show a rich healthy source of nutrition based on what is now known as the four pillars of the human diet according to Catherine Shanahan author of best-selling book, Deep Nutrition. What is fascinating is how African dishes combine every aspect of the four pillars of the human nutrition making it one of the most nutritious and earlier diet in the world.
Fermented food: delicacies like kunu (fermented millet drink) masa (fermented rice fried in oil) beautifully incorporate food techniques like fermentation ensuring adequate gut health and microbial balance in the body.
Organ meat: Organ meat known to contain vital vitamins are extensively used in preparing soups broth popularly known as pepper soup in southern Nigeria. It is also eaten with other delicious dishes.
Meat on the bone: dishes with meat containing bones are known to provide collagen and body building nutrient and a Nigerian dish that incorporates this is miyankuka dish(a favourite) from northern Nigeria.
Sprouted foods: sprouting known to convert carbohydrate in grains to complex nutrients like vitamins and mineral was on e of the ways our ancestors could successfully grind their grains to powdery usable forms. A traditional African dish that incorporate the technique is Eyin drink from the north central part of Nigeria.
Healthy nutritious diet is delicious, natural and better. Our generation advanced in technology, science and knowledge but needs to pay attention to a vital part of history- our nutritional history. History tell us what’s worked in the past and what’s not working now. It’s time we change the trend once again and return to our roots.
Deborah Ogwuche is the creative director and founder of Food Channel Africa, a 24-hour television channel dedicated to showcasing African cuisines. She is a published author, a food blogger and a healthy food advocate.
Email: [email protected]
Innovate for Life (I4L) Program 2020 for Health Innovators
Applications are open for the Innovate for Life (I4L) Program 2020 for Health Innovators. The Innovate for Life (I4L) program is centered around developing shared value partnerships between Amref country offices and health innovators to support health innovations from around the world scale in SSA and address major health challenges in the region.
Deadline: November 30, 2019
Through this mission, I4L aims to catalyze innovation for the creation of lasting health change in Africa, which supports the overall vision, mission, and promise of Amref Health Africa. I4L combines health knowledge, capacity, and networks, business and leadership coaching, and partnership acceleration for innovators in the program.
The program will leverage a combination of in-person and remote work, online courses and workshops, and independent learning and co-creation. The program will be composed of three key phases:
- Phase 1: Scouting – Over 3 months, I4L will understand Amref country office programmatic needs, source global innovators based on these needs, and select and match innovators to country office programs
- Phase 2: Core Programming – Over 5 months, I4L will hold an orientation, lead business and leadership coaching, and co-create partnerships between health innovators and Amref country offices. These activities will lead to the development of a partnership proposal that can be signed during the completion of this phase
- Phase 3: Follow Up – Ongoing after completion of the core program, I4L will monitor the progress of I4L innovators and the developed shared value solutions from the core program and continue to provide support through pilot implementation and/or alumni programming
I4L’s value proposition will be centred around leveraging Amref’s strengths as a leading health NGO in Africa to support the scale of innovations, specifically:
- Affiliation with the Amref brand to gain industry credibility;
- Access to Amref experts and entities;
- In-country health knowledge, capacity, and networks;
- Business and leadership coaching from an experienced Amref business partner;
- Development and implementation of strategic partnerships with Amref programs;
- And an alumni network and access to Amref conferences and events on an ongoing basis.
They are looking for passionate health innovators who have a proven business and health impact model, have tested their innovation for scale in SSA, and fit the needs of Amref country offices to enable a demand-driven innovation program and strong partnerships for scale.
In specific, the future I4L innovator should:
- Have an innovative solution in Ethiopia in any of the following areas: NCDs, CDs and WASH;
- Have an innovative solution in Kenya in any of the following areas: HIV/TB/Malaria/NCDs, RMNCAH and WASH & NTDs. Special interest to innovations targeting behavioral change and data collation in the aforementioned thematic areas;
- Have a proof-of-concept innovation with demonstrated business viability;
- Have proof of testing the innovation in the Kenyan or Ethiopian market; for example, a feasibility assessment, registration, and/or launch of the innovation in this geography;
- Be interested in scaling their innovation through a partnership with one or many Amref program(s).
Application Click here to apply
For more information, visit Innovate for Life (I4L) Program.
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