VISION 2010 FOR PHARMACEUTICAL SERVICES

DISTRICT OF KOTA MARUDU

1.0 VISION 2010 FOR KOTA MARUDU DISTRICT

Optimising pharmaceutical services, enable pharmaceutical care reaching even to the most remote areas of the district.

2.0 WHY VISION 2010 IS NEEDED

To ensure all people, wherever they may be, are able to obtain continuous pharmaceutical care, medicines they need conveniently, medicines are safe and cost-effective and that they are prescribed and used rationally.

3.0 STRATEGIES TO ACHIEVE VISION 2010

3.1 Human Resource

To have pharmacy services at all health clinics by requesting and filling up more/new posts for Pharmacy Assistants. Pharmacist and senior Pharmacy Assistant U6/U7 at all regional health pharmacy units and fill up all pharmacist posts at hospitals.

3.2 Medical Supply System

a. Decentralisation of prescription refills at any convenient health institution/clinic/hospital.

Enable patients who need long term drug therapy to collect their subsequent supply of drugs

at any convenient hospital or health clinics.

b. Allow health clinics where pharmacy services and doctor are available, to keep ‘list A’

drugs for follow-up patients.

c. To use on-line information technology nekwork to implement the remote prescription order

entry.

3.3 Finance/allocation

Adequate financing/allocation is needed to provide smooth running of pharmacy services. (e.g. facilities, purchase of drugs and non-drugs)

3.4 Facilities

a. Up-grading all pharmacy units at health clinics and hospital.

b. On-line system between TPKN (Farmasi) and hospital pharmacy unit as well as regional

public health pharmacy unit.

4.0 PARADIGM SHIFT

4.1 PHARMACEUTICAL CARE

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4.1.1 Current situation

The pharmaceutical care concept of practice in pharmaceutical services has not come to its fullness in hospital Kota Marudu as well as in the health clinics. This is due to the unavailability of pharmacist in hospital and health clinics. At the present situation, the functions in the delivery of pharmaceutical care are only:-

a. Hospital without pharmacist

- Patients receive medications and supplies in a timely manner.

- Patients receive correct prescribed medications with usage instruction clearly and

completely explained to them.

- Medications that patients receive are correctly packed, labeled and safe to be used.

- In patients receive medications in the form of ‘unit of use’ system.

- Discharged patients receive medications at bed-side dispensing (starting April 2000).

b. Health Clinics where pharmacy assistant and doctor are available

Patients may not be able to receive all their medications and supplies in a timely manner

due to limited types of drugs that available at the health clinics. In all cases, patients are

referred to the nearest hospital.

c. Health Clinics where pharmacy assistant/doctor are not available

Patients may not receive any pharmaceutical care because no pharmacy services available

in such clinics.

4.1.2 Our goals

Patients are able to receive continuous pharmaceutical care and their medications wherever

they may be.

4.1.3 Strategies

a. Pharmacy services be available in all health clinics.

b. Filling up pharmacist posts in hospital pharmacy unit.

c. Set up regional public health pharmacy unit.

4.1.4 Challenges

a. Shortage of pharmacists and pharmacy assistants.

b. Shortage of funds/allocations.

4.2 MEDICAL SUPPLIES

4.2.1 Current situation

Drug supply to hospital through 2 distributors. Remedi Pharmaceuticals (M) Sdn. Bhd. For APPL drugs and Pusat Bekalan Farmasi Negeri for non-APPL drugs (LP drugs). For health clinics, non-APPL drugs are managed and distributed by district hospital integrated store whereas APPL drugs are managed by regional health office and drugs are being distributed by Remedi Pharmaceuticals(M) Sdn. Bhd. to district hospital integrated store where individual health clinics to collect.

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4.2.2 Our goals

a. Hospital and health clinics get drug supply on time.

b. Patients are able to have continuity of drug supply.

4.2.3 Strategies

a. Adequate drug allocation

b. Adequate and efficient drug supply by both distributors (Remedi and PBFN).

c. Efficient managers at district hospital integrated store.

4.3 PHARMACY MANAGEMENT

4.3.1 Current situation

Due to shortage of pharmacists, pharmacy services in hospital Kota Marudu are run without a pharmacist, only managed by pharmacy assistant U7. Therefore, pharmaceutical care that patient received is limited.

There are only three health clinics in the district of Kota Marudu where pharmacy services are available. They are managed by just one or two pharmacy assistant whereas other health clinics are operating without pharmacy services.

4.3.2 Our goals

Hospital pharmacy being managed by pharmacist so that patients can receive complete and continuous pharmaceutical care.

Pharmacy services to be available at all health clinics.

4.3.3 Strategies

Filling up pharmcist post in hospital, more training on management for senior pharmacy assistant, pharmacist and senior pharmacy assistant to be available in all regional health pharmacy unit.

4.4 CLINICAL PHARMACY

4.4.1 Current situation

At present, clinical pharmacy services such as TPN, TDM, CDR or intravenous additives facilities are not available in hospital and health clinics of Kota Marudu district. Patients are referred to Hospital Queen Elizabeth, Kota Kinabalu. In many cases, patients may not receive continuous patient care.

4.4.2 Our goals

To establish TDM service at hospital Kota Marudu. This service could be regionalized to the nearby health settings.

4.4.3 Strategies

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a. Adequate funding to provide TDM analysis of blood samples.

b. Adequately trained pharmacists and pharmacy assistant to initiate and monitor TDM

service.

4.5 PUBLIC HEALTH PHARMACY AND DRUG EDUCATION

4.5.1 Current situation

At present, drug education to public mostly through pamphlets ready by ministry of health or printed by the government. There is no availability of public health pharmacists to provide talks or forum to the public, school children.

4.5.2 Our goals

Public are given awareness towards drug education especially to those on long term drug therapy, treat themselves with OTC drugs, etc.

4.5.3 Strategies

a. Availability of pharmacist in all regional health pharmacy units.

b. Talks and forums for public and school children.

c. Drug information on drug administration intruction, storage, patient care and diet for

diseases such as hypertension, diabetes, asthma etc be available in TV program or video

tapes.

d. Set up drug information unit in hospital and health clinics where patients can get access to

web site that provide more information on drugs that they are taking.

4.6 PHARMACY TRAINING

4.6.1 Current situation

At present, the 3^rd year pharmacy assistant trainees are being trained at health clinics for 10 months and 1 month at hospital Kota Marudu through out their one year training. Whereas other pharmacy staffs are attending refresher course (in service training) once a year by turn. Every pharmacy staffs are encouraged to attend courses related to duties/work.

4.6.2 Our goals

All pharmacy staffs are well-equipped, knownledgable, having fair personality and with up-to date drug information for daily duties.

4.6.3 Strategies

a. In service training courses with test paper and certificate to ensure participants are attentive.

b. Seminars and talks for program pharmacy staffs.

c. More articles on drug education.

4.7 PHARMACOECONOMICS

4.7.1 Current siruation