Wed, Oct 10, 2007
Mind Your Body, The Straits Times
Sharp-eyed pharmacists save lives
Last year, some 100,000 people would have taken the wrong drugs, taken them in incorrect doses, for the wrong durations or in the wrong combinations. They would have taken more drugs than necessary, or were not given the right ones needed because the medicine was accidentally left out of a prescription.
But they didn't - because those incorrectly written prescriptions were spotted and rectified by sharp-eyed pharmacists.
These interventions are usually documented on the prescription forms themselves and kept at the pharmacies or individual hospitals and polyclinics. The figures are collated through the Ministry of Health.
Said Ms M.K. Fatimah, vice-president of the Pharmaceutical Society of Singapore: "Doctors do the diagnoses and treatment plans. As the drug experts, pharmacists optimise the drugs prescribed to ensure that they are safe and affordable to patients."
One case involved a 65-year-old female patient who was bleeding inside the head because of uncontrolled high blood pressure.
Ms Fatimah, who is the head pharmacist at Alexandra Hospital, said: "The patient was started on Phenytoin, a seizure medication. But the dose prescribed was too low, so she was still at risk of a seizure.
"It was a pharmacist who noticed that the patient was in danger of fits if her dose was not increased. And then she helped to monitor the drug levels until they were optimal for the patient's recovery."
Not everyone may realise that a pharmacist does much more than fill prescriptions.
Out of the 1,482 registered pharmacists here, almost half work in hospital and community pharmacies, which include retail and clinic pharmacies. The others are in pharmaceutical companies, regulatory bodies such as the Ministry of Health and research institutions.
Pharmacists can also opt to specialise, and Singapore has specialist pharmacists in areas such as infectious diseases and cancer, critical care, paediatrics, medicine management and anti-coagulation.
The traditional role of pharmacists has been to ensure that medical prescriptions are properly filled and dispensed. They also participate in disease management, by managing drug therapy. They have many areas of expertise which see them working in research, in the manufacture or marketing of drugs, or as regulators.
In Singapore, a pharmacy degree at the National University of Singapore (NUS) takes four years to complete. Graduates are registered with the Singapore Pharmacy Board upon completion of a one-year pre-registration training.
The recently passed Pharmacists Registration Bill aims to raise standards further in the profession and to address shortages.
The Bill concerns training, registration and the enforcement of professional standards.
Like doctors, pharmacists will soon have to clock 50 hours of continuing professional education in order to renew their practising certificates every two years.
A register will also be set up for pharmacists with training in areas such as cancer, critical care, and neonatal and paediatric care.
The Singapore Pharmacy Council will be given more powers to discipline errant pharmacists.
And the introduction of temporary and conditional registrations means that foreign pharmacists can be hired to work here.
Despite NUS tripling its yearly intake of pharmacy students from 41 to 115 over the last 10 years, there is a need for more practising pharmacists - 200 more a year for the next decade, according to the Ministry of Health.
Like other allied health professionals, pharmacists are an integral part of the overall health-care team managing patients.
Ms Fatimah said pharmacists provide checks and balances in the dispensing process by reviewing if the prescription is appropriate, educating patients on medicines and side effects and addressing patients' concerns.
Logistics analyst Derrick Tan, 31, an exercise buff who suffers from sinus infection and aches, said he turns to pharmacists for advice on medication and supplements and he hopes they would "update themselves with the latest research on drugs".
Housewife Lenny Wong, 72, who also relies on her pharmacist at the polyclinic for her regimen of drugs for her high blood pressure, arthritis and bone care, said: "After all, she spent four years at the university to become a drug expert. It is about time she gets due recognition."