COVID PANDEMIC:- PHARMACIST INTERVENTION IN DISEASE PREVENTION

 PHARMACIST INTERVENTION IN COVID-19 PREVENTION

• The Pharmacist job incorporates guaranteeing satisfactory capacity and gracefully of proper supplies of pertinent prescriptions, and other clinical items and gadgets to flexibly the interest; giving awareness to general society about protection, measures and conduct insurances; and danger appraisal by giving early discovery and referral of people suspected to be at a higher danger of disease.
  
• During pandemics, the role of pharmacists broadened from routine duties to preventive activities such as disease monitoring and surveillance, immunizations, and diagnostic testing.
• Pharmaceutical care, medication therapy, infection control, and immunization are among the top listed duties delivered by the pharmacists during various epidemics.
• The community pharmacists have reduced the burden on the healthcare system by diverting the influx of patients away from hospitals through triaging and screening patients.
• The role of pharmacists is beneficial during the outbreak of vaccine-preventable diseases. One such role is the education of patients and the public regarding the importance of vaccines which resulted in increased vaccination rates increasing the protection of high-risk individuals
•  Pharmacists are often the first point of contact for the public, especially during pandemics. They are the most accessible healthcare practitioners, which is evident from their direct patient care provision despite restrictions imposed due to COVID19 pandemic.
• As outlined by the International Pharmaceutical Federation, community pharmacists have an important role in public health, during this COVID19 public health emergency.

Following are the potential roles of the pharmacist at the community level to serve the public in the current circumstances.

INTERVENTION OF PHARMACIST AT COMMUNITY LEVEL

1. Education for disease prevention & counselling-. Counseling will help the patient to understand the point or time when medical attention is needed. Community pharmacists can educate the public about the differentiating symptoms, thereby reducing the unnecessary visits and rush to the emergency departments.
2.  Education on hand & respiratory hygiene and provision of facial masks -Pharmacists can arrange hand sanitizers and masks at all patient counters and should practically demonstrate the correct method of hand sanitization and use of mask through Educational presentations in video formats, posters, flyers, or hangings.
3. Breaking the Myths and eliminating the confusing narratives- Pharmacies can make pamphlets on prevailing myths and can distribute to each customer attending the premises which prevents self-medication .The WHO has issued various videos and images which can be utilized in the pharmacy premises.
4. Telepharmacy Services-. Telemedicine provides electronic consultations and has reduced the risk of transmission by reducing in-person contact among people. Telepharmacy will also reduce the volume of patients seeking care at health facilities by providing medication counseling through real-time audio-video conferencing technology to the COVID-19 patients but also for chronic patients and the general community experiencing the restricted movements amid lockdown.
5. Extemporaneous Preparation of Sanitizers and Disinfectants- Either due to increased consumption or disruption of raw material supply, the COVID-19 pandemic has caused shortage of hand sanitizers in many countries. Pharmacists can also prepare disinfectants according to national legal provisions.
6.  Ensuring Appropriate Medicine Inventory :-The management of inventory comprises a large portion of the pharmacy technician’s responsibilities. It is essential to ensure there is an adequate stock of medications and supplies to serve the needs of the patients a pharmacy serves, and careful inventory management can also increase the profitability of a pharmacy.
7. Effective Medicine Supply System to Customers- In order to ensure appropriate supply of medications especially in small towns where local pharmacies may have closed, community pharmacists can arrange home deliveries or an electronic prescription refill system and even home delivery services will prove to be very helpful for people in quarantine as well as for those with weak immunity, i.e., the elders.
8. Medication and Disease Management-Disease management (DM) is a comprehensive approach to preventing and treating disease that: (1) targets patients with specific diseases; (2) provides integrated services across organizational and professional boundaries; (3) utilizes services based on the best scientific evidence available; and (4) focuses on outcomes.

HOSPITAL PHARMACISTS AND THEIR ROLE

1. Inventory Management-The goal of inventory management is to reduce costs and improve operational efficiency. To do this, pharmacies need complete visibility into their existing inventory levels in order to take some of the guesswork out of maintaining ideal supply levels. This involves being able to track inventory stores, orders being generated, inventory receiving – and all in real time.
2. Pharmacovigilance at the Hospital Level Although many national pharmacovigilance programs are largely based on ADE reporting, a comprehensive system should encompass monitoring of medication errors and therapeutic ineffectiveness, product quality problems, and communication of such information to health care professionals and consumers for risk-benefit decision making .
3. Drug Utilization Evaluation & Active Member of the Clinical Trial Team (DUE)-DUE, a system of improving the quality of medicine use in hospitals and clinics, is an ongoing, systematic, criteria-based program of medicine evaluations that will help ensure that appropriate medicine use is provided. A DUE can be structured so that it will assess the actual process of administering or dispensing a medicine. The primary areas in which pharmacists can work include safety and efficacy evaluation, provision of drug or placebo, and follow-up of patients to ensure optimal therapy.
4. Development of Clinical Guidelines and Treatment Algorithms- Hospital pharmacists can prepare dosage guidelines, precautionary notes, and list of potential drug interactions, adverse drug reactions, and contraindications according to rapidly changing and evolving with ongoing research
5. Provision of Authentic and Updated Research Data & Hospital Pharmacists' Educational Services- Pharmacists can communicate to healthcare providers regarding potential medication-related problems (MRPs) of repurposed drugs in order to ensure the drug safety and optimal therapy. This service can be utilized to educate patients regarding precautionary measures in order to prevent the acquisition of infection.
6. Disinfection and Sterilization Services-Hospital pharmacists are responsible and strictly advised to adhere to the regulations for infection prevention and control in hospitals and medical institutes. Safety measures aid to protect both the pharmacy staff and patients from infections.

ROLE OF INDUSTRIAL PHARMACISTS AND DRUG REGULATORY AND ADMINISTRATIVE PHARMACISTS

1. Improving Access to Medicines-Industrial pharmacists must be fully prepared and should develop a contingency plan to avoid any sort of shortages. However, various health regulatory agencies have spared and relaxed the manufacturers from the fulfillment of conventional regulations and granted the priority approvals for the repurposed and experimental drugs
2.  Monitoring of Reported Adverse Drug Reactions (ADRs)-It is the fundamental responsibility of the pharmacist to update these events in the National Pharmacovigilance Database. Pharmaceutical organizations and industrial pharmacists producing investigational drugs should ensure safety reporting according to national legal requirements. Pharmacists should develop a smooth and convenient reporting tool for the adverse events.
3. Urgency to Comply With Legal Requirements-Industrial pharmacists need to adopt proactive and active measures to fulfill the legal requirements of production and supply. Since regulatory authorities in many countries provided legal flexibilities, pharmacists should ensure that drug supply should not be disrupted merely due to legal procedures.
4. Adequate Drug Supply-Drug administrative authorities should highlight alternative vendors to make sure the availability of life-saving drugs.The administration can ask federal health authorities to safeguard the drug supply which will help in maintaining transparency in the supply chain.
5. Ensuring Good Selling Practices (GSPs)-Pharmacists at the administrative levels along with community pharmacist should make sure the pharmaceutical companies and other stakeholders realize their duty and make sure the availability of the drugs to those who need them the most.
6. Administrative Actions Against Secondary Wholesalers-In the best interest of patient care, pharmacists and clinicians must be able to access the medication and supplies they need during the outbreak. Personal protective equipment commonly employed in healthcare facilities are now a scarce commodity.
7. Occasional Quality Testing Through Drug Testing Laboratories (DTLs)-Considering the occasional testing of medications through drug testing laboratories will shorten the time span of drug availability in the market. Such sort of regulatory relaxations will be beneficial for alleviating the shortage of medicines.
8. Mandatory Actions Against Unregistered Drugs, Sanitizers, and Disinfectants-Drug inspectors and drug monitoring teams should be authorized to seize and impede the sale of any unregistered drug.
9. Ease Operational Barriers-Drug administrative authorities can allow a grace period in the renewal of licensures during emergency period. They should also waive some restrictions of good manufacturing practices thus making sure the timely availability of the medicines.

ELIZABETH RACHAL JAMES,  LINETTE SABU    -     II^nd  PHARM-D