Practice of Hospital Pharmacy in Bangladesh: Current Perspective

Bangladesh Pharmaceutical Journal 17(2): 187-192, 2014 Practice of Hospital Pharmacy in Bangladesh: Current Perspective Tripti Rani Paul1, Md.Ajijur Rahman2, Mohitosh Biswas2, Mamunur Rashid2 and Md. Anwar Ul Islam2 1 Department of Pharmacy, Khwaja Yunus Ali University, Sirajganj-6751, Bangladesh 2 Department of Pharmacy, University of Rajshahi, Rajshahi-6205, Bangladesh Received: June 22, 2014; Accepted: July 22, 2014; Published (Web): July 23, 2014 Abstract Although hospital pharmacists are recognized for its importance as health care provider in many developed countries, in most developing countries it is still underutilized. The aim of the present study was to summarize the current scenario of pharmacy practices in four hospitals of Bangladesh and to identify the pharmacist’s rolesin these seftap. The study was conducted through convenient sampling method using a well-designed 14-item questionnaire to collect the opinions from the respondents. The results showed that hospital pharmacy service, as a unique department of hospital, existed in 50% of the studied hospitals where activities were done by graduate pharmacists and they were also involved in different departments to provide clinical services to the patients. The rest 50% of the studied hospitals had no hospital pharmacy service. Only a retail drug store inside the hospital was present and there was no diploma or graduate or any pharmacy technician for providing patient care. This study concludes that hospital pharmacy practice is just started in some private modern hospitals in Bangladesh which is inaccessible for the majority of peoples due to high patients cost of these hospitals. Key words: Pharmaceutical care, Good pharmacy practice (GPP), Pharmacy and Therapeutic Committee (PTC), Hospital pharmacy, Clinical pharmacist. Introduction The conventional role of pharmacist is to manufacture and supply medicinal products. Recently, however there is a significant change in the pharmacy profession in terms of professional services delivery due to the increased demand of pharmacists (Azhar et al., 2009). Complexities due to increases in range of medicines and poor compliance have shifted the focus of pharmacist toward patient-centered approach. This situation has made pharmacy discipline to be recognized as an equally important profession in the multidisciplinary team for the provision of health care. Since the improvements in health outcomes depends on the workforce levels and quality, accomplishment of desirable results are difficult to achieve without a competent pharmacy workforce (Robinson et al., 2000; Anand et al., 2004; Zurn et al., 2005). The pharmacy profession is still lagging behind in developing countries as compared with developed countries in a way that the pharmacy professionals have never been considered as a part of health care team neither by the community nor by the health care providers (Doucette et al., 2006). In arecent study in UK, researchers found that most of the pharmacists were involved in advising the doctors and educating the patients (Martin et al., 1998). The findings of Spencer and Edwards with respect to pharmacists' services suggest that general practitioners were satisfied with the pharmacist's health education activities (Spencer et al., 1994). Despite the criticism, pharmacists in developed countries have shown zeal in upgrading their knowledge and have refined their professional skills to meet the health care demands, and this has positioned them in a suitable place in the health care system. Various professional bodies of pharmacists also supported and encouraged the pharmacists' involvement in better patient care (Crown, 2002). In countries like UK, pharmacists were also given the prescribing rights for certain diseases (Stephen, 2003). The Good Pharmacy Practice Guidelines developed by the FIP, and subsequently adopted by the World Health Organization, state that a pharmacist’s first concern should be the welfare of the patient (International Pharmaceutical Federation, 2004). In Pakistan, there are opportunities for pharmacists to become more involved with patient care; however, there are difficulties with identifying their role Correopondence to: Md. Anwar Ul Islam; E-mail: 188 Paul et al. / Bangladesh Pharmaceutical Journal 17(2): 187-192, 2014 and responsibilities and having those recognized by hospital administrators, government, and patients (Ghani 1993). According to WHO, future pharmacists must possess specific knowledge, attitudes, skills and behaviors in support of their roles (Zammit, 2003). The paradigm shift for pharmacy practice took turn in 1990, when Hepler and Strand introduced the term "pharmaceutical care" (Hepler et al., 1990). In many parts of the world, pharmacists have played a significant role in provision of pharmaceutical care services. In addition, it is also widely believed that pharmacists can make a great contribution to the provision of the primary health care, especially in developing countries (Smith, 2004; Jesson et al., 2006). Literature review showed that there was very limited information of this type of research within the hospital inpatient pharmacy services in Bangladesh. Many researchers have found that, prescribers are in favor of the new extended roles of practicing pharmacists as patient counselors and drug information providers. The objective of this study was to summarize the current scenario of pharmacy practices in the four hospitals of Bangladesh and to identify the pharmacist’s activities in these hospitals. Methods: study design, data collection and evaluation A cross sectional survey based study was conducted by convenient sampling method from October to December 2011 in four hospitals of Bangladesh. Among these four hospitals three were privately owned and one was government hospital. Among these four hospitals two was located at the centre of Dhaka. These hospitals were selected because these provide patient care services including hospital pharmacy department as a unique part of the hospital and symbolized as “A” and “B” for the study purpose. Another two medical college hospitals was located in the district region of Bangladesh. One was symbolized as “C” located in Bogra and another one was government hospital located in Rajshahi, symbolized as “D”. These two were selected as there was no hospital pharmacy department and pharmacist intervention. A 14-item questionnaire with an open-ended question for personal opinion was supplied to all the respondents. The questionnaires were drawn in English. Different variables were evaluated such as education, experience, dispensing routine of the attendants at medical stores or functional pharmacies. Their knowledge about hospital pharmacy, commonly dispensed drugs, influence of different factors on prescribing practices and the willingness to have a qualified pharmacist at their medical store were also evaluated. Result and Discussion This study tried to explore (...truncated)