Actual reasons for urgent need of patient care center/prescription center in Govt hospitals..

 

There is a long queue.  A relative of a patient however reaches the medicine counter but couldn't understand properly about the administration of medicine as prescribed by the doctor. On request at the counter, she had been told to visit the doctor who prescribed it. But it isn't possible because it would be a time-consuming matter.

     I have just been shocked to see the horrible condition of persons on a national TV that happened in a renowned hospital in west Bengal. It is not that there is no patient counselling centre in the hospital. But the number of such hospitals is very less. The lack of patient counselling centres in maximum hospitals indicates the urgent need for its establishment attached to the hospitals.

 You might have heard about it. Patient counselling is providing information, assistance & guidance about the administration of medicine. It might be orally or in the written form. 

  Now, reasons are many for which such a set-up should be there in a developing country like ours.

• Low % of literacy rate.
• Lack of patient's compliance due to low % of literacy & inadequate knowledge about drug administration.
• To help the patient or representative of the patient getting information about recovering from illness 
• To provide information about a lifestyle that becomes a causative factor for many diseases.
• To provide guide & to make patients/representatives understand the importance of getting diagnostic tests done as per doctor's advice.
• To ensure that patient is taking medicines properly.
•  To provide mental strength to the patient which is required in recovering from illness. 
• To remove misconceptions regarding adverse drug reactions among patients.

While working on an ICMR project(INDIAB-phase-ii, diabetes study) I have seen in many places people are not following medication as per prescriptions For eg-- not fulfilling the total course of antibiotics, having a negative perception of the health administration system resulting in non follow up, excessive dependency on quake or even in the worst form as sorcery.

  Lack of patient counselling centre in Govt set up is attracting private players to set up & providing such facility which is beyond of the access of common people. 

It is a fact that all pharmacist counsels patients on drug administration free of cost.  But lack of law related to this reflected in inadequate infrastructure, lack of skill for adopting the latest technology, lack of willingness in attending patient counselling properly -have created a barrier to having a good health system.

  In this respect, the OBRA Act'90 of the US needs to mention. As per this act-pharmacists have the responsibility in patient care counselling like making the patient understand well about-name & description of medicine, its side effect, proper storage & doses etc.

    In our country, we also need of law which will ensure of providing such service from the Govt end. 

      If you perceive needs from the patient's perspectives-following points should be emphasized as a patient/representative wants--

1. Empathy to understand his or her situation.
2. Coordination in understanding medication process & accessing integration in the total health care system --
3. Support (mental, emotional)that will make their willpower stronger in recovering.
4. Their needs to be heard & to repeat oral communication in case they don't understand properly.
5. Respect as a human being irrespective of class, caste, creed in accessing services.

 Industrialization & Urbanization had worked as push factors for migration &  population growth in the city. Comparatively growth of Govt. hospitals/health care system is less to provide a basic health care service to the beneficiaries. People from adjacent villages have to attend the city hospital for some cases as a referral which can be avoided with some infrastructural development & deployment of manpower.

  We all know that in order to improve health care services at the village level, NRHM was implemented in 2005 with the aim of providing universal access to integrated health care services to the villagers.

   Though it's being helpful to the rural population still as stated above, lack of infrastructure, machinery & manpower are acting as barriers for the people to access health care as per their needs. Above all due to materialistic attitude & fear from depriving of all city facilities, health professionals are not ready to be posted & visit in interior areas of the village. 

 You also will agree that implementation of rules like OBRA Act'90 of US & its strictly monitoring should be the ist step & every Govt hospital(like Beliaghata ID hospital-- West Bengal) should have patient care/Prescription centre. 

 

 With this, the following steps can be considered in order to obtain a good, skilled community pharmacist.

• Implementing & regular updating of patient care counselling aspects in pharmacy course.
• Emphasize developing communication systems.
• The technique of counselling like countertransference, training on desensitization process to know about overcoming from anxiety, principles like acceptance, Non-judgemental attitude etc can be helpful.

Perhaps you have noticed that the private players in health care have a networking system right from physician to Pharmacy centre. Here Prescription reflecting branded medicines centre around a total business policy & profit making involving those physician & Medical representatives of the pharma company. A needy, poor, person from an underprivileged society can't afford those branded medication costs & thus face difficulties in the completion of medication.

Generic medicines would no doubt be helpful-- not only as cost-effective but also from its qualitative perspective.  But there is a myth that generic medicines are cheap & hence these are inferior to branded medicines.

Generic medicines prescribed by the physician & their accessibility in pharmacy attached to the hospital &  simultaneously making beneficiaries understand the importance of generic medicines by the prescription centre/patient care counselling centre is need of the hour. 

It can't be denied that schemes like -"Jan Aushadhi", "Sasta Sundar" actually providing relief to the people by providing generic medicines. During this pandemic when people are are really anxious about the meeting of health expenditure within a low-cost budget, the use of generic medicines is really helpful. 

But mass awareness is required  & that is possible by the opening of more & more patient care centre/prescription centre.

You might add here that implementation of the related act will only be the solution but the fact can't be avoided is that rules are made for human beings & made by human beings. 

 If the nature & attitude of human beings are guided by empathy, gratitude then we can also have a new dawn where even people from underprivileged societies will not have to be in the long queue in front of hospitals with anxiety just to understand & to continue medication.

You also know that where there is a will there is a way..... We have to be determined first....