PRESCRIPTION ADALAT: A novel concept by Pharm D students

PRESCRIPTION ADALAT: A novel concept by Pharm D students

Augustine Xavier,Aravind R.S,Athira B.M,Aswathy K.S,Belsy Boban,5^th year PharmD,Dept of Pharmacy practice,ACP

This is just a beginning; it is the dreams and responsibility of a new generation. A process of interlink age of knowledge and social commitment and also a stepping stone towards a bright new venture.

 Here we are introducing a simple but a unique concept, which arise from the existing circumstance. Healthy critics, suggestion along with appreciation can make it easy to achieve this aim. In this era were hearth and medicines having an important role? Almost all countries were spending their major portion of GDP for health and improving quality of life. Even though there exist advanced amenities, most of the developed countries are facing so many challenges. Situation remains same for developing countries also. Report and statistics shows that private health care institution are playing important role in Medicaresystem. But it is insufficient to develop the entire health care system. The reality is that such services are still not reaching the rural areas where a major portion of the population lives.

   In that scenario Prescription Adalat can be a novel step which is being initiated by a group of young clinical pharmacist students that can make such dreams come true. It can be considered as a rejuvenating step which brings about the real revolutionary change in the current health system of our nation. The basic concept is to implement a direct face to face interaction between the clinical pharmacist and the patients. The difference is that here the pharmacist is moving towards the patient rather than patient towards the pharmacist. Either the person be a patient or not we are just focusing on their concern and drought regarding the drugs about the medical condition, drug they taken, matters regarding prescription, administration etc.

Scientific background

      Prescription Adalat is a novel system of alternative dispute resolution developed by young IndianPharm D students. It roughly means “patient’s court”, where the disputes are solved regarding their medication, life style, knowledge about disease and drugs are governed by clinical pharmacist. Now a day’s service of clinical pharmacy is not focused on common man but the implementation of this program has widely benefitted the common man.

 The introduction of Prescription Adalat is adding a new chapter to the health dispensation system of our country and succeeded in providing a supplementary forum to the victims of unsatisfactory settlement of patient health dispute. This system merges the western clinical applications like medication chart review, history interview, DUE, with the Ghandhian principles, there by expanding the clinical and community services to the rural areas.Usually the patients directly consult a physician for their medical problems. And their busy service schedule of the physician directing the patient to the qualified pharmacist.With the advent of many pharmaceutical markets have transformed the patient care into marketing lobby minimalizing the involvement of health care professionals in the pharmaceutical care service. It fractioned the patient cares in to product care.  This improper   culture is to be lubricated with by transforming the product oriented care to patient oriented one with implementing programs like Prescription Adalat by the clinical pharmacist.

The institution of Prescription Adalat in India as the very name suggests means patient’s court. Prescriptions stands for any order or written format by physician or any other registered medical practitioner to a pharmacist to compound and dispense a specific medication for a patient and the term Adalat means court. India has not tradition and history of such method being practiced in the pharmaceutical community.

One of the key components of the National Rural Health Mission (NRHM) is to provide every village in community with a trained female health activist ASHA (Accredited Social Health Activist). ASHA will be a health activist in community who will create awareness on health and its social determinants and empower the community towards local health planning and increased utilization and accountability of the existing health services.

Origin

    The concept of Prescription Adalat was pushed on against the oblivions existing against the current pharmaceutical scenario. Now this concept have being reformed as a part of the academicals project for the Doctor of Pharmacy program as a part of familiarisation of this professionals, as an attempt for integrating the clinical pharmacist with rural India.  The first Prescription Adalat was held on May 23^th  of this year at Perinthalmanna, Malappuram. The camp have being very successful in settlement of prescription assessment, patient medication history interview, assessment of ADR, medication error, assessing the prevalence of disease.

Fig description

As a part of the project work in 5th year Pharm D students, Augustin, Aravind and Athira conducted ‘Prescription Adalath’ to promote and practice ideal health campaign as a vehicle for rural development of each village. A special thanks to Mr. Karthikeyan, Asct. Professor, Dept. of Pharmacology, Al Shifa College of Pharmacy for his innovative ideas and works. There was an introduction talk by Augustin and Athira followed by the program.Prescription adalath aims to educate, engage and empower the people by new generation pharmacists.

Scope and  objective 

The advent of drug and cosmetic act 1948   gave a statutory status right for pharmacist the prescription handling as their the prime duty.This program is full-fledged to provide free and competent pharmaceutical services to weaker sessions of the society to ensure that opportunity for preserving the health are not denied to any citizen by reason of economic or other disabilities and to organise Prescription Adalatto secure that the operations of the health system provide justice on a basis of equal opportunity.

Need of Prescription Adalat

·         The numbers of clinically efficient pharmacist for the rural India in all grades are alarmingly inadequate.

·         The introduction of Doctor Of Pharmacy programme in India and the need for popularising the new program in rural community.

·         Increase in flow of health related issues and prescription misuse due to multifarious conditions.

·         Alarming rise in drug induced issues and antibiotic resistance in recent years.

·         The high cost involved in medical services and regular health follow up.

·         Lack of public awareness and individual patient knowledge in medication, storage, administration, etc.

·         The lack of opportunity for the Clinical Pharmacist in Government initiated health programs.

Organisation of Prescription Adalat

Every Prescription Adalat so organised shall consist of

a.        Serving or active Clinical Pharmacist.

b.       Well experienced Community Pharmacist in handling of prescription.

c.        Accredited social health activist (ASHA workers) workers of each village/ward.

d.       Any other person who is interested in public service that is engaged in the upliftment of weaker sections of people, including SC/ST women, children, rural and urban labours.

e.       NRHM nurse of each ward.

Procedure

·         The initial step for conducting Prescription Adalat is assessing the demand of selected community home medication review;prevalence taking, Patients home visit etc. enhance the productivity and promptness of the program.

·         Select an appropriate space and accommodate the patients and people who are interested to take part in Prescription Adalat.

·         Assessment, clarification, counseling, supporting, cooperating in good health culture in reconciliation process

·         Permanent Prescription Adalat should assist the patients in their medical reconciliation process between patient and Clinical Pharmacist in an independent and impartial manner.

People came with their prescriptions and cleared their doubts with the students by a one to one meet. A special thanks to Mr. Karthikeyan, Asct. Professor, Dept. of Pharmacology, Al Shifa College of Pharmacy for his innovative ideas and works

Advantages

·         Patient care at no cost.

·         Speedy patient care with in the rural premises.

·         Solving the health related problems, droughts, questions in their vernacular language.

·          Need of maintaining personal hygiene to prevent disease especially for females.

·          Make people aware about recent Government health policies   like MDA, Polio vaccination, health census, etc.

·         Providing awareness against communicable disease and prepare guidelines for management of malnutrition.

·         Need of importance of new health insurance policies which aims on the upliftment of rural society.

·         Emphasizing the need of a family Clinical Pharmacist as that of a family Physician.

·         Promoting the efficacy of a drug information centre and familiarising the information   technology and other Medicare resources.

·         Good environment twith pharmacist and public which make inspiration of joining health activities.

·         Exchange of the knowledge of other health care system like Indigenous systems of medicines.

 Challenges

·         Regional variation among prescription pattern and pharmaceutical brands.

·         Space and time barriers.

·         Lack of pioneers in the field of integrated clinical-community work.

·         The patient are always eager to know the sources of free drugs and most times such questions are difficult to answer.

·         Language barriers.

Future plans

·         Convince the next generations to consider it as a routine clinical activity.

·         To spread this trend all over Kerala by other institutions having clinical pharmacy services.

·         Funding allocation should be made available for promoting such programmes by state and central governments.

·         Extending the Prescription Adalat from rural to urban community.

Conclusion

Even though we have passed seven decades after getting independence, still we fail to make the dreams of Mahatma ji, to build a soul of the nation in the villages. Let’s hope this be an attempt to fulfill such dreams. Being a Clinical Pharmacist let us put an effort from our side for this movement through approaches like Prescription Adalat.