80 percent of pharmacists at hospitals not qualified
A new survey has shown that 80 per cent of individuals charged with the responsibility of dispensing drugs at Level Four hospitals are not trained, pharmacists.
The survey also reveals that drugs in 70 per cent of Level Five hospitals are dispensed by people who are licensed but not qualified to do so.
The survey was conducted by the Young Pharmacists Group (YPG). Its findings were released last week.
The YPG team went through data from different hospitals. The survey was carried out at 535 Level Four and 80 Level Five hospitals listed on the Kenya Medical Practitioners and Dentists Council website.
It reveals that eight out of 10 Level Four hospitals are non-compliant.
Of the 535 hospitals surveyed, some 424 are non-compliant, and only 50 follow the required standards.
The survey shows that 61 hospitals have no records.
It also says 71 per cent of Level Five hospitals are not manned by qualified superintendent pharmacists.
Nairobi County has the highest number of such hospitals at 19.4 per cent, Kiambu (seven per cent), Nakuru and Kisumu (4.3 per cent), Kajiado and Mombasa (four per cent), Wajir (3.4 per cent), Machakos (2.4 per cent) and Nandi at 1.3 per cent.
Of the 80 Level Five hospitals, 56 do not comply, five do not have records while three are operating on expired licences.
A superintendent pharmacist is in charge of a pharmacy, including its professional and clinical management. He or she manages the administration of the sale and supply of medicines.
They should be licensed by the Pharmacy and Poisons Board (PPB).
Superintendent pharmacists are responsible for guiding hospitals on drug-related issues, including reviewing patient files and guiding senior consultants on therapy.
The superintendent can decline to administer drugs if he or she deems the medicines not appropriate or valuable for the indicated treatment.
However, most hospitals do not have a qualified superintendent pharmacist. They hire pharmacy technicians instead.
The absence of the superintendent pharmacist puts the lives of those purchasing drugs at risk as there is no professional input.
While pharmacy technicians are skilled, the law prohibits them from performing tasks meant for pharmacists.
A study in the US found that pharmacy technicians showed the need to be regulated.
“Given the complexity of prescriptions and their lack of formal training, pharmacy technicians are placed in a situation where serious mistakes could occur,” said a recommendation to the Virginia General Assembly in 1998.
Hospitals in Kenya ignore regulations by allowing pharmacy technicians to do a job that does not fit their bill.
“At most hospitals, the right professional for the role is not the one whose licence was used. Without professional input, patients are at risk,” said Dr Cohen Andove, the chairperson of the Pharmaceutical Society of Kenya and lead author of the survey.
The absence of pharmacists at Level Four, Five and Six hospitals also undermines the quality of care to patients. It increases the risk of medication errors.
“Drugs can turn into poison if mishandled. Medication mistakes are a leading cause of death, where patients – after proper diagnosis – receive wrong, inappropriate or inadequate medicines,” he said.
Dr Cohen said the study unearthed grave non-compliance on superintendent permits issued to hospitals and wholesale dealers.
“The absence of pharmacists at these hospitals is a disservice to patients who do not get the required care. In this time when medication-related problems contribute to a significant number of deaths, it is important to have the pharmacist at the core of services at hospitals and wholesale practice as required by the law,” he said
The survey also shows that hospitals do not recruit qualified pharmacists.
“It costs more to hire specialists but patients are also charged more at these hospitals. How do you expect someone without a certain understanding and knowledge level to add value, respond to queries, ask for clarity or even dispute treatment sheets?” he asked.
Dr Cohen adds that some hospitals deliberately weaken the pharmacy leadership, making it difficult for them to check on the prescribers.
“Some of these hospitals own the pharmacies as well. It is in their conflicted commercial interest to drive sales as high as possible,” he said.
“Unfortunately, some prescriptions are more commercial than medical. A weak compromised non-technically proficient team is tied and can barely push back.”
Pharmacists play a critical role by providing specialised knowledge and expertise related to medication management.
They help ensure patient safety by providing medication counselling and giving information on dosages, drug interactions and potential effects.
According to the law, a pharmacist is mandated to be the sole custodian of dangerous and controlled drugs and substances, including narcotics.
Narcotics are highly addictive drugs that require proper supervision and administration by registered pharmacists.
“It is unfortunate that negligence has led to a rise in the misuse of narcotics among the public, especially the youth,” Dr Cohen said.
“Without the proper licence of premises, the risk of the public being exposed to controlled drugs is very high.”
A recent study by Kemri indicates that many community drug sellers advise clients to take a fraction of the dose and get the other later. The other bits are often ignored.