Monday, March 27, 2017
   
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Pharmacy Unit

Unit Head
Mr. Yohanna Avong
B.Pharm, MPH, MCIP

 

BACKGROUND

The Pharmacy Unit is part of the clinical department. It ensures that there is uninterrupted drug supply to the patients of all IHVN supported sites and that these are high quality drugs. The unit guarantees that there is rational use of antiretroviral drugs and other medicaments; determined by appropriate prescription, appropriate dispensing and adherence to prescribed regimens. The division provides support in three core areas, Pharmaceutical Supply Chain, Training and Pharmaceutical Care.

Broadly, the activities include ensuring Good Pharmacy Practice (GPP) at ART Pharmacies, capacity developments of hospital pharmacists and management of drug logistics.

Ensuring Good Pharmacy Practice (GPP) at ART Pharmacies

Good Pharmacy Practice (GPP) incorporates maintaining standard practices that provide optimum care to the patient. These include drug dispensing, monitoring of side effects, patient counseling on drug utilization and adherence to antiretroviral therapy. The Pharmacy division is especially proud of the efforts undertaken to stamp out the Window Dispensing System (where patient collect drugs through the window) for a more friendly and adherence-improving method – Indoor Dispensing System (IDS) in which drugs are dispensed in private and secured environment so as to facilitate confidentiality and improve adherence to antiretroviral therapy. As at September 2016, pharmacists have dispensed antiretroviral medications to 290,611 HIV/AIDS patients spread throughout the managed IHVN supported health facilities in Nigeria.

Capacity development of Hospital Pharmacists

The main focus of the capacity development is to support the local capacity of pharmacists for the HIV/AIDS treatment and care program of the Federal Government of Nigeria. Under this initiative, over 500 Nigerian pharmacists have been trained to provide care at the various health facilities where HIV/AIDS patients are treated.

An official training manual consistent with the Nigerian National Treatment Guidelines for the training of pharmacists have been developed. Multiple tools, Standard Operating Procedures (SOPs) and guidelines have also been developed to assist the pharmacists and to entrench the basic principles of GPP.

Drug Logistics

Drug logistics activities include facility renovation, drug quantification, procurement, distribution, and storage and data management. Using procurement's standard operating procedures and guide lines, drugs are procured through reputable international and local vendors. To maintain the quality of drugs, drugs are stored in warehouses at manufacturers' recommended temperatures.

Drug distribution employs the use of soft wares that allow the monitoring of stock level and therefore, minimize drug stock-outs or over stocking situations. In order to ensure optimal quality of the drugs at each site, pharmacists monitor the temperature of the storage facility daily. Managing waste is a very important component of drug logistics; therefore, in collaboration with NAFDAC, expired drugs are destroyed and disposed according to international guidelines.

IHVN has also been committed to ensuring that all facility infrastructures meet the highest standards for pharmaceutical service. Poor infrastructures at health facilities minimize the delivery of pharmaceutical services and as such, site assessment and renovation remain the initial activities we perform before any site activation. The pharmacy division has developed a tool for site assessment with which infrastructural defects can be evaluated and necessary renovation effected in a timely manner.

Quality Assurance

Pharmacovigilance and monitoring of antiretroviral regimens and medication errors are the key activities under the quality assurance initiative. Adverse drug reactions constitute a great challenge to adherence to antiretroviral drugs. Under the pharmacovigilance initiative, these reactions are reported and documented using the standard tool.

Operational Research

Operational research (OR) refers to researches that are conducted in order to improve the delivery services or operations. In the Pharmacy Division, we conduct OR in order to improve the services we provide to the patients as well as answer critical questions that affect the delivery of our services. The research topics listed below are some of the studies that have either been conducted and published or are still on-going.

  1. Adherence to antiretroviral therapy in the North-Central Nigeria
  2. Dosing of patients with second line anti-tuberculosis drugs in Nigeria: an emerging clinical and public health problem
  3. Aminoglycosides-induced ototoxicity among MDR-TB patients on second-line anti-tuberculosis drugs in Nigeria
  4. Adverse drug reactions among hospitalized patients with multidrug-resistant tuberculosis in Nigeria
  5. Fixed dose combination Anti-retroviral drugs are not a better option over single drug combinations
  6. The role of community pharmacists in HIV/AIDS care in Nigeria
  7. Gynaecomastia among HIV/AIDS patients taking Efavirenz
  8. Evaluation of drug stock-out in the ART program in Nigeria

Assessment of Product Availability at Health Facilities

Constant availability of drugs and laboratory commodities is crucial for the treatment and control of diseases of public health importance like HIV/AIDS, TB and Malaria. The Pharmacy Division measures stock-out as well as availability of products at facilities in order to generate information that will strengthen the procurement and supply management system. This effort has largely improved the supply of drugs to the health facilities such that chronic drug stock-out that could significantly disrupt services to the patients have not been reported.

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:: Support and Funding

The Institute of Human Virology, Nigeria AITRP Training Programmes are supported and funded by the Fogarty International Center.
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