Involving pharmacists in taking primary healthcare to rural areas

RB Smarta | Updated on March 02, 2019

Why not train them to screen and direct patients to secondary and tertiary facilities?

The Pradhan Mantri Jan Arogya Yojana needs to create an additional 1.5 lakh doctors in rural areas to take care of the primary healthcare requirements. However, there are only around 15,000 medical doctors graduating every year in the country and 25 per cent of this number opt for specialisation. So, even if we compound the medical graduates for 10 years, at today’s rate, PMJAY looks difficult to execute. And due to this limitation in access to primary healthcare, thousands do not get the necessary treatment. Hence an execution plan is vital.

Today, there are more than 7,00,000 pharmacists in India, including the rural areas. So in regions where there is a shortage of doctors, especially in villages, pharmacists can be certified after being given adequate training in providing/checking basic primary health parameters. They can be trained to screen and direct patients to secondary and tertiary healthcare facilities.

Project Concern – a pilot project

A few years ago, pilot projects of three months’ duration were planned with a few community pharmacists of Maharashtra in select towns for the disease segments of diabetes and blood pressure. The objective was to assess the improvement of healthcare delivery system through the intervention of a pharmacist. The study was undertaken in the centres of Mumbai, Thane, Pune, Raigad, Kolhapur and Aurangabad. Ten pharmacists from each location were selected. The pilot study involved 200 doctors and 200 patients. The pharmacists were equipped with a weighing scale, measuring tape, digital apparatus, glucometer and strips.

The pilot projects were jointly conducted by the All India Organisation of Chemists and Druggists and All India Drugs Control Officers’ Confederation (AIDCOC), along with consultant Interlink who provided the training.

The study concluded that intervention by pharmacists helped disease management and compliance for diabetes and BP patients. Pharmacists were able to check BP and sugar levels in a select population of patients and their relatives.

They were able to record the variations in sugar levels, BP; monitor cough levels and direct the patients and relatives to doctors. Irregularity with check-ups, ignorance of the diseases and ignoring appointments were also noted. The access to primary healthcare became speedier. And this changed the perception of a pharmacist from being a mere drug dispenser to provider of medical services.

People who travelled to towns to check their BP or sugar were now able to check them at their local chemists, resulting in early detection. Pharmacists were also available easily as compared to busy doctors. And, importantly, healthcare expenses also came down.

Such pilot studies clearly prove that rural India will gain better and timely healthcare management with an increased involvement of pharmacists in the delivery of primary healthcare. More such studies should be conducted in other regions of the country, on a variety of ailments, to understand if a workable, safe model can be drawn up.

The Cenrtal government should consider undertaking such studies and increasing the roles and responsibilities of a community pharmacist, as it will help achieve the objectives of PMJAY. It will also enhance the image and reputation of a pharmacist, as a knowledge service provider and life saver in some cases.

A pharmacist is often overlooked in society despite his or her training to dispense specialised medicines. And doctors see them as promoters of self-medication and substitution. The Centre should make changes in the pharmacy curriculum in such a way that a budding pharmacist gets sufficient training at the college level in primary healthcare.

If a pharmacist can take part in the research and development and manufacture of medicines, with necessary training, surely he or she can also contribute towards an essential role of providing healthcare.

The writer is Chairman & Managing Director of Interlink, a pharmaceutical consultancy. Views are personal

Published on March 01, 2019

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