24/10/23

The role of Community Pharmacists in TCAM practice by Livy-Elcon Emereonye

According to the World Health Organization, medical practice is classified into three namely: Orthodox or Conventional Medicine, Traditional Medicine (TM), and Complementary and Alternative Medicine (CAM). Natural Medicine is a combination of Traditional Medicine (TM) with Complementary and Alternative Medicine (CAM). In other words, Traditional, Complementary and Alternative Medicine (TCAM) is Natural Medicine.

From the above, one can say that there are basically two types of medicines: Orthodox Medicine and Natural Medicine. An unbiased marriage between the two is what is called Integrative Medicine.

Globally, there is an awakened consciousness in the practice of Natural medicine, and Nigeria is not left out in this trend. The Nigeria land mass with its rich bio-flora and biodiversity are of immense advantage.

The philosophy of Natural Medicine (TCAM) is different from that of Orthodox Medicine. The therapeutic substances used in Orthodox Medicine are called medicines (drugs), but in Natural Medicine therapeutic substances are called remedies. Differences also exist in the methods of production and administration of medicines and remedies.

Whatever the case, the patient is not only the target but the end user of both medicines and remedies. This calls for caution and utmost care. There is a need for standardization and proper regulations.

Natural medicine is not just broad; the opportunities therein are huge and the same goes with the challenges and risks. Thus, the need for adequate training and proper regulation bearing in mind that quacks exist in every practice and errors can occur in every human endeavour. This can be minimized or mitigated with a functional standard operation procedure.

The community pharmacy is the most accessible health facility in the world. Activities in the community pharmacy are geared towards health promotion, disease prevention and therapeutic management through pharmaceutical care. It is the centre for rational drug therapy through incisive drug audit.

A community pharmacy by operation may include a community-based pharmacy traditional retail setting, a retail pharmacy operating out of both large and small chains or grocery stores, an outpatient pharmacy found within a health systems, a federally qualified health centre, a primary care clinic, compounding pharmacy that prepare medications for patients who require unique dosing or modified formulations, and a specialty pharmacy where patients receive outpatient care for complex medication therapies. Whatever the type, the community pharmacist makes the community pharmacy.

The community pharmacist is the most accessible healthcare professional. Among other things, he provides personalized advice about health issues and medicines when needed, sometimes without the need for an appointment, and oftentimes at no cost. A competent community pharmacist is passionate and dedicated to duty with focus on the patient’s wellbeing. This is an opportunity nay a blessing everyone should explore and enjoy without delay or hindrance.

As a drug expert, the primary role of the community pharmacist is to fill prescription, review and detect medication errors as well as recommend and dispense over the counter drugs (OTCs).

The expanded role of a community pharmacist geared towards patient safety include among others to: process prescriptions, check for drug interactions, dispense medications, prepare medications, dispose medications, counsel patients, provide advice, promote healthy lifestyle, and engage in public health programmes.

The roles of a community pharmacist in patient safety has been summarized in

the rights to describe the steps that lead to safe medication use through the right dose of the right medication taken by the right patient at the right time and by the right route for the right indication and right duration. This is the summary of Rational Drug Therapy, and going further, each part of the medication use process may contain different numbers and types of “rights” whose expansion authenticates the indispensable role of the pharmacist in the healthcare team. For example, in the community pharmacy setting, outcomes like the right education, right monitoring, right documentation, and right drug formulation are functions that can only be done properly by the pharmacist, so to safeguard the health of the people, these rights must apply in TCAM remedies.

The marketing, distribution, dispensing, and even administration of TCAM remedies are key areas community pharmacies and the community pharmacist can play a very important role.

Another area where the “trained and certified” Community pharmacist can play important, if not an indispensable role, is in patient counseling.

The monitoring and reporting of possible interactions: remedy-remedy interaction, remedy-food interaction, remedy-drug interaction, as well as adverse events reporting of TCAM remedies are specialized roles of community pharmacists.

The therapeutic role of the pharmacist is required to establish and review standardized dosing information: dosage, frequency and duration for TCAM remedies especially those administered orally with emphasis on pregnant women and children.

Furthermore, the area of Research and Development in TCAM is a gold mine begging to be explored. ACPN and PSN should liaise with Research Institutes and Universities to carry out more research on our “bio-flora”.

The concept and philosophy of “From Farm to Pharmacy (F2P)” should be embraced and maximized by Community Pharmacists. The opportunity therein is huge. The economic and health benefits are endless.

Being the healthcare professional visited most frequently and seen most often by patients and patient relatives, the community pharmacist is in a vintage position to play a vital role in the continued healthcare and check-ups for patients for optimum health through Orthodox or Natural medicines approach using allopathic drugs or TCAM remedies.

As usually, abuse is inevitable where value is not known, and where the right professionals shy away from their responsibilities, charlatans will take over.

Therefore, there is a need for the rational distribution, dispensing and use of TCAM remedies by trained pharmacists in registered premises.

In conclusion, the regulation of the production of TCAM remedies and products should remain with PCN and NAFDAC while TCAM Council when signed into law should regulate the training and practice of TCAM.

Livy-Elcon Emereonye; Pharmacist, Herbalist, Naturopath and Integrative Healthcare Practitioner is the Chairman of ACPN-TCAM Special Interest Group, and PSN TCAM Desk Officer.

We can do training and consultancy on TCAM for interested members.

Email: livy_elcon@yahoo.com
Tel: 08033922445