Hospital pharmacy play a pivotal role in patient care in a hospital and this is the department or service in a hospital which is under the direction of a professionally competent, legally qualified pharmacist, and from which all medications are supplied to the nursing units and other services, where special prescriptions are filled for patients in the hospital, where prescriptions are filled for ambulatory patients and out-patients, where pharmaceuticals are manufactured in bulk, where narcotic and other prescribed drugs are dispensed, where injectable preparations should be prepared and sterilized, and where professional supplies (including more specialized medications) are often stocked and dispensed. Hospital pharmacists serve as a link between physicians and patients to promote better patient outcomes. But it is a matter of great regret that in Bangladesh, people are totally unknown to the responsibilities of the hospital pharmacist, even they don’t seek for recruit for the hospital pharmacist in any hospital except a few aristocrat hospitals. Hospital pharmacy service, as a unique department of the hospital, existed in half of the studied hospitals where activities were done by graduate pharmacists and they were also involved in different departments to provide clinical services to the patients. The rest half of the considered healing centers had no clinic drug store benefit. Only a retail drug store inside the hospital was present and there was no diploma or graduate or any pharmacy technician for providing patient care. Hospital pharmacy practice is just started in some private modern hospitals (including Apollo hospital, Square hospital, United hospital and Gastro liver hospital etc. where graduate pharmacist worked in 24 hours successfully and it was proved by the local survey that their quality of treatment and services to the patient is quite appreciable.) in Bangladesh which is inaccessible for the majority of peoples due to high patients cost of these hospitals.
In Bangladesh perspective, for a new pharmacy graduate, industrial pharmacy practices are the major option (more than 95% opportunities for pharmaceutical industries) to build up his or her career, as a result, proper health services are not maintained and job crisis for a graduated pharmacist day by day increases. The educational system of pharmacy is one of the major reasons for bounded pharmacy practices because the courses included in bachelor degree principally emphasize on industrial practices.
Although the pharmacy education started its journey by the hand of the Department of Pharmacy, Dhaka University in 1964. Still now very nearly seven government universities and twenty two private universities offer Bachelor of Pharmacy (Honors) degree. Among these universities only 2-3 universities offer five-year Bachelor of Pharmacy (Honors) professional degree but other remaining universities offers four-year bachelor degree. In the event that we see some developed country in the world their employment locales for graduate drug specialist are not restricted in mechanical drug store practices and real part of drug specialist are included in community, hospital and clinical drug store administrations. For example, USA, Australia, Canada and the Middle East, pharmacy profession is highly patient care oriented, and they have much more opportunities in hospitals, clinics, and community pharmacy sectors. Pharmacy educational systems have to play in these pharmacy practices because they have updated their pharmacy education to 5-year pharmacy professional degree (Pharm. D) and this Doctor of Pharmacy (Pharm. D) course mainly focused on patient care services rather than industrial practices.
Challenges for implementing hospital pharmacy in Bangladesh are absence of talent pool among the qualified pharmacists, lack of government policy towards the hospital pharmacy, business-oriented mentality of the management, doctor dominant medical services, redundant and obsolete curriculum in the universities, no functional pharmacy council and professional bodies run by untrained, inexperienced and politically motivated individuals, non-conforming curriculum related to hospital pharmacy practice, financially more rewarding career in marketing, sales and manufacture, lack of career growth.
Changes we need for the establishment of hospital pharmacy in Bangladesh; those are policy change with respect to the pharmaceutical care (government and management), society for hospital pharmacy in Bangladesh should be established, awareness building among the public towards the quality pharmacy services, curriculum revision in the pharmacy education, sending a limited number of graduate pharmacists overseas for up to three months to receive specific training in clinical pharmacy and hospital pharmacy management.
National Drug Policy 2005 of Bangladesh suggests that medicine distribution and utilization in retail pharmacies and hospitals should be under the supervision of qualified pharmacists. But the reality is that no graduate pharmacist is working in retail pharmacies or government hospitals of Bangladesh except very few tertiary level private hospitals. These one or two hospitals can not improve the overall health care system in Bangladesh. Along with the lack of human resources, the profession seriously lacks government interest. Actually, the first footsteps should come from the government by making it mandatory to have at least a graduate pharmacist in every hospital. In the recent year, the number of the hospital in Bangladesh is more than 2000 (in 2006 it was 1683, 678 were government hospitals and 1005 were non-governmental). In that case, if I consider a simple statistics, that is in every hospital 10 graduate pharmacists are involved (in Apollo hospital it is 24) in patient care system so required the number of pharmacists will be 16830. The challenge of health care system can be faced only by changing the approach to a pharmacists education. Every pharmaceutical institution should focus on the applied and effective knowledge of pharmacy rather than the traditional one.
It is also recommended to the hospital administrators that hospital pharmacy should be launched to ensure patient compliance and therapy outcome and to provide healthcare services of international standard. Pharmacists and pharmacy services are a vital part of a healthcare system. To attain the ideal healthcare service doctor, pharmacist, nurse and other healthcare professionals must work together. Legal reform is needed to achieve the health objectives of the nation to contribute towards attainment of the Sustainable Development Goals (SDG) and to achieve the acceptance of the pharmacy profession as an integral part of a well-structured health care system. The government of Bangladesh should ensure the hospital pharmacy service to all the peoples in order to reduce medication-related errors and to improve patients care and safety.
Md. Delowar Hossain is a Student at Department of Pharmacy in East West University, Bangladesh. He can be reached at email@example.com
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