Pharmacy Education Newsletter, Issue 4

PEN

PharmacyEducationNewsletter

InternationalPharmaceuticalStudents’ Federation

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[email protected]://pharmacy-ed.ipsf.org

PENeditorial

Dear IPSFers,

It is a great pleasure for me to pres-ent the fourth edition of Pharmacy Education Newsletter to you.

The highlight of this edition comes from our Chairperson of Pharmacy Education, Mr. Marouen Ben Gue-bila, himself. He wrote an interesting article about genome sequencing and the latest developments in this field - i especially related to person-alized medicine and the controversy this may bring.

Ms. Ahlem el-Ghoul shares some information about a common but sometimes overlooked problem pharmacists encounter in their pro-fessional work, medication errors.

Our experienced IPSF’er, Ms. Shirley Young, provides us some insight on academic detailing, a relatively new practice she is doing in her profes-sional work as a clinical pharmacist

in Canada.

Last but not least we have an event review where Ms. Sevdenur Karataş shares her experience in the 11th National Pharmacy Fair, in Turkey, which is somehow unique because in addition to being an event where pharmaceutical companies promote their firms and latest products; it provides separate programs for final year pharmacy students and also gave pharmacy students’ clubs and associations opportunity to pro-mote their activities.

As a publication PEN is still a new project and there are much room for improvement. For this reason, don’t hesitate to contact us at [email protected] if you have any comments, suggestions, or even if you want to get your article published here.

Enjoy reading, viva la Pharmacie!

contentpublicationteam

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Mr. Fahmi Fuady

Phuture Co-Ordinator 2012-2013

Design & LayoutMs. Alexandra Marques

Cover photoLoadPaper.com

http://loadpaper.com/id61808/wallpaper-original-dna-helix-metal-shape-background-download-1920x1080-pixel.html

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[email protected]@ipsf.org

Ed innovation

Page 14

Medication Errors: Causes and Prevention

Ms. Ahlem el Ghoul

Academic Detailing – An Expanded Role of a Pharmacist,

a Canadian ExperienceMs. Shirley Yeung

Page 8

Page10

Ms. Yuqian Liu [Editor-in-Chief]Ms. Amber Liu

IPSF Chairperson of Media and Publications

know IPSF partnersStudyPortals

Page 12

Post-event

11th Pharmaceuctical Fair in Turkey & OTC

WorkshopMs. Sevdenur Karataş

Page 4highl

ight Genome sequencing :

a paradigm shift in personalized medicine

Mr. Marouen Ben Guebila

PENhighlight

Genome sequencing : a paradigm shift in personalized medicineby Mr. Marouen Ben Guebila, IPSF Chairperson of Pharmacy Education 2012-13

The first human genome was sequenced from 1992 to 2002. It took more than ten years and the involvement of several hun-dreds of molecular biology labs from different countries in the world. In 2013, sequencing the human genome takes … six hours(figure 1).

In terms of financial load, today, sequencing the human genome costs only 1000 dollars

while in the beginning , the human genome project cost was around 1 billion dollars.

The direct outcome of this study was that there was not only one human genome, but several ge-nomes. We are all different and this difference is coded in our genome. Humans only differ by 1% to the Chimpanzee genome. Inter-individual variabil-ity concerns only slight parts of the genomes. Sev-eral studies revealed that these regions are highly responsible for drug efficacy.

The big question scientists had at the time is: if we are all different, why should we take the same medicine? The concept of personalized medicine started from this fact.

The variability in the genome comes in the form of mutations (silent or active), called single nucleo-

tide polymorphism (SNP). Several studies focused on these variations to find a correlation to drug re-sponse. Codeine and Warfarin were the first drugs that had a genetic tests developed for patients and the list is still enlarging. The human genome (Ornl, 2003) sequencing allowed moving from pharma-cogenetics (studying one gene at a time) to phar-macogenomics, with a whole genome overview to variability.

Genome Wide Associations Studies (GWAS)(Psy-chiatric GWAS Consortium coordinating comittee, 2009) are the direct income of genome sequencing. The purpose was to find inter-gene interactions that could impact drug efficiency. Today, more variabil-ity sources were identified like Copy Number Vari-ation (CNV) and epigenetic factors. All these com-bined together, in meta-analysis helped identifying causes of non-response to several drugs.

Since then, an ambitious project was launched; 1000 genome project (Siva, 2008)aims to sequence the genome from different countries and ethnics to understand better the variation in the genome.

Transcriptomic studies, started very recently had a lot of interest. In several cases, transcriptomic pro-filing can give more information than just studying the genome. Several successes have been made in understanding, drug response using transcriptom-ics. ENCODE project with 30 original article (Encode, 2012), especially, gave a better understanding of coding regions in the genome. Maybe a bigger con-

PENhighlight

clusion is that, non-coding regions are as useful as coding regions and can have a great impact on vari-ability between individuals.

In 2012, The FDA, was the first drug agency to de-liver a marketing authorization for drugs for African-American people, based on these genome studies.

In conclusion, a lot of question remains without an answer. Genome studies are a new path that adds a new element to the answer. But not without risks, in fact, several countries refuse to segregate people on genome basis, called ethnic studies. Ethically, our ge-nome, can, in the near future, inform about the dis-ease predisposition. Imagine this kind of information falling in the hands of your banker or your employer … Limits need to be set to avoid any misuse of medi-cal data.

Finally, It is true that human genome sequencing costs almost 1000 dollars nowadays, but analysis cost

is getting higher and higher, with a need of highly trained people, high computational capabilities and last but not least a relevant interpretation.

References:

Ornl. (2003). Taken from HGP: http://www.ornl.gov/sci/techresources/Human_Genome

Encode. (2012). Taken from Nature: http://www.nature.com/encode/

Psychiatric GWAS Consortium coordinating com-ittee. (2009). Genomewide Association Studies: His-tory, Rationale, and Prospects for Psychiatric Disor-ders. Am J Psychiatry.

Siva, N. (2008). 1000 Genomes project. Nature Bio-technology.

Figure 1 – Third generation sequencers (left) and first generation sequencers (right).With more precision, longer reads and higher speed, third generation sequencers are taking New Generation Sequencers (NGS) to the next level. An error rate of 20 % re-mains their main weakness.

PENEd innovation

Medication Errors: Causes and Preventionby Ms. Ahlem el Ghoul

Although drug therapy is considered as a widely used type of remedy, it is not al-ways the safest path to take, knowing that many errors may occur during its process causing health disorders, which are sometimes life-threatening.

Medication Error is defined by the American Food and Drug Administration (FDA) as “any preventable event that

may cause or lead to inappropriate medication use or patient harm while the medication is in the con-trol of the health care professional, patient, or con-sumer. Such events may be related to professional practice, health care products, procedures, and sys-tems, including prescribing; order communication; product labeling packaging, and nomenclature; compounding; dispensing; distribution; administra-tion; education; monitoring; and use”

Studies have been devoted to reveal causes of drug errors that are usually due to negligence of health care providers or patients themselves, some of the most common causes are: illegible handwrit-ten prescriptions, oral transmission of prescriptions -sound-alike names may cause error -, selection of an incorrect drug or dose or a too complex regi-

men can lead to prescribing errors, pharmacists’ lack of attention and concentration (in a busy day for example), lack of patient information about their drugs, self medication, the absence of communica-tion between prescribers and pharmacists, includ-ing hospital nurses, and also between pharmacists and patients.

There are other reasons such as: illiteracy, mostly in the third world countries, and the replacement of pharmacists by unqualified sales clerks at drug stores.

To assure medication safety Institute of Safe Med-ication Practices (ISMP) developed the 10 key ele-ments of medication use:

• patientinformation• druginformation• adequatecommunication• drugpackaging,labeling,andnomenclature• medication storage, stock, standardization,

and distribution • drug device acquisition, use, andmonitor-

ing • environmentalfactors• staffeducationandcompetency• patienteducation• Qualityprocessesandriskmanagement.

Each country implements its own medication vig-ilance system in order to prevent and reduce drug errors:

PENEd innovation

Canada:

ISMP Canada, ensures safe use of medications, prevention of medication errors and regulates healthcare policies by collaborating with several national and international patient safety organiza-tions worldwide along with ISMP US. ISMP Canada, Canadian Institute for Health Information (CIHI) and Health Canada have led to the development of Canadian Medication Incident Reporting and Pre-vention System (CMIRPS), which is concerned with reporting and prevention of medication error inci-dents all over the nation.

ISMP Canada and ISMP US have created internet accessible software called Analyze ERR that records, tracks and performs a root cause analysis of medica-tion error.

Europe:

The European Foundation for the Advancement of Healthcare Practitioners (EFAHP) introduced the European Medication Error Reporting Program to provide a uniform method to report medication er-rors. This program is useful in helping healthcare or-ganizations and practitioners across Europe to use medicines more safely. It has also initiated medica-tion safety awareness, which includes meetings and seminars.

United States:

The United States Pharmacopoeia (USP) Medica-tion Error Reporting Program (MERP) is run in coop-eration with the Institute of Safe Medication Prac-tices. All reports are reviewed and assessed than forwarded to FDA, which also has an adverse event reporting program called MedWatch.

To augment the USP MERP and MedWatch pro-grams, USP has launched MedMARx®, an Internet-accessible method for hospitals to anonymously report and track medication errors in a standard format.

Meanwhile, many internal institutions are also developing medication errors reporting programs, which are turned out to be even more effective than the national programs.

Algeria:

The national center of Pharmacovigilance and Materiovigilance (Centre national de Pharmacovigi-lance et de Materiovigilance) (CNPM) is a surveil-lance system established to insure safety. The center set a system of detection, evaluation and risk man-agement in terms of drugs, vaccines and medical devices, as well as dissemination of information on incidents and potential incidents.

One of the CNPM objectives is to promote ration-al use of medication and prevent medication errors.

Since pharmacists are the most accessible health care professionals they play a crucial role in pre-venting and reducing medication errors by deliver-ing correct and accurate information about drugs, permanently actualizing medicines information and improving their patient counseling skills.

To reach our goal, which is reducing medical er-rors, we should all shout out the seriousness of the matter and its risks.

Sources:http://www.ismp.org

http://www.fda.govhttp://www.cnpm.org.dz

PENEd innovation

Academic Detailing – An Expanded Role of a Pharmacist, a Canadian Experienceby Ms. Shirley Yeung, from Vancouver, Canada

The pharmacist is often known as the medication expert within the healthcare team. Typically, pharmacists have been placed in a traditional dispensary role, provid-ing medications and counselling to patients as required. Globally, there has been a push, where pharma-cists are trying to expand beyond the technical dispensary role and into the more clinical role, where their medication knowledge can be fully utilized.

Over the years, it has been noted that prescribing practices are often

influenced by the marketing done by various pharmaceutical companies. These companies often send out representatives, with little or no medical knowledge to sell various medica-tions to the doctors. It is common for these representatives to overemphasize the benefits and minimize the risks of the medications to make them more appealing to the physicians.

To counteract these influences, in Canada, a relatively new-er service, often known as academic detailing or educational outreach, has been implemented. This service utilizes health-care professionals, mainly pharmacists, to provide evidence‐informed drug information to the physicians. The goal of the service is to provide the most up‐to‐date drug information to optimize prescribing practices and promote the best possible outcomes for patients.

Physicians, especially general practitioners, are extremely busy; therefore, it is important to be mindful of this when speaking to them about drug information. In order to provide the most practical information, a detailed literature review must already be completed on the topic. This may include critically reviewing the latest meta‐analysis, randomized

controlled trials, observational studies and various national guidelines as necessary. The literature is then summarized and condensed to a format that can used as a reference for the de-tailing session.

During the detailing session, the pharmacist and the physi-cian would have a discussion about the drug information. Giv-en that time is valuable for the physician, not every physician will have the same learning needs, making each and every de-tailing session unique. In order to fulfil each of the prescriber’s needs, it is important to have effective communication skills. It is especially helpful to be flexible and adapt to questions that the prescriber has and be able to provide practical recommen-dations that can be applied easily to clinical practice.

The trickiest aspect is to convince the physician to adapt and use the information that is provided. In a sense, the phar-macist is trying to “sell” information, and market an idea. This is why it is important to have effective communication skills to persuade the physician to “buy in” on the information, so that his or her prescribing practices would be changed. It is also important to develop a respectful relationship between the pharmacist and prescriber. This will create a non‐threaten-ing learning environment to ensure better delivery of the drug information to improve the overall pharmaceutical care of the patient.

Services like this have been implemented in multiple coun-tries including USA, Australia, UK, and Sweden for about 20 years. Multiple studies have also been conducted to assess the effects of academic detailing on prescribing. It is evident that these discussions and educational sessions with the pharma-cists will effectively modify prescribing habits to ensure opti-mal patient care.

This is an example where pharmacists can use their ex-pertise in medication knowledge to enhance pharmaceuti-cal care. It is an extremely unique role as the pharmacist can modify patient care at the point of prescribing, rather than at the point of dispensing.

PENFIPEd corner

FIP Education Initiatives and WHO are implementing a global survey that aims to collect information:

To ascertain the educational background of the pharmacy workforce and production capacity;

To ascertain quality assurance accreditation mechanisms and processes.

The data will be used to identify gaps, shortages and cooperation opportunities, besides provid-ing the evidence-based information needed for investment policies that will reduce existing gaps

and increase pharmacy education capacity.

The participation of all pharmacy education institutions in this survey is vital to provide a better understanding of current pharmacy education issues, and will assist in the development of global

pharmacy education policy recommendations.

For these reasons, FIP and WHO have sent an invitation to the Deans of all schools of pharmacy to complete the Global Survey of Pharmacy Schools. Please help us by ensuring that your Dean or School leader has completed the survey for your pharmacy school/faculty/department [www.fip.

org/education].

Should you wish to provide data on behalf of your school or your country please contact Andreia Bruno [email protected] to obtain the information to be able to complete the survey. If you have any comments or

questions concerning the project please send them to [email protected].

A million thanks in advance for your help!FIPEd Development Team

FIP-WHO Global Survey of Pharmacy Schools Has your school responded?

PENpost-event

11th Pharmaceuctical Fair in Turkey &OTC Workshopby Ms. Sevdenur Karataş , IUPSA International Vice President of Education 2012-2013

11th Pharmaceutical fair and OTC workshop took place on 3rd and 4th Novem-ber 2012 in Istanbul, Turkey. The event was hosted by Devajans, a company whose main activity is organizing fairs around Turkey. Numer-ous pharmaceutical compa-nies including recently es-tablished ones participated in this fair to promote their companies, products, and

most importantly new licensed medications for more than 4.000 visitors. There were also booths for pharmacy faculties and students’ associations, which gave them the opportunity to introduce themselves, their goals and their activities. This also helped to gather students from all over Turkey un-der one roof. As IUPSA International, we promoted not only our association but also IPSF, its activities and how to get involved.

The fair was a great opportunity for pharmacists, pharmacy students and healthcare professionals to discuss and acquire the latest knowledge about the changes in pharmacy system and our ongoing role in it. In recent years, the health care system has de-veloped very fast in Turkey therefore it is crucial to keep updated with the changes and be aware of the challenges that comes along them.

This year the fair has improved compared to the previous years. In addition to the fair itself, there were a workshop about OTC, a separate conference for final year pharmacy students, an essay competi-tion and a pharmacy technicians meeting.

OTC products were chosen as the topic for the workshop because of their rising importance in Turkey. It has been observed that the sales of these products have increased lately which may be a di-rect result of some changes in laws related to ad-vertising. This also has affected the trend in medica-tion consuming in the population. In the workshop, the speakers informed the pharmacists about the changes in laws, aromatherapy, homeopathy, and staffs management. They also gave practical infor-mation which can be used when counseling pa-tients.

During the conference, which held for final year students, the speakers focused on topics such as communication skills, pharmacists’ role in coun-seling, and career steps for future pharmacists. They explained what kind of difficulties we may face ear-ly in our career and most importantly how we can overcome them. Two successful pharmacists gave a presentation about their career in pharmaceutical company and their path to success.

The essay competition was also organized for final year pharmacy students and fresh graduates, who probably have the most expectation about how they are going to practice their professions.

PENpost-event

The topic was ‘the pharmacy of my dream’ and the goal behind this competition was to get some new ideas in that can be implemented in community pharmacy practice in Turkey. Some students wrote their ideas about how to improve pharmaceutical care practice, some described more about crazy designs of a dream pharmacy and some wrote in a more literary way. Although all the essays were well-written and interesting, only the first five es-

says were awarded at the end of the competition. The first prize winner wrote a detailed essay cover-ing many aspect of pharmacy from the pharmacists function in his imaginary pharmacy to the relation with patients and other healthcare practitioners.

All things considered 11th Pharmacy Fair & OTC Workshop was a great experience, filled with many educational seminars and stands.

PENknow IPSF partners

Did you know that there are are more than 150 Master’s programmes related to Pharmacy in Europe?

And did you know that there is over 16 billion euro available in scholarships to study in Europe? Now you do. Be surprised by the great study opportunities that Europe has to offer with thanks to StudyPortals – the European study choice plat-form.

The team of StudyPortals does its best to stimulate and inform you on international study choice. On several web portals you can find relevant information about study programmes, including pharmacol-ogy and related studies as well as information about funding opportunities. In addition on you have a great chance to learn from others students and experiences they have shared on Student Experience Exchange platform.

StudyPortals provides a unique overview of all study programs offered in any European country. Through the search engine you can find study programmes in pharmacy or other disciplines of interest. Each program has a short description, information about the tuition fee, duration and university infor-mation. It provides all details related to study programme: application requirements, contents, applica-tion deadlines, start dates, mode etc.

Check it out and find your Bachelor’s, Master’s, PhD, Short Courses or Online Degree (and Scholarships to finance it).

InternationalPharmaceuticalStudents’ Federation

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Tel: +31 70 302 1992Fax: +31 70 302 1999

Email: [email protected]: www.ipsf.org

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/.

Pharmacy Education Newsletter, Issue 4

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