Hiding Medication information from Patients  Unethical – Onwuka

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Dr Chukwudi Onwuka is an accomplished pharmacist with about four decades of practice in the United States. In this exclusive interview with Pharmanews, he shares some of his experience over there, while also highlighting the numerous essential roles of pharmacists in the society. Excerpts:

Can you briefly tell us about your background?

Let me first of all appreciate you for the good work you   are doing under Pharm. Ifeanyi Atueyi. This is the second time I am interacting with Pharmanews. The first one was in October 1979. If you check your archives, you will see my article you published when I was a student at the Northeastern University in Boston. Indeed, I started with Pharmanews 41 years ago.

Hiding Medication information from Patients  Unethical - Onwuka
Dr Chukwudi Onwuka

I am from Okija in Anambra state. I left for the US in September 1977 and studied Pharmacy at the Northeastern University, Boston, Massachusetts, obtaining Bachelor of Pharmacy in 1982 and master’s degree in Hospital Pharmacy Administration in 1985. Later I obtained PhD in Healthcare Administration from Capella University. I own and manage Broad Ridge Drug in Gary, Indiana. I am glad that two of our children are also pharmacists practising in the US.

What motivated you to study Pharmacy?

Pharmacy has always been my dream, even though when I was young, I met a judge, who is a close relative and he advised me to study Law, in order to become a lawyer. But I didn’t yield to that advice because of my desire to practise Pharmacy.

My love for Pharmacy started from my father. He was not educated but he practised both traditional pharmacy and surgery. People who had abscess and boils consulted him for treatment, and he operated on them. So, Medicine had always been in the family, and some of my elder brothers became medical doctors, but Medicine wasn’t my own desired profession. Pharmacy has been the profession I wanted and I’m glad I achieved my ambition.

How would you describe the roles of pharmacists in the healthcare industry in Nigeria?

Pharmacists have several responsibilities to patients and in the drug distribution system.

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Some of our roles include: ensuring the supply of medicines within the laws and regulation, ensuring that medicines prescribed for patients are safe and suitable; advising patients about medicines, including their doses and side-effects and answering their questions.

We also supervise the medicines supply chain and ensure pharmacy premises and systems are fit for the purpose; advise other healthcare professionals about safe and effective medicines use, safe and secure supply of medicines; respond to patients’ symptoms and advise on medicines for sale in pharmacies; supervise the production and preparation of medicines and assessments of quality of medicines before they are supplied to patients.

However, these roles of pharmacists are affected by shortage of professionals and inadequate remuneration in Nigeria. Their roles will be more effective when more pharmacists return to the country, because one thing is obvious; healthcare professionals that left Nigeria for overseas will eventually come back.

From my personal experience, I know that most people that travelled out desire to come back and work in Nigeria, but their present condition may not allow them. For instance, when I left Nigeria, I had the intention of staying over there for just five years; I never planned to stay this long. But, it is still on my mind to come back to the country. In fact, my desire is to practise here, and this is why I came to the University of Benin few years ago and attended the mandatory course for my registration to practise locally.

Having practised in the U.S, what are the values of pharmacy there that can adopted in Nigeria?

The first thing to know is that the pharmacist’s role there is well defined. Over there, physicians don’t practise Pharmacy, as pharmacists dispense drugs and do counselling, and also get involved in clinical aspect of Pharmacy. That is why we study and acquire the Pharm D. degree.

There are procedures a pharmacist must follow to avoid giving wrong medications because hospital settings are different from community pharmacy settings.

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Hospitals have their ways of checking medications to ensure pharmacists dispense drugs to the right patients at the right time.

One key difference in Nigeria is that when medications are given to patients in Nigeria, most caregivers usually avoid disclosing the names of the medications, so that they can protect their business. But that is wrong because a pharmacist is expected to take care of patients.

In the United States, pharmacists and physicians adhere to healthcare regulations to make things easy for patients to understand their medications.

Going forward, how can this wrong practice be corrected?

Pharmacy law prescribes that you have to label the medicine before handing it over to patients. This needs to be enforced. The policies and the laws of the Nigerian healthcare systems should be enforced. Laws are as good as non-existing if they are not enforced. Also, monitoring teams need to go round to find out those violating the regulations.

Again, it is necessary to give patients drug information, because if they travel and need to visit a health facility, they will know what to tell the caregivers.

What are the processes to help the society deal with the menace of fake, adulterated, and counterfeit medicines?

I will suggest that pharmacists should be conducting training for nurses on adequate use of medications, while nurses, in return, should learn how to explain medications use to patients.

Patients should be guided on how to recognise counterfeit drugs. They should be educated on the repercussions of buying cheap medications, which could lead to buying of fake ones.

Government also should endeavour to make free medications available, to enable patients know where to get authentic medicines free of charge.

This could be possible if there is a contract between pharmacists and government, where the government pays pharmacists for their services, and pharmacists dispense the medicines free to patients.

With this arrangement, if there is a dispensing fee, pharmacists will ensure that the medicines are not sold in the market, and they could even form a task force to ensure that nobody sells the medicines.

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Have you participated in any medical mission? If yes, tell us your experience during the exercise?

We started the Anambra State Association in the United States of America (ASA-USA) and Okija-USA (Okija people in USA). These medical missions were motivated by the fact that our people are not able to see doctors and do not have access to medications. So, some of us came up with the idea of medical mission and decided to come home on our own expenses. We contributed money every year to buy some medications and came home to help our people.

The medical mission team consists of different healthcare professionals, with pharmacists, nurses, doctors and others working together for the good of our people. Unlike visiting the hospital, where patients will have to pay to get cards to see doctors, you don’t need any formalities to see us during the mission; you can just walk in to see the doctors and pharmacists and they dispense medications to the patients, based on their needs after examination.

Let me state clearly that we embarked on the medical mission because of our love for our people, as some of the medical facilities in the state were dilapidated, and there was no access to medical care. In fact, it was when we initiated this idea that the government started picking interest in medical mission. Most patients who cannot afford to see a doctor were able to walk in to get diagnosis and treatment for any problem they had. Some of them, for the first time, knew they had blood pressure or diabetes. Another thing we did was to incorporate health education with the care, because we came across a lot of people who were ignorant of their problems.

The first medical mission we had was from June to August 2008, and I was privileged to coordinate the team.

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