Educators-led Diabetes Mini Clinics in Sudan

 

“There are 1.7 million diabetic patients in Sudan” said Prof.Mohamed Ali Eltom, “and the number is increasing because of the social life. Consumption of excessive sugar, starch, oil and no exercise is the cause. We need to work on both prevention and care at the primary level”.

Diabetes Care Organization (DCO) was formed three years ago under the Chairmanship of Prof. Mohamed Ali Eltom. DCO is a non-profit organization comprising health professionals, businessmen, social activists spread across 12 states in Sudan who work with Diabetics, provide them with medications, advocacy, tell them about patient rights and carry out awareness campaigns on diabetes. They had a campaign last Thursday in a village called Kabashi in Khartoum North.

Under the leadership of former Ambassador Dr.Mohamed Ali Eltom, DCO has initiated a one year post graduate diploma course for ‘Diabetes Educators’. This is in collaboration with the University of Ahfad and the Federal Ministry of Health. This course will be provided for 100 healthcare professionals. The course will consist of a three-month intensive training at the University of Ahfad that includes lectures, workshops, student presentations, and clinical work. The curriculum of the course is based on the “International Curriculum for Diabetes Health Professional Education” designed by the International Diabetes Federation (IDF). Upon successful completion and examination of the postgraduate course, students will be granted a diploma in diabetes education. The course has been approved by the scientific board of the University of Ahfad, and accredited by the Ministry of Higher Education.

Following the course, diabetes educators will complete a nine month internship at Diabetes Mini Clinics, and sign contracts to work at the DMC for three years after completing the training program. In addition, the diabetes educators will be the focal point of the Diabetes Association and act as diabetes coordinators for the district health authority. The DMCs will be integrated into the existing health care system. The key feature of the DMCs will be self-management and care training delivered by well-informed diabetes educators and medical practitioners. Each DMC will dedicate at least one day per year for community diabetes screening and awareness.

Prof.Mohamed Al Eltom said that the Diabetes Centre in Dongula is the best so far with mobile clinic, awareness programmes and patient monitoring. DCO provides only technical support but no financial assistance.

Life saving medicines donated to Khartoum State Ministry of Health

We are all aware that recent rains and floods have affected thousands of people in Khartoum and other areas. Some of the people have lost their lives and the rest have lost their homes and property. As an aftermath of this crisis the major problem that arises in the affected people are diseases like malaria, gastrointestinal infections and other infections. As a social responsibility to help the affected people, Fast International Company a leading importer of medicines from India, Jordan, Cyprus, Austria, Switzerland and Egypt donated life saving medicines and other medications to the Khartoum State Ministry of Health on 2^nd September’13. Dr.Mamoun Homeida thanked Dr.Tarig Mohy Eldin Algemiabi the Chairman & CEO of the company. The value of the medicines donated was SDG 400 million. Dr.Tarig was happy to extend this help because the State Ministry he said knows where and who are the needy people for these medications.

The Changing Role of Community Pharmacists FROM DRUG DISPENSATION TO MEDICAL INFORMATION

According to the National Association of Boards of Pharmacy in USA, there are as many as 7000 deaths annually from incorrect prescriptions. These Medication Errors can occur in hospitals or pharmacies and the error may be made by any of the staff involved with choosing or dispensing medication.

 Medication Errors may be of the following types:

Inappropriate medications: the wrong medication given for a disease.

Wrong medication: the patient gets the wrong medication despite the doctor prescribing the correct one.

Drug name mix-ups:  several medications have similar-sounding names and can be mixed up by doctors or pharmacists.

Wrong medication combinations:  there are numerous types of medications that should not be mixed, because of side-effects and cross-reactions when combined.

Adverse reactions to medications:  some people have allergic or other adverse reactions to certain medications. These are risks and not necessarily avoidable mistakes if the person has no previous history of a particular adverse reaction.

Side Effects of medication:  Almost all medications have some types of side effects. Some are mild and some not so mild. It is almost impossible to know whether a person will have side effects from a medication.

Non-compliance: the failure to follow your medication regimen can be a mistake made usually by the patient.

A survey in the city of Khartoum revealed that the drug mix-ups due to similar sounding drugs may occur between Podoxime and Poxidium; Diaxine and Digoxin; Methycobal and Methyldopa; Yesolon and Yesytion. Each one of these names is a different medicine prescribed for different diseases. The mix- ups happen more when the prescriber’s handwriting is not very clear.

Sometimes a Doctor prescribes Chloramphenicol Eye Drops but by mistake Chloramphenicol Ear Drops is dispensed to the patient due to unclear handwriting of the words Eye and Ear.

Sometimes mistakes are made because the packaging is very similar of different medications. The bottles of Yexoral and Yamidine look similar and when Pharmacists are very busy at the counter such mistakes may occur. The former is a mouth wash and the latter an antiseptic solution.

As a consumer you can avoid these errors by going back to the Physician with the medication dispensed to you for verification.

The best way to minimize Medication Errors is by continuous training and development of Community Pharmacists and by providing Medical Information Services to Pharmacists.

Community Pharmacists are recognized as the expert on medicines , the most accessible healthcare professional, often the first point of contact for patients with health enquiries and for some the only contact. There are Good Pharmacy Practice (GPP) guidelines and Standard Operating Procedures (SOPs) which assure quality and consistency of the service. This enables the Pharmacist to follow good dispensing procedures which comprises checking the prescription that it is clinically correct for the patient, checking drug interactions, labeling, re-checking accuracy against prescription and delivery to the patient with the appropriate advice about the medication.

Khartoum Medicines Information Centre (KhMIC) was established by the General Directorate of Pharmacy –Khartoum State in the year 2000, aiming at developing the pharmaceutical services provided to citizens and medical care professionals. KhMIC provides many services including responding to all questions and queries related to medicines and received from customers using the latest methods.

For the first time in Sudan, an electronic Patient Medication Record (ePMRx) and Labeling System has been installed at Khartoum Centre for Pharmaceutical Care Practice (KCPCP).

Dr.Abdelrahman Hamid Ahmed B.Pharm, M.Sc, PhD, MAPS of the University of Bath, U.K. keeps visiting Khartoum from time to time to conduct workshops under the Ministry of Health for Pharmacists. He has introduced MiDatabank, a Windows software application that enables Medical Information Pharmacists to answer, record, store and analyse Medical Information Enquiries, Complaints and Adverse Drug Reactions. Dr. Abdelrahman  Hamid Ahmed  has made it his mission to upgrade the professionalism of Community Pharmacists in Sudan and introduce the concept of Medical Information Pharmacists.

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Captions for Photographs:

      Above: Khartoum Centre for Pharmaceutical Care Practice

Below:     Dr.Abderahman Hamid Ahmed