Improving the Quality of Pharmaceutical Services to Enhance Treatment Outcomes

 

Good treatment outcomes depend on patient-centered pharmaceutical services that ensure that medical products are prescribed, dispensed, and used appropriately.

Effective pharmaceutical services enhance patient outcomes and satisfaction by improving responsiveness to patients’ needs and contexts, reducing wastage, and maximizing efficiency. For example, with support from MSH, national stakeholders in Ethiopia successfully institutionalized clinical pharmacy services in hospitals to improve patient safety and outcomes. Pharmacists at six participating hospitals identified 79 treatment errors at the point of service between October and December 2016, all of which were immediately corrected.

However, inappropriate medicine use by prescribers, nurses, pharmacists, and patients is common. Quality of pharmaceutical care is often suboptimal in low- and middle-income countries due to a lack of systems, governance, tools, standards, awareness, and expertise for providing patient-centered pharmaceutical services. Overuse and misuse of antimicrobial agents is rampant—about half of viral respiratory infections and diarrhea cases receive unneeded antibiotics. This fuels drug resistance. To be effective, pharmaceutical services need to go beyond supply management and encompass strategies and interventions to improve patient-centered care and medicine use.

MTaPS applies systems-based approaches using proven tools, interventions, and quality improvement methodologies to strengthen in-country capacity and enhance patient-centered pharmaceutical care. In doing so, MTaPS embeds the culture of quality of care emphasized by the Sustainable Development Goals, the World Health Organization, and other global and national bodies. In particular, MTaPS focuses on the following USAID results areas:

  • Delivery of effective pharmaceutical care as part of an essential package of health services
  • Increase in appropriate medicines use by patients and providers
  • Support for pharmacovigilance to improve patient safety
  • Comprehensive approaches to support antimicrobial stewardship

MTaPS helps countries:

  • Improve patient satisfaction, adherence, and outcomes through partnership with patients and caregivers; support better patient-provider communication techniques; and test mobile tools to reduce barriers to information access for providers and patients
  • Improve competencies and coverage of providers through preservice trainings and continuing professional development activities, including eLearning programs
  • Develop, update, and integrate appropriate tools and standards into the pharmaceutical services system
  • Support ministries of health, faith-based organizations, and the private sector to develop/adapt standards, guidelines, and tools to institutionalize pharmaceutical care as part of essential packages of health services
  • Promote and support a culture of continuous quality improvement, team work, continuum of care, and use of data to monitor improvement
  • Build the capacity of drug and therapeutics committees, quality assurance committees, and other multidisciplinary teams to monitor appropriate use of medicines and patient satisfaction through patient surveys and other interventions
  • Mobilize and coordinate with stakeholders, including professional associations, consumer/patient advocacy groups, and civil societies to optimize the use of medicines
  • Support patient-centered pharmaceutical service standards, clinical governance, and accreditation schemes for pharmaceutical outlets in the public and private sectors
  • Adopt minimum standards for dispensing areas, including privacy for counseling; strengthen the roles of pharmacists in patient care (e.g., through clinical pharmacy programs); and support accreditation schemes to improve pharmacy practice standards
  • Support medicine use reviews and help develop and implement interventions to ensure that prescribing complies with guidelines and formularies
  • Develop, implement, and monitor national action plans and disseminate best practices from national strategies to combat antimicrobial resistance (AMR)
  • Help countries strengthen their pharmacovigilance systems, including involvement of civil society organizations and the private sector; improving capacity and availability of local experts; and instituting active surveillance
  • Promote operational research to improve evidence on safe, cost-effective, and appropriate use of medicines; work with national and international partners; and advance the global learning agenda relating to patient-centered pharmaceutical care

With MTaPS’ help, countries will choose from and customize these strategies based on their own needs and work closely with national counterparts to achieve sustainable improvements in the use of medicines, patient-centered pharmaceutical care, and AMR containment. MTaPS helps apply such interventions in both acute and chronic care settings and for both noncommunicable and communicable diseases, including HIV and AIDS, malaria, TB, neglected tropical diseases, and mother and child health conditions.

For more information, contact:

Senior Principal Technical Advisor, Pharmaceutical Services

Mohan Joshi

mjoshi@mtapsprogram.org