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PHIDISA Pharmacy Operational Team Report. Richards Bay Conference July 2004. Pharmaceutical Care Operational Team. Outline. Accomplishments, Challenges, and Future Plans/Proposals: Drug Procurement & Storage ARV Use Projection/Budget (Aug 2004-July 2005) Site Development & Personnel Needs

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phidisa pharmacy operational team report

PHIDISA Pharmacy Operational Team Report

Richards Bay Conference

July 2004

outline
Outline
  • Accomplishments, Challenges, and Future Plans/Proposals:
    • Drug Procurement & Storage
    • ARV Use Projection/Budget (Aug 2004-July 2005)
    • Site Development & Personnel Needs
    • Pharmacist Accomplishments
    • Staff Training
    • Other Accomplishments & Future Plans
  • Non-ARV Budget
drug procurement major challenges
Drug ProcurementMajor Challenges
  • Forecast of drug usage& stock levels –
    • Need to project rate of patient enrollment
    • Assure uninterrupted supply of ARV
    • Awaited access to MHBD for ARV stock level
    • Challenge will increase as all sites become operational
  • Anticipate manufacturer backorders and delivery delays – estimate time from order to delivery
  • Treatment of ARV-experienced adults and pediatric patients (PEPFAR) – acquisition of paediatric formulations & new accountability system
drug procurement future plans challenges
Drug ProcurementFuture Plans/Challenges
  • Establish new mechanism for ARV procurement – via NIH contract instead of HJF
  • Establish new demand projection & budget for:
    • Opening of 2 Mil Hosp. & Umtata sickbay
    • Initiation of PHIDISA III protocol
    • Use of PEPFAR funds for paediatric patients & adult patients excluded from PHIDISA II
  • Separation of PHIDISA vs. PEPFAR accounts & stocks
  • Delivery of ARVs to the 2 new sites (at least 1-2 weeks prior to launching of PHIDISA II)
  • Potential for opening of 3 Mil & Phlaborwa
pharmacy personnel accomplishments
Pharmacy Personnel Accomplishments
  • Development of PHIDISA Pharmacy SOP
  • Key adherence counselors for all patients
  • Development of documentation tools:
    • Patient medication profiles
    • Patient 1st visit medication history (w/ info on herbal meds) & assessment
    • Patient progress note at all patient encounters
  • Abstract submitted to American Society of Health-System Pharmacists’ Annual Meeting – pending approval (Dec ’04, Orlando, FL)
pharmacy personnel site development challenges
Pharmacy Personnel & Site Development Challenges
  • 1 Mil - PHIDISA Pharmacy can only dispense ARVs, pts need to fill other supportive meds in C-block pharmacy
  • Drug Information Specialist hired for PHIDISA has not been able to receive training to perform this task due to more urgent administrative functions
  • Awaiting installation of computer & printer in Mtubatuba – for prescription entry & labelling printing – currently writing Rx labels manually
  • Pharmacy registration at Pharmacy Council
  • Training of pharmacist assistants
  • Projected workload increase with increasing enrolment into multiple protocols & additional sites
pharmacy personnel site development preparation of new sites proposals
Pharmacy Personnel & Site Development Preparation of New Sites/Proposals

Identify, hire, and train 2 new pharmacists ASAP (at least one month before launching of PHIDISA II at each site – ie. mid-August for 2 Mil & mid Sep for Umtata)

  • Preparation of 2 Mil and Umtata Pharmacies ASAP
    • Section head to visit both sites to assess readiness
  • 1-week training for new pharmacists at 1 Mil prior to beginning of PHIDISA II
  • US Pharmacists to assist in on-site clinical training
  • Register Umtata pharmacy with Pharmacy Council
pharmacy personnel training future plans proposals
Pharmacy Personnel TrainingFuture Plans/Proposals
  • US pharmacists on site periodically to provide intensive trainings
  • MicroMedex software – training by visiting US pharmacists and physicians at the different sites
  • At least one local, national, or regional HIV conference per pharmacist per year (leave coverage to be provided by 1 Mil pharmacists)
  • Attendance and presentations at PHIDISA clinic meetings
  • Continue or initiate self-training via medical journals or websites
  • Potential for training in the US for selected pharmacist(s)
pharmacy personnel needs future plans proposals
Pharmacy Personnel NeedsFuture Plans/Proposals
  • Section head willassess the needs for additional pharmacy staff (pharmacist and/or pharmacist assistants) as enrolment increases
  • Liase with SAMHS pharmacy administration – for cross training of SAMHS pharmacists for PHIDISA project with potential for providing leave coverages
  • Potential for hiring and training part-time pharmacist(s) for leave coverage
other pharmacy section accomplishments
Other Pharmacy Section Accomplishments
  • Conducted 1st PHIDISA substudy – led by Edmund Capparelli, Pharm.D., UCSD entitled:

“Stability of Lopinavir/ritonavir (co-formulated as Kaletra®) at Elevated Temperatures – Relevance to HIV Therapy in Sub-Saharan Africa”

To be presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Oct 2004 (Washington DC); manuscript in preparation

goals from july 2003 not yet accomplished plan for the future
Goals from July 2003 Not Yet Accomplished – Plan for the Future
  • Development of a Drug Information Center for PHIDISA
  • Pharmacovigilance substudy
  • Adherence substudy
  • Medication Usage Evaluation
other issues to address
Other Issues to Address
  • Initiate request for addition of rifabutin into the SAMHS pharmacy formulary for use in HIV/TB co-infected patients
  • Potential for acquisition, storage, and dispensing of nutritional supplement for PHIDISA III protocol
  • Budget for PHIDISA III nutrition supplement