Dr Chinyere Anyanwu is a pharmacy manager at Rite Aid Pharmacy, in Livonia, Michigan, USA, with a decade of successful experience in diverse areas of professional practice. An active member of the Nigerian Association of Pharmacists and Pharmaceutical Scientists in the Americas (NAPPSA) since 2015, she has also served as president of the Nigerian Pharmacy Association of Michigan, as well as being a member of the LOC that hosted the Detroit NAPPSA conference in 2015. In this interesting edition of Diaspora interview, Anyawu advocates the inclusion of immunisation certification in pharmacy course work, emphasising the urgency of its implementation, particularly as COVID-19 has revealed the need for pharmacists to be vaccine administrators. The certified coach/trainer and motivational speaker with the John Maxwell Team also speaks on other germane issues as related to pharmacy practice in Nigeria and abroad. Excerpts:
As a biochemist of several years, what informed your decision to study Pharmacy?
My journey into the pharmacy profession came as a result of my love for science and being influenced by my mother because she worked in the healthcare sector. Pharmacy for me was a perfect intersection between being a drug expert and a patient advocate. Science has always been my passion, especially growing up with my mum who is a nurse. Watching her attend to her patients as she incorporated medication administration piqued my interest in how drugs work in the body.
Prior to my first degree in Biochemistry from an accredited University in Nigeria, my intention was to become a medical doctor. During the process of obtaining my first degree, my interest shifted to a different area of study – Genetic Engineering. Nonetheless, I still didn’t feel the satisfaction of where that would lead me because of my faith. Ultimately, it was glaringly obvious that I wanted to help and serve my community by either mentoring or improving their lives.
So, when I immigrated to the United States and the opportunity presented itself for me to further my education, I did not hesitate to go after my passion. Pharmacists play an important role in improving health outcomes. We are patient educators, improve adherence and our involvement in the community cannot be overstated because we also bridge the gap between providers and patients. Being a pharmacist has been a rewarding career so far.
You have earned some recognition as a vaccinator, while your colleagues in Nigeria are still struggling to become licensed vaccinators. How would you advise the government on their behalf?
The COVID-19 pandemic continues to remind us of the necessity of preparedness against healthcare emergencies and the need for a robust and efficient deployment of all facets of the public health machinery towards achieving our national healthcare strategy. Preventing pharmacies from providing immunisations creates a vacuum and negatively impacts the community.
Already, doctors, hospitals and clinics are overwhelmed with high patient-load. Vaccination is an integral part of the pharmacy profession. Pharmacy schools should incorporate immunisation certification as part of their didactic course work to enable graduating students function more efficiently. Community pharmacists are one of the most easily accessible healthcare professionals in the community. It will be a value-added choice to allow pharmacists provide immunisation.
We absolutely need all hands on the deck now more than ever. The COVID-19 pandemic underscores the importance of revisiting and possibly eliminating these drawbacks from our healthcare system, to ensure that Nigeria is not only better prepared and equipped to tackle any future healthcare emergencies or vaccine preventable diseases but that it is providing the best public health it can to all her citizens.
In this COVID-19 pandemic, what is the importance of medication therapy management in patient’s wellbeing?
Medication Therapy Management (MTM) is a distinct service provided by healthcare professionals, including pharmacists. MTM is designed to monitor, reconcile medications, and ensure patients get the desired treatment outcomes. The goal of all pharmacists providing MTM is to help patients get the best benefits from their medications. It requires a thorough review of their medications by actively managing drug therapy and by identifying, preventing, and resolving medication-related problems, in order to create treatment plans and monitor safety and efficacy.
Under the COVID-19 pandemic, strong evidence exists that MTM alleviated the pressure on healthcare systems. To mitigate the spread of the virus, not only did the lockdown affect patients with multiple comorbidities who were otherwise unable to access healthcare facilities for their routine care and medication management; it also negatively impacted their mental health. MTM is especially important because it helped to improve health outcomes and bridge the gap that was created as a result of the pandemic. Pharmacists improved patients’ overall wellbeing by keeping them abreast of their maintenance medications, making sure they were compliant, and in some cases, deliver their medication to them. It also decreased hospitalisation, mortality and healthcare cost.
Being a pharmacist with top-notch clients care service skills set, what would you describe as the most needed patient-care skill for pharmacists?
The most important patient care skill a pharmacist should possess and hone is empathy. It allows patients to know that you respect them; that you understand their plights, which subsequently builds trust. Empathy fosters a better relationship with patients and leads to better therapeutic outcomes. Since respect begets respect, patients will value the knowledge and expertise you have to offer.
Point of care testing (POCT) became more prominent in the pandemic as COVID testing turned out to be a required screening. Are pharmacies protected enough to be centres for POCT?
With the strain that COVID-19 has placed on the healthcare system, pharmacies are fast becoming the go-to locations for POCT – because pharmacists are the most accessible and most visited members of the health team. The pharmacy can help in triaging, assessing, and treating patients with minor ailments. With regards to protection, the pharmacy is not well staffed for multiple disinfecting of high touch areas throughout the day. Also, under collaborative practice agreement, we are limited in what therapy to initiate in the case of treating patients, so with respect to liability, it falls on both the physician and the pharmacist.
While it is an excellent idea to expand the roles of the community pharmacist towards provider status, now may not be an ideal time for it because we are engrossed with bridging the gap created by the pandemic. It is important that we continue to provide quality care in patient counselling/education, immunisations, MTM, dispensing and other operational duties to successfully run the pharmacy. The addition of POCT at this point is a strategy that can be considered to straddle the healthcare system and impact patient care. Access to POCT can be a bedrock for a healthier community but timing is of the essence.
Having spent many years in the profession, which would you describe as the most memorable day in your professional life?
The most memorable day in my professional career was the first day I administered the Moderna COVID-19 vaccine on a patient. I can literally still picture it vividly. As someone who has worked in the community pharmacy for many years, I’ve experienced many public health crises; but none came close to what the coronavirus pandemic did to the community.
I practised in an area of low socioeconomic status. Giving my first patient her shot was an emotional experience for a lot of reasons; but most importantly, I was among those who brought hope amidst despair. I was improving our nation’s health, and ultimately, I actively participated towards bringing the pandemic to an end, while embracing a fresh start. I felt and continue to feel proud to be a contributor of this ground-breaking technology’s effort in improving public health.
As a pharmacist, who is into many other areas aside from pharmacy, how have you been coping, without hampering your commitment to your profession?
Well, my profession is my ministry. That is one thing that has always stood out for me. I often tell people that someday I will retire as a pharmacist but I will die a Christian. My coaching and speaking/training ability are even beneficial to my profession. We teach people what we know but we reproduce what we are. It is all about finding your niche.
My passion has always been to help people. Right now, I am in the process of creating and developing a customised pharmacy practice that will coach and train patients to live a fulfilled life. So, my profession has become a platform for me to impact people and help them navigate the obstacles, challenges and opportunities that appear along the way. It actually helps to maintain business.