Dr Teresa Pounds is a specialist in critical care/nutrition support and also a board certified nutrition support pharmacist. A holder of PharmD, Pounds is the programme director, Pharmacy Residency Postgraduate Programme, at WellStar Atlanta Medical Centre (WAMC) in Atlanta, Georgia, USA. In this exclusive chat with Pharmanews, she speaks on how to advance different aspects of pharmacy practice, with special emphasis on the roles of consultant pharmacists in healthcare delivery, as the global community battles circulation of counterfeit medical and pharmaceutical supplies in hospitals. She also highlights the place of passion in successful pharmacy practice. Excerpts:
Can you tell us briefly about yourself?
I started my pharmacy career as an outstanding student on a four-year academic scholarship at Spelman College, an Ivy League institution in Atlanta, Georgia. I graduated with the highest academic honours (cum laude); and continued my excellent academic career at Mercer University in Atlanta, Georgia, as a dean’s scholar.
On the completion of my first year postgraduate residency training, I forged ahead to complete my second year postgraduate residency training in Nutritional Support at the Georgia Baptist Hospital.
WAMC is a part of the WellStar Health System, which is one the largest health systems in Georgia. WellStar Health System is a non-profit Level 1 trauma centre and teaching hospital that is well known for its commitment to the community and innovative patient care. It comprises 11 hospitals, hundreds of healthcare sites, and tens of thousands of healthcare staff.
The WellStar Health system continues to be known for providing care to our patients, regardless of their financial wellbeing, and is dedicated to delivering world-class healthcare. I have been a crucial facet in helping to deliver this institution’s vision on a national level, because I have played an integral role in collaborating with principal stakeholders to bring the PharmD programme to Nigeria.
This was largely due to my enduring prowess in many pharmacy schools’ programmes across the United States universities, such as the Mercer University, Philadelphia College of Osteopathic Medicine, South University, and many more. Through my expertise, I have managed to not only practise clinical pharmacy, but also instruct thousands of pharmacy residents and students over the years.
I am very passionate about pharmacy professionals’ standards and educational excellence in the United States and my home country, Nigeria. In my home country, I have collaborated with the Association of Nigerian Physicians in the Americas (ANPA) and a group of Nigerian and US pharmacists for a medical mission to provide medical care for Abuja residents. I supervised the medication arm of the medical mission, organisation of the donation, transportation of medical supplies, and managing the financial support from private individuals, pharmacies, and hospitals in Abuja.
The WAMC residency programme has the pleasure of being a part of the Accreditation Council for Graduate Medical Education (ACGME) programme. This collaboration has allowed me the opportunity to minimise the gap between physicians and pharmacists. Pharmacists and physicians are working together to enhance the management of patient medication and ultimately improve patient outcomes. Consequently, this would provide my residents with the platform to work together with other medical residents.
Furthermore, I have been fortunate to hold several academic appointments in the US and beyond, as I actively work with different national and multinational organisations that manage the advancement and development of pharmacy practice and education, pharmaceutical care initiatives, implementation and development of collaborative frameworks within interdisciplinary organisations to underpin the advancement of pharmacy practice in Nigeria through medical missions, educational workshops, curriculum development and preceptorship.
Additionally, due to my experience with medical nutrition, I have gradually developed the passion to advance my medical nutritional skills in the United States and beyond.
I am very passionate about pharmacy education, standardisation protocols, curricula development, appraisal, and accreditation processes and procedures. I am honoured to be able to help my home country, Nigeria in the journey towards the evolution of pharmaceutical care standardisation and better healthcare for all.
Being an experienced practitioner of clinical pharmacy, would you say the consultant title for pharmacists is out of place, as being claimed by Nigerian medics?
I would say the consultant title for pharmacists is not out of place since this title supports patient care through the safe, evidence-based, cost-effective use of medicines and, most of all, it is very important. Precisely, individuals holding this role lead interdisciplinary development of medicine use policies and procedures. These policies and procedures help to set a plan of action for using a particular drug for the desired clinical outcomes. In other words, the policies and procedures help to formulate guidelines for using a particular drug. They also ensure that drugs used in the medical facilities are acquired from renown and quality suppliers.
Today, the world is filled with counterfeit products and hospitals should not make the mistake of buying nonstandard drugs or hospital equipment. However, due to the expertise of consultant pharmacists, they can help to identity drugs that meet the standards of preparation and whose use has been found to be effective. These consultants can also be involved in drug preparation for patient administration.
Additionally, they oversee the role of drug distribution in their respective hospitals. In this case, they ensure that all hospital departments are supplied with the right amount and types of drugs, depending on the cases and the dosages required.
Nevertheless, they are expected to evaluate the documentation of adverse effects and behaviour of the medication for patient or drug review. It is worth understanding that some drugs cause adverse effects than others, due to their variability in the pharmacodynamics and pharmacokinetics. Besides, genetic, pharmacological, and immunological factors have been known to contribute to the adverse effects.
At times, patients may fail to respond to their treatment regime and these consultants have a role in facilitating the transition of regimes with little or minimal adverse effects
A critical review of pharmacy practice shows there are differences in practice across the globe. As a professor of pharmacy, how can this gap be bridged?
By uniting pharmacists with pharmaceutical scientists, to build on the importance of healthcare knowledge using evidence-based medicine. Also, introducing community pharmacists to different pharmacy disciplines that can be career transition options. Examples include clinical pharmacy, entrepreneurship, medical science liaison, and others.
Additionally, other strategies that can be put in place include the implementation of legislation or policies on clinical pharmaceutical requirements for accreditation or hospital licensing, implementation of policies that support the increment of pharmacy training and educational reforms, integrating clinical pharmacists to diverse care teams, developing and integrating clinical documents tools in healthcare facilities, ensuring that practice sites have qualified clinical preceptors and strengthening regional and national pharmacy and clinical associations.
As an expert in nutritional support and from your experience with COVID-19 patients, what would you say is the place of nutrition in patients’ outcome?
Good nutrition is important in a patient’s response to the infection. A patient needs to eat and drink so that he or she can support the body’s ability to fight the virus and support the body’s immune function. Eating of high calorie and high protein foods enhances the body to maintain its metabolic functions and body weight during the critical time. Depending on the patient’s specifics, a nutritional support regime that is tailored specifically to each individual patient can help to replace nutritional deficiencies and speed up the recovery process.
Hospitalised patients who contract the virus are at a heightened risk for malnutrition. The novel COVID-19 has shown to cause loss of taste, smell, and appetite, which can lead to weight loss and muscle wasting. Nutrition regimens can be formulated using the patient’s specific nutritional needs to help with weight gain and muscle loss. Patients who receive proper nutritional support while being treated for COVID-19 have a decreased risk for further complications and show faster times to recovery.
My passion for medical nutrition can be traced back to the interest I had in the nutrition aspect of food while I grew up. Precisely, my family was strict on the nutritional value of food that was consumed in the household. Throughout my profession, I have come to learn the true essence of nutrition for in-patients. Primarily, good nutrition is essential for preventing malnutrition, degenerative illnesses, and promoting the general well-being of patients. As such, it has been proven time after time that nutrition plays a big part in patients’ outcomes through nutrition programmes that shorten the duration of stay at the hospital.
Having made valuable contributions in the areas of pharmacotherapy and the pharmaceutical sciences, what would you describe as the challenges impeding best practices in these areas?
As technology and research advance in the pharmaceutical sciences and pharmacotherapy, many other pharmacological methodologies within precision medicine are being developed with great promise for clinical application and therapeutic outcomes. One of the challenges is the ability to determine which biomarkers and technologies are most informative or applicable to the patient’s care. Also, it has become relatively challenging to develop new drugs that provide cure to today’s most prevalent and incurable illnesses. As a result, this has called for continued investments from governments and stakeholders to carry out extensive research that will provide long-term solutions or cure for these diseases.
On the other hand, the expectations of pharma customers are quickly rising as the commercial atmosphere continues to be ruthless and harder because patients expect the treatment and therapies to be effective and extremely reliable. On this note, these patients have continued to demand evidence of clinical results associated with drugs to ascertain the claims made by pharmaceutical companies. Nevertheless, scientific productivity has become stagnant and lacklustre over time holding new drugs at a constant level.
Still on COVID-19, how would you assess the global management of the infection?
On testing of COVID-19, there are still inadequate testing kits in some countries, making the testing capacity too low; yet there might be more patients that have acquired the diseases, and they are spreading it.
Contact tracing of COVID -19 patients is being done. Still, countries with a larger population are experiencing challenges with this mechanism as not all of the people who came in contact with the patient are able to be traced. Some of them may decide not to report, making the exercise harder.
Wearing masks has been termed as one of the best methods of minimising the disease’s spread, but some countries haven’t made this guideline compulsory for each citizen. It is worth understanding that facemasks help to prevent the passage or spread of the virus from one individual to another. Precisely, when someone sneezes, coughs, or talks, facemasks act as a control strategy that prevents the virus from spreading to other people.
In what ways can pharmacists upgrade their roles in the critical care of patients?
For pharmacists to upgrade their role, the curriculum courses must provide them with full knowledge of addressing the patient’s problems and develop a plan for him or her.
Pharmacists need to contribute to rounds, managing medication therapies for their patients, and participating in codes and medical emergencies. Also, they should collaborate with senior pharmacists and mentors to address the patients’ needs, redefine their roles, and the scope of their activities, and identify areas in practice that need further training or insights from knowledgeable individuals.
As an accomplished pharmacist, what is your advice to young pharmacists aspiring to be like you?
Not only is the pharmacy profession growing relatively fast, it is gradually becoming very competitive because the drug market is continually seeking cost-effective and effectual drugs that meet medical needs of the patients. As such, obtaining the PharmD is now one of the key requirements for obtaining a job and meeting the requirements needed to execute these tasks. Many universities offer the PharmD degree programme to pharmacists who are still practising in their own countries to keep them up to date with the current pharmaceutical trends.
However, young pharmacists must be very passionate about pharmacy education because it takes effort to blend different aspects of learning and understand the logic behind the magic in pharmacology. Thus, they must be mindful of what they do each moment because it adds up to who they become. Learning should never stop even after graduating because new and scholarly knowledge is put to the world every day.
Therefore, young pharmacists should take the initiative of reading new research studies and keeping up with information about new drugs in the market. They should also consider other ways to make themselves more marketable in this increasingly saturated market. Pharmacists should consider additional degrees like a Master of Business Administration or Engineering.
President John F Kennedy once said, “Ask not what your country can do for you, but what you can do for your country.” Hence one must have goals on what you need to do and accomplish as a pharmacist. With such convictions, one is likely to put more effort in their profession and carry out researches that help to solve different issues in society.
Finally, mentorship is very important because it provides one the stage to learn their mentor’s skills and further share their knowledge. Therefore, finding the right mentor can be a powerful tool for professional growth because it provides the road map to success and a feeling of togetherness.
When choosing an effective mentor, one should consider people who have made significant change in society or seek guidance from people we perceive successful in what we desire the most. An effective mentor should be someone who has enough time to dedicate to develop a positive mentorship relationship and follow up with those who look up to him. As a result, one should avoid choosing mentors solely on popularity or monetary success.