13th Singapore Pharmacy Congress

27 Nov 1999
By Mr Lim Hng Kiang
Ms Chang Sook Mei, President of the Pharmaceutical Society of Singapore; Dr Chui Wai Keung, Chairman of the Congress Organizing Committee; Ladies and Gentlemen,

I am pleased to join you this afternoon for the 13th Singapore Pharmacy Congress. I understand that this annual event of the Pharmaceutical Society of Singapore serves as a platform for your members to interact and deliberate on current issues pertinent to your pharmaceutical profession. I am pleased to note that the success of the congress over the years has resulted in the attendance of participants from our neighbouring countries. Let me take this opportunity to extend a warm welcome to all our distinguished overseas delegates and to wish you a fruitful and enjoyable stay in Singapore.

The theme for this year's Congress, "Emerging Trends in Pharmacy: Impact and Opportunities" is timely and relevant. Pharmacy is important and integral to effective and efficient healthcare delivery. Today, pharmaceutical practice has evolved beyond the traditional role of dispensing of medication. Pharmacists today are more directly involved in patient management and more able to influence healthcare decisions for patients. Let me highlight three areas where pharmacists can play a significant role in contributing to more effective and efficient healthcare delivery in Singapore:

 healthcare expenditure;

 healthcare for the elderly; &

 health promotion.

HEALTHCARE EXPENDITURE

In Singapore. the national expenditure on drugs on average is estimated to be 8% of the total healthcare expenditure. As knowledge and technology continues to advance, the availability of new and expensive drugs will inevitably exert pressure to increase this percentage. One of the challenges for healthcare providers will be to provide drug therapies that are efficacious and affordable. Pharmacoeconomics, which is the study of the economics of drug use, can be applied to measure and compare the economic impact of an individual therapeutic agent with its clinical outcomes. Pharmacists and doctors can collaborate to conduct drug use evaluation studies to assist hospitals in their selection of the most cost effective drug therapies to be included in the hospital formulary. These studies can also help clinicians establish meaningful guidelines for the appropriate use of individual drugs.

Pharmacists must foster effective partnerships with the medical, nursing and other paramedical disciplines for more effective patient management. In some acute hospitals, pharmacists are members of special healthcare teams in specialised clinics for asthma, diabetes and anti-coagulation therapies. The pharmacist plays the role of a drug therapy manager, counselling the patient on proper use of the drugs prescribed, and assessing and monitoring the effectiveness of the drug therapy. This partnership promotes more rational drug prescribing practices and helps to ensure more cost-effective use of drugs. By achieving more effective control of the patient's illness, the risk of patients being hospitalised due to inadequate control of their chronic illnesses is reduced.

Another benefit of such a partnership in the hospital environment was illustrated in a recent study conducted at the Harvard School of Public Health. The study assessed the effectiveness of pharmacist intervention on the rate of preventable adverse drug events. The conclusion of the study, published earlier this year, found that the involvement of a pharmacist at the intensive care unit was able to achieve a 66% reduction in adverse drug events. Some of these adverse drug events prevented were due to incomplete orders, wrong dose, wrong frequency, inappropriate choice of drug and duplicate therapy. The study estimated that such intervention by the pharmacists translated into significant cost savings amounting to US$270,000 per annum for the hospital.

HEALTHCARE FOR THE ELDERLY

Singapore's population is ageing rapidly. Today, 1 in 14 Singaporeans is aged 65 years old or older but by 2030, this ratio will increase dramatically to 1 in every 5 Singaporeans. The elderly patients often require special attention for their drug therapeutic management. It is not uncommon for an elderly patient to be prescribed with multiple medications for multiple chronic diseases. Such polypharmacy if not properly monitored can lead to drug induced side effects and complications. Pharmacists who are medication experts can step in to safeguard against such side effects and complications and help manage the multiple drug therapies and ensure positive therapeutic outcomes. I am pleased to note that the Pharmaceutical Society of Singapore has already started a pilot project to look into the feasibility of providing pharmaceutical consultation at nursing homes. This is indeed a step in the right direction and should be encouraged as it will promote a better quality of drug therapeutic management of the elderly residents.

HEALTH PROMOTION

Health promotion and disease prevention is a cornerstone strategy of my Ministry's mission. Nurturing a health-conscious nation will ensure a fitter work force and reduce the burden on the healthcare delivery system. A report of the World Health Organisation Consultative group on the role of the pharmacist in the healthcare system suggested that pharmacists can serve as health promoters for the people. The study recommended that pharmacists can play a key role in helping people make informed choices about self-care and self-medication. This requires a greater focus on health maintenance, rather than on just the dispensing and sale of medicinal products to combat specific illnesses. Indeed, self-care does not always require the use of a drug. However, if there is a need, the pharmacist will be able to advise on the appropriate medication to take and to advise their clients to seek medical attention, if necessary. In addition in our local context, pharmacists who are trained in the knowledge of herbal and natural products can give balanced advice based on scientific evidence should the use of complementary medicine, such as herbal medicine, aromatherapy or homeopathy be selected as a form of self-care.

In closing, let me congratulate the Society for taking the initiative to organise this annual Congress. The world is constantly changing and professional practice must adapt and evolve in response to the changing environment so as to remain relevant and effective. This Congress demonstrates your Society's commitment to continuing professional education and provides your members with the opportunity to be updated with the advances in pharmaceutical science and innovative pharmacy practices. I wish all of you a beneficial and enriching time in your deliberations and discussions.

On that note, it is now my pleasure to declare the 13th Singapore Pharmacy Congress open.

Thank you.