FG to reduce severe preventable medication harm by 50 percent in 5 years

By Linda Ike

The Federal Government said Nigeria is working to develop its National Policy and Strategy on Patient Safety and Quality of care in the country.

The Minister of Health Dr. Osagie Ehanire who made this know on Monday in Abuja at a conference to commemorate the 2022 World Patient Safety said the goal is to reduce severe preventable medication-related harm by 50%, in the next 5 years. by addressing harm resulting from errors or unsafe practices in the health system.

Dr. Ehanire said the policy focuses on improving medication safety, surgical safety, safety of all medical procedures among others.

Represented by the Director, Hospital Services, Federal Ministry of Health, Dr. Adebimpe Adebiyi the Minister stated that the policy document will improve patient safety, clinical outcomes and client satisfaction by establishing the systems for assessing, measuring and improving patient safety at all levels of care in Nigeria.

He said, “This policy is binding on Government MDAs, at both National and State levels as well as Stakeholders NGOs, Regulatory bodies, Professional bodies, Scientific Associations and Societies, Accademic and Research Institutions and Civil Society Organisations.

“Sensitization and capacity are ongoing in our Federal Tertiary Health Institutions in the form of training on medication safety, infection prevention control, and other aspects of patient safety”.

Dr. Osagie said that policy can be achieved by making improvements at each stage of the medication process, including prescribing, dispensing, administering, monitoring and use.

“It is my hope that hospitals at all levels will be able to adopt and implement patient safety at different levels of care.

“Patient safety is everybody’s business and it requires the active participation of many key partners ranging from patients and their families to governmental, nongovernmental and professional organizations.

“Every one of us at some point have used medicines for treatment of illnesses. The benefits of drugs/medications cannot be over emphasised, however medications can sometimes cause serious harm if not used correctly either as a result of miscommunication between the patient and healthcare giver, error in prescriptions, poor monitoring of patient on medication, misuse of antibiotics which can result in antimicrobial resistance, confusion in dispensing look alike and sound alike drugs, just to mention a few

He also noted that ” Patients and members of the public are sometimes passive while receiving drug treatment. Most patients especially those on long term medications for chronic illnesses such as hypertension, diabetes, etc. are not aware of medications prescribed for them.

“Some patients abuse medications such as antibiotics that can create problems of antimicrobial resistance. Polypharmacy which is the routine use of four or more over-the-counter, prescription and/or traditional medications at the same time by a patient can also cause harm from multi drug interactions and increase the side effects of drugs”.

According to him, miscommunications can also occur when patients’ drugs are not properly handed over either during change in shifts or transfer of care from one health facility to another.

He advised,” everyone has a role in promoting Medication without Harm.
Patients should be empowered to ask questions about the medications prescribed, know their names, and learn about the side effects of drugs being taken.

The Minister expressed optimism that the project will be completed and launched this year so that it can be deployed for use in all the health facilities.

“I am glad to be part of this year’s activities which present the opportunity to advocate for safer medication practices as well as a call for action for Government and relevant Stakeholders to work together to achieve the goal of “Medication without harm”.

“The entire healthcare system from the federal level to the local government level, and across both the public and private sectors will be committed to patient safety and reducing harm;

“The public will witness and experience a nationwide push to improve clinical outcomes, with demonstrable results; and Professionals within the healthcare system will make the patient experience a priority, providing compassionate, respectful care that balances patients’ rights and responsibilities and exceeds the expectations of patients and families.

He also said that Underreporting of medication errors is also a serious issue.

Ehanire disclosed, “A study conducted by Ogunleye at all on medication errors amongst health care professionals
Doctors, Nurses, Pharmacists in 10 tertiary hospitals across the country shows 35.5% of 2386 professionals that participated in this study reported medication error, while 33.4% did not think reporting was necessary.

“A high incidence of major medication errors related to prescription of incorrect antiretroviral therapy (ART), protocols, potential drug-drug interaction in Nigeria’s HIV treatment Programme have been reported in the past.

“The incidence rate of medication errors was somewhat high; and majority of identified errors were related to prescription of incorrect ART regimens and potential drug-drug interactions; the prescriber was contacted, and the errors were resolved in majority of cases. Active screening for medication errors is feasible in resource-limited settings following adequate capacity building.

“Patients and members of the public are sometimes passive while receiving drug treatment. Most patients especially those on long term medications for chronic illnesses such as hypertension, diabetes, etc. are not aware of medications prescribed for them.

“Some patients abuse medications such as antibiotics that can create problems of antimicrobial resistance.

“Polypharmacy which is the routine use of four or more over-the-counter, prescription and/or traditional medications at the same time by a patient can also cause harm from multi drug interactions and increase the side effects of drugs. Miscommunications can also occur when patients’ drugs are not properly handed over either during change in shifts or transfer of care from one health facility to another.

He continued,”You will agree with me that everyone has a role in promoting Medication without Harm. Patients should be empowered to ask questions about the medications prescribed, know their names, and learn about the side effects of drugs being taken”.

He noted that errors also occur in surgical such as operations on the wrong side, ligation of Ureters during hysterectomy, as well as stories of how surgical instruments, sponges and needles were left inside a patient.

“We have seen cases where the wrong patient was wheeled into the operating room because they were bearing similar names etc.

“Errors are not limited to medical or surgical services alone, some errors have also been recorded in our laboratories, he noted.

The Minister called on all State Ministries of Health, NAFDAC, Heads of health care facilities, Educational and research institutions Regulatory and professional bodies, Health care professional societies Patient advocacy groups, Donors and sundry stakeholders including development partners, Pharmaceutical industries and the Media to collaborate with the Federal Ministry of Health to reduce medication errors and ensure safer medication practices to enthrone patient safety in Nigeria.

The Country Representative, World Health Organization,(WHO) Dr. Walter Kazadi Mulombo said Weak medication systems and human factors are the major contributory factors to unsafe practices, with many countries lacking the capacity to detect, evaluate and prevent medicine safety issues

Dr. Mulombo who was represented by the Deputy Country Representative, Dr. Alex Chimbaru added that other contributory factors include fatigue, inadequate knowledge and training, staff shortages, workplace distractions, and high workload and limited resources
Illiteracy, language difficulties, as well as socio-cultural and religious beliefs, also play a role

He said, “Medication errors occur most commonly due to weaknesses in medication systems, and are aggravated by shortages of well-trained health staff, and poor working and environmental conditions for delivery of quality health care. Consequently, patients’ rights to medication without prejudice can be compromised through inappropriate prescribing, transcribing, dispensing, administration and monitoring

“About one in every four cases of preventable medication harm is clinically severe, or life-threatening”.

He advised that administration of surplus medication at home, the purchase of medication from pharmacies on the advice of friends and relatives rather than trained professionals, and the use of old prescriptions to buy medication to treat a current ailment should be avoided.

Mulombo said that One study done in 2021 shows that as many as one in every three respondents admitted to self-medicating to prevent COVID-19.

He said, the unguided practices often lead to dangerous consequences as a result of drug interactions, or incorrect administration, dosage or choice of treatment., delays in treating diseases, dependence and abuse, disability, and even death.

While disclosing that the National Drug Policy 2005 was revised in 2021 which contains policy direction prescription and dispensing of medicines and pharmacovigilance, he advised Nigeria to develop at least a guideline on prescription and dispensing of medicines and medical products to support safety and audit of these professional practice.

Commemoration of the World Patient Safety Day started in May 2019 when the World Health Assembly adopted the Resolution for global action on patient safety.

The day is marked annually on 17th September and commemorated by the World Health Organisation (WHO), International partners and all countries with the aim of increasing public awareness, stakeholder engagement, and advocacy for adoption of best practices at the point of care to promote patient safety