ABSTRACT: As a result of COVID-19 pandemic, people worldwide have been facing several challenges like economic issues, physical health issues, emotional issues like anxiety and depression that affects mental health, etc., irrespective of their exposure status. This article speaks about the issues faced by the patients at a Government Secondary care Hospital due to lack of means to obtain proper information on their disease-drug-dietary recommendations regarding their clinical conditions.

KEYWORDS: Drug Information Centre (DIC), Out-patients, Drug-disease-dietary information, Patient-Medication Adherence, Pharm.D Interns.

INTRODUCTION:

Since the emergence of COVID-19 as a Pandemic, till now it has led to drastic changes worldwide as it has affected the daily routine and normalcy of life irrespective of incidence of infection in people and also its impact on people with Chronic diseases like Diabetes, hypertension, etc., and their quality of medication use and understanding aren't an exception.

MEANS FOR THE PROVISION OF DRUG, DISEASE, DIETARY INFORMATION: DRUG INFORMATION CENTRE (DIC):

The Drug Information Centre (DIC) run by The Erode College of Pharmacy & Research Institute at the Government District Headquarters Hospital-Tiruppur (-cum-) Government Medical College Hospital-Tiruppur as a major part provides both the out-patients and in-patients with an expedient and effective information on their disease conditions, appropriate use of drugs and dietary recommendations.

This process of provision of adequate information to the patients is done by Pharm.D Interns as a part of their Internship program for both out-patients and in-patients.

In case of out-patients they're directed to the DIC after they're provided with drugs dispensed from the Out-Patient (OP) Pharmacy as per Physician prescription. In the DIC the out-patients are provided with adequate information to reach their understanding via Patient Counselling (PC).

PEOPLE TOWARDS GOVERNMENT HOSPITAL:

Most of the people from nearby rural areas visit the Government Hospital considering their socio-economic status and economic burden for an effective treatment. Even though the patients are clinically well treated, they lack sufficient knowledge and proper understanding about their disease condition, information on appropriate use of drugs. This was a major contributor for Patient Medication Non-adherence especially in out-patients.

PROVISION OF PATIENTS WITH DRUG INFORMATION AND COUNSELLING - PRE-PANDEMIC (COVID-19):

Since the 2018 i.e., after its establishment the Drug Information and Patient Counselling Centre (DIC) by the Department of Pharmacy Practice, The Erode College of Pharmacy and Research Institute functioning by training the Pharm.D Interns and Clerkship students has provided many patients with immense information on disease, drug use and dietary recommendations regarding each of their clinical conditions.

• FOR OUT-PATIENTS:

The out-patients with chronic conditions like Diabetes, Cardio-vascular diseases, Kidney diseases and neurological conditions like Epilepsy, Parkinson's disease, Schizophrenia, etc., and the people with acute conditions voluntarily visit DIC on regular basis during their monthly visit after their consult to the Physician because of the provision of Patient Counselling for a better patient understanding as provided by the Interns and it is mainly due to the people's interest to obtain information. Patients prefer DIC because they lack post-treatment counselling and information from the doctors and nurses even though they provide effective treatment. This is mainly due to the workload of Physicians and nurses.

• FOR IN-PATIENTS:

In-case of in-patients in every ward, they're provided with appropriate information on basis of disease-drug-diet recommendations regarding their clinical conditions by the Pharm.D Interns and Clerkship students at respective wards on basis of their scheduled Ward-rounds by Case collection with Patient Counselling at every patient's bedside. And if there is any susceptibility of mild or adverse drug events / drug interactions prior otherwise on their occurrence, also if there is any inappropriate indications in treatment chart will be analysed and reported to the DIC and to the respective Physicians by the Interns / Clerkship/ IV /III /II years of Pharm.D program in a polite and professional manner.

The above Clinical / Pharmaceutical care activities for both out-patients and in-patients of the Government District Headquarters Hospital-Tiruppur provided by the Interns and students of other years of Pharm.D had an impact on patient satisfaction and their understanding which was heard as a feedback from them on every of their monthly visits to the hospital and DIC. It has also encouraged and developed the Medication-Adherence in various patients which was observed on each of them during their further visits.

IMPACT OF COVID-19 ON THE PROVISION OF DRUG-DISEASE-DIETARY INFORMATION TO THE PATIENTS:

Since April 2020, due to the increase in prevalence of COVID-19 pandemic in India, especially in Tamilnadu has distanced one-third of people from visiting the Government Hospital-Tiruppur as a cause for the reduction in their regular visits. This is because of the quarantine procedures and also a fear that COVID-19 patients are treated here. Not only the regular patients but also the Pharm.D Interns and practising students are also now separated from providing drug information to the patients, physician assistance and other pharmaceutical care activities towards the patient healthcare this lockdown.

DISCUSSION:

This has created a non-appreciable impact among the patients with chronic conditions who normally visit the hospitals to consult their Physician regularly. But patients who still visit to consult Physicians are an exception (i.e., the other two-third of population).

Most of the out-patients who visit the hospital regularly irrespective of Pandemic, on basis of their WORD-OF-MOUTH (WOM) the issues they face are estimated as they suffer with confusion about their drug-disease-dietary information and understandings because of the temporary closure of the DIC considering this pandemic.

This may lead to poor Patient Medication adherence and decrease in therapeutic progress/outcomes/maintenance of clinical conditions of those patients.

This is also an extraction /result of the fear of getting infected by COVID - 19 on hospital visit for check-up because the Government Hospitals act as a public domain for the diagnosis and treatment of people infected with COVID -19, but the reality is they are treated in an isolated manner with adequate facilities.

Follow up of quarantine procedures and the people's concern to maintain social distancing is an appreciable act, but it also acts as a factor driving to reduction in their hospital visit even on their necessary situations.

CONCLUSION:

It is necessary for the patients to consult their physicians regularly regarding their health conditions with appropriate safety measures. Even if they visit the hospital despite lockdown, they are deprived of necessary drug-disease-dietary information via Patient Counselling due to the temporary closure of the DIC of GH-Tiruppur. It may be useful and effective for some patients to use Telemedicine services for their better understandings, but for the patients from the surrounding rural areas and who are illiterate, for their option and condition is a question mark (?).

NOTE: The write-up article is my own creation and no data is included directly or indirectly from any available sources.