Wednesday, August 9, 2017

Home Visits in Thailand

Hello everyone!

Yesterday we got to go to the homes of some Thai people to review their medicines with them. The medical system is very different here and it was very interesting to see the differences. The people we met yesterday were very kind and really appreciated the help. There was also many duplications in therapy that was corrected during the visits. The visits also showed me how important The pharmacy profession is to keep the people healthy and to prevent medication errors. I'm so excited to do more home visits and to learn more about parmacy in Thailand.

Thanks for reading,
Michael Abrahamson

Evidence Based Medicine vs Cost - A Case on Real Life Risk vs Benefit


Today, we did home visits with patients in the community and I was able to have hands on experience in seeing patients with very advanced gout. The patient said that the doctor told her she had gout but she said she didn't. She also had obvious pitting edema from her congestive heart failure and hypertension yet she only takes her blood pressure meds "when she has symptoms" if she drinks too much water. I taught her to push into her leg to see when her leg was swollen due to leg edema as an indicator of her heart failure so that she can visually see when she has symptoms to remind her to take her medications. I also learned that she was taking simvastatin and that it's very common first line in Thailand because of the price compared to our first line of atorvastatin in the US. It's amazing that although we have evidence based guidelines for superior medications these patients still can not have access to the best available care. Another lady also had osteoporosis and I learned that first line calcium is recommended over a medication like alendronate because of the cost limitations as well.
Lots more photos posted at https://www.facebook.com/media/set/?set=a.10155294126614473.1073741867.635549472&type=1&l=957b5a802b!

Mike

The Trip So Far

Hi everyone!

We are currently on day 5 of our Thailand trip. I will say it's been a great but exhausting trip so far. I love that we've been able to do so much. Even though I've been here in Bangkok before. There has been plenty of sights that I missed during my first trip. The trip to Ayutthaya was was my favorite. It's the capitol of the Kingdom of Siam. The ruines were increadible. I'd highly recommend visiting this site when in Bangkok.

The pharmacy experiences have been my overall favorite so far. We went to Mahidol university, Siriraj hospital, and Chulalongkorn University so far. In these experiences, we learned about the pharmacy curriculum in Thailand and the integration of western and traditional Thai medicine. The integration of the two medicines was interesting to see. I like the idea because Thai traditional medicine allows patients to try non pharmacotherapy treatments first. I think we could learn something from that ideology because not every problem necessarily requires medication.

I also enjoyed my home health visit with the students from Chulalongkorn university. The interview process reminded me a lot of the CSA in patient assessment. I was even able to do a microfillament test on one of our patients! Pharmacists here have some unique problems here in Thailand. The neighborhood we went to for the home health visit had an average income of only 3000-4000 baht ($90-120) a month. For example, most people in this neighborhood didn't have refrigeration. They have to carry a cooler with ice to store the insulin. I feel like they have to be a little more creative when they dispense medications.

Any who I'll write again soon!

Scott

Thai community pharmacy/home health

Hello everyone!

Today we went on our first rotation in a community pharmacy/home health setting. In the community pharmacy, we learned the different screenings that the pharmacists do. This included diabetes, hypertension, dyslipidemia, and smoking cessation. Most of the practices are the same, however we learned that in Thailand, there are no prescriptions for medications. Instead, pharmacists will screen patients and suggest a medication that is appropriate for them based on their signs, symptoms and the standardized Thai pharmacy guidelines. Also, pharmacists are more limited to  certain practices than pharmacists in the US. An example of this is not being able to check HbA1C, blood glucose, or give immunizations. We were also lucky enough to experience a home health visit and witness the pharmacist and pharmacy students perform physical assesments and med recs with two patients. The pharmacist and students also educated one of the patients on his new medication and provided nutrition and exercise education. Overall, it was great to learn and see how pharmacy is practice in the Thai community and we were a little shocked as to how similar it is to the United States.

Alejandra, David, Mariam



Every little detail

Wow! I can't believe our trip is already half way over!! As others have shared we have seen so many beautiful and cool places since we've been in Thailand. It's been really neat to experience the Thai culture. I am eternally grateful that we have people driving us around because the traffic here is insane! (And I thought Phx was bad 🙈). I've really enjoyed getting to go visit all of the temples and palace buildings, as well as the parliament building. They are all so beautiful and covered in intricate designs. I cannot begin to imagine all of the hard work that went into each and every building. When we were at the parliament building there were several art pieces that were only a few feed wide and tall that took 100+ people and over a year to build. So I'd guess these buildings were to the extreme! Even the old ruins are beautiful! Can't wait to see what's next.

Kendall