P&G Health, the health care division of Procter & Gamble, announced the launch of the ‘First Iron Deficiency Diagnosis and Counselling Guide’ for Pharmacists on the occasion of Iron Deficiency Day 2021. It was developed using the ASHP (American Society of Health-System Pharmacists) Guidelines on Pharmacist-Conducted Patient Education and Counseling and IDA-specific management considerations from peer-reviewed literature. The guide, with its novel 4-step framework, will equip pharmacists to better engage and counsel patients on Iron Deficiency Anemia (IDA).
Today, approximately 2.3 billion people globally suffer from anemia, with an estimated one in two attributed to IDA. Patients experience symptoms such as frequent tiredness, dizziness, paleness, and impaired immunity, which thus impacts their quality of life, mobility, and productivity. Many patients remain asymptomatic. Southeast Asia and Africa continue to report the highest prevalence rates of anemia, accounting for 85 percent of global reported cases.
With no existing or consistent guide in place for dealing with IDA, 84% of patients end up being under- diagnosed especially since symptoms for IDA are vague with some patients being asymptomatic.
“P&G Health has been committed to awareness and education efforts on iron deficiency anemia, a condition affecting a large part of our population across Asia. Iron Deficiency Anemia inhibits a person’s ability to live life to their fullest potential. With pharmacists being among the first line of contact for patients, they are well positioned in the community to have a significant impact on public health. We realized that the lack of a standardized guide creates the possibility of under-diagnosis, incomplete counsel, or worse. With this ‘First Iron Deficiency Diagnosis and Counselling Guide’ we aim to equip pharmacists with a structured framework to diagnose and counsel for iron deficiency thereby helping empower consumers to live healthier, and more vibrant lives.” shared Aalok Agrawal, Senior Vice President, P&G Health – Asia Pacific, India, Middle East and Africa.
Dr Catherine Duggan, Chief Executive Officer, International Pharmaceutical Federation (FIP) stated, “The FIP vision is for a world where everyone benefits from access to safe, effective, quality and affordable medicines and health technologies, as well as from pharmaceutical care services provided by pharmacists, in collaboration with other healthcare professionals. FIP is happy to see these guidelines being published to support pharmacists in dealing with such an important condition, globally and, in particular across Indonesia, India and Philippines. We look forward to seeing how these guidelines are used in practice and have contributed to better patient outcomes as a result.”
Armed with this structured guide, pharmacists would be even better equipped in detecting high risk patients, identifying their symptoms, and counselling them on nutritional and lifestyle modifications. It will be rolled out progressively worldwide starting with Southeast Asia and India.
Novel 4-Step Framework
The 4-step framework guides pharmacists on approaching patients with IDA or those suspected to have IDA in a logical and sequential manner based on ASHP guidelines. The framework identifies four steps for pharmacists go through – Establish, Assess, Educate, and Verify.
In the first step, pharmacists are guided to establish a relationship with the patient, ascertain diagnosis and identify suspicion of IDA. Leveraging existing principles of patient communications, pharmacists are advised to identify themselves and communicate in the patient’s primary spoken language before ascertaining if the patient is diagnosed with IDA. With this, pharmacists are advised to inform the patient on the expected length of the session before obtaining the patients agreement to participate.
Moving to the second step, pharmacists would need to assess the patient’s knowledge on IDA and the utilization of diagnostic tools that can identify IDA. This would depend on whether the patient is already diagnosed or is suspected to have the condition.
For the former, pharmacists are advised to assess the patient’s current knowledge of their condition, their attitude towards their condition and check if medication was prescribed previously along with any dietary changes made. For the latter, pharmacists are advised to assess if the patient is at high risk. This would be done by recording clinical signs and symptoms while utilizing laboratory tests to confirm the diagnosis.
Once completed, the third step looks to educate the patient on the correct dosage, highlight results from taking the prescribed medication, understanding underlying issues, and providing supplementary general information. This includes recommendations for dietary changes and educating patients about oral iron supplementation. Pharmacists are also advised to reiterate the importance of dietary diversification.
The final step in the framework would require pharmacists to verify the patient’s knowledge and understanding. Pharmacists are advised to verify the patient’s understanding of IDA, the prescribed medication, and the suggested lifestyle changes needed to manage the condition. To emphasize understanding on the use of medication and its effects, patients should be able to describe the effects. Finally, pharmacists would need to observe their patient’s medication-use capability and attitudes towards IDA.
By utilizing the framework, pharmacists would be able to support patients on their journey to self-care. This would include creating awareness and educating patients about IDA while ensuring the familiarity and enacting of necessary steps among patients to improve their own health when dealing with IDA.