2015 13th TSHP Annual Congress
The 13th Taiwan Society of Health-System Pharmacists (TSHP) Annual Congress and its 3rd executive board meeting took place on 8th November at Kaohsiung Chang Gung Memorial Hospital. Despite the first day of winter by lunar year, pharmacists around Taiwan all gathered and heated up the south by discussing the congress theme ” Medication safety, quality and efficacy.” The first keynote speaker was Director Jiang Yu Mei, Food and Drug Administration Taiwan Ministry of Health and Welfare, explaining the government’s efforts regarding ensuring the quality of the medicines, improvements on regulatory systems and other projects, including risk control, risk communication and drug relief system. Hoping that through inter-collaboration from industry, government and academia can strengthen Taiwan health system. The second half, Dr. Hung-wei Chih told us more about biosimilar products’ in its quality, safety and efficacy.
Various Awards was given during lunch and was followed by five parallel sessions focusing on: “Medicine News”,”Pharmacy Ethics and Professionalism”, “Clinical Pharmacy Showcase”, “Oral presentations” “Clinical research and publishing”.
Among all, “Clinical research and presentations skills” is a burgeoning topic these days. How to strike a balance between busy working hours and still carry out the abstracts is very demanding in Taiwan. But to transform these experiences into research is the key of all matters. Panelists shared their own stories and hope that more pharmacists will be willing to invest their time and efforts in this field.
“Clinical Pharmacy Showcase”
Two panelists were from China and six were from Taiwan.
Director Chao Zih-Gang from Beijing Tian Tan Hospital, Capital Medical University, introduced the “China standards on pharmaceutical service and current remuneration consensus”. Unlike Taiwan, China doesn’t have a system like National Health Insurance which support (monetary) pharmaceutical services and thus, makes it impossible to sustain, which now has resulted in a “pay for service” situation. These include Therapeutic Dose Monitoring (TDM), Gene test (like HLA-B*1502 for carbamazepine), Compounding for Total Parental Nutrition (TPN) or Chinese Herbal Medicine, Counseling service (for Warfarin, Diabetes Mellitus…) and more. Although they do have a consensus with the existing price for each services but the speaker did not mention much on real statistics and we know it’s not on the same track as what WHO promotes – equality – Universal Health Coverage. On the contrary, this represent different perspective, we should think about how to convert service to revenue, attract/keep talented people around.
The next panelist, China Health Promotion Foundation Secretary General Mr. 于国超, spoke on “Continual Education” explaining that China has more than 400 universities that have 4 to 6 years of pharmacy department systems and the overall quality varies. Facilities like universities are responsible for promoting the profession and ensuring the competence of their students. Geographically speaking, how to make this program effective, and enroll broader pharmacists to take part in and keep them interested are the most challenging part. He proposed to utilize online courses, periodical regional forums and professional development competitions to enhance their capacity. On the other hand, Pharmaceutical tools net (http://www.yxgj.net) is, like the combination of Micromedex and Wikipedia, qualified pharmacists co-edit the information and it is divided in to two teams, one focusing on life threatening cases, one solving the public rumors/questions. It surely is helping China to establish something like a think tank and is worth learning for, but in our country, intellectual property rights are far more stricter then China; therefore, it takes efforts and wisdom to form a platform like this (the existing platforms are mostly hospital based, individual or small-team-works and they are flourishing). Secondly, online courses are very common in here but it is still not as effective as an on-site /face-to-face learning. Thirdly, competitions such as students’ Patient Counseling Event (PCE, an IPSF project ipsf.org) and Pharmacists’ Evidence Based Medicine (EBM) Competition are all very successful but the gap between competition and real clinical works still exist and need to be improved.
The following panelists are from Taiwan, first is Director Yang Bi-ying, Taipei City Hospital Chung Hsiao Branch, talked about the role of a pharmacist in home visiting and its outcome. Cases are mainly from those who have been just discharged form hospital, unable to leave their houses, report by nursing homes, enrolled in citizen service  and patient from diabetes clinics. Pharmacists take advantage of their ingenuity (mini reminding stickers, medication guide stamps, etc.) to aid people on self-care and self-medication; this is truly valuable for general hospital pharmacists’ despite the fact that they are often short of manpower. Next, Liu Jia-mei from Shin-Kong Wu Ho-Su memorial Hospital presented her report on in “Pharmacists involved in Hospice care team”. According to NHI, they do not reimburse/pay pharmacists for their service in those cases; only a few hospitals have pharmacists on their team. She pointed out that hospice care is not necessarily about reducing drug use, but the proper use of drugs to optimize the quality of life. Fifth panelist is Clinical Leader Wang from Tri-service General Hospital. She talked about “Pharmaceutical Care Clinic”, shared with us from the very beginning of building this clinic (difficulty such as locating, costumer loyalty, short in manpower, lack of doctors’ support) to now – a mature integrated clinic. She explained succinctly how they solved the problem and gained trust from doctors. Next, Clinical pharmacist Wu from National Taiwan University Hospital, shared with us his view on “Extended infusion of piperacillin / tazzobactam in MICU”. By improving the pharmacokinetics of the medicine in critical patients to better their prognosis is indeed our irreplaceable role. Researcher Liao from logistics center for rare diseases, China Medical University, highlighted on the importance of obtaining adequate medicine timely. This was followed by pharmacist Huang from National Cheng Kung University Hospital, who explained “The pharmacists role in collaborative care for pulmonary arterial hypertension”. Pulmonary hypertension is rarely to have pharmacists involved but it also enable us to rediscover the value of pharmacists. Lastly clinical pharmacist Kang from Kaohsiung Chang Gung Memorial Hospital shared her experience on implementing evidence-based medicine in clinical care and her participation in establishing the national guideline.
“Clinical Research and Publishing”
Dr. Ye Ming-gong, the editor of TSHP Journal, opened this panel by explaining the current status and its direction. Now the team is in the process of inviting more experts from different areas in order to have broader scope of committee and speed up the review, priority is ensuring the quality. Mr. Richard Hill Davis followed by teaching us how to write a popular SCI papers and reminded us not to be afraid of being rejected. Young pharmacist nick-named Hua from Chi Mei Hospital is an example of being able to balance heavy workload and research. Fresh eye, time management and teamwork are crucial to success.
 Citizen service is a multisectoral project lunched by Mayer Ko Wen-je, who had been doctors for decades, in April 2015 starting from one hospital and now to two districts in Taipei. The aims is to fully implement the family medicine and integrate all government agencies, district chiefs and really go to their houses. Through home visiting, he hopes to foster the most optimized medical care which every citizen, , cancer patients, minor groups or whoever in need can have a designated doctor/healthcare provider to lean on.