13 May 2017 – IMU Pharmacy Alumna, Christina Chan, received an award from the Pejabat Kesihatan Daerah Kota Tinggi (PKDKT) which is under Jabatan Kesihatan Negeri Johor (JKNJ) for the running of the Best Diabetic Medication Treatment Adherence Clinic at a Klinik Kesihatan in Felda Bukit Besar, Johor. The clinic covers a very small remote area of Kampung Bukit Besar, Bukit Ramun, Sg Sayong, Ladang Alaf and Ladang YPJ. Commenting on receiving the award, “When they were announcing the award, the thoughts that were running through my head were like, “Nah, I won’t get this award. I run this service in such a small remote area. Why would they pick me? There are so many other bigger clinics than mine. When the winner was announced, I was in shock, and after that it felt so surreal. It certainly felt like, all my hardwork paid off.” A Diabetes Medication Therapy Adherence Clinic (DMTAC) is an ambulatory care service offered by pharmacists in collaboration with physicians with the aim of helping diabetic patients to achieve better medication adherence level and glycemic control. Patients will be monitored for a minimum of eight visits where they will receive medication adherence assessment, identification and management of drug related problems, medication counseling, monitoring of clinical outcomes and diabetes education by the pharmacist. According to Christina who was sent to work in this area after her PRP, this clinic has been in existance for some time. However due to manpower limitation, the clinic only sees 50 patients/year. Now, with 2 pharmacists available at the clinic, it is fully functioning and sees 350 patients/year which is the same number as that seen at hospital settings. “In the beginning, I was quite beaten down by how hard it was to start this clinic because setting up something on your own is never easy. No one will help you and you just got to make it. There were a lot of sweat and tears with lots of obstacles to face. Many other staff in the clinic will not want to help you take the patient’s blood pressure and glucose reading because it adds on to their job. Finally, I decided to do everything by myself. I got a blood pressure machine and borrow the clinic’s glucometer when needed and I had the clinic up and running till today.”
“What makes me want to make it better? Seeing patient’s HbA1c reduced. Even if it is just 1%, I am happy. But thankfully, many patients have achieved tremendous reduction in HbA1c and I am proud to say mostly below 6.5% (which is the normal blood sugar levels in the blood). Although the objectives are to improve a patient’s medication adherence, I go the extra mile to also reduce the HbA1c levels. Their simple thank you and smile on their face when their blood sugar levels reduced brightens up my day every time.”
In the future, Christina foresees the clinic helping more patients understand the degree of risk, severity and complications of diabetes. “If we improve their medication adherence and hopefully reduce their HbA1c levels, there will be lower risk of complications such as heart diseases, amputations, cataract as well as kidney failure. I hope to reduce and create awareness among more patients or whoever that comes along the way.” Besides work at the Diabetic Medication Treatment Adherence Clinic, Christina is also responsible for other things as well such as stock keeping, managing the pharmacy and dispensing medications to other patients alongside with her other colleague. Her main work however is the running the clinic and home visits. Speaking on the challenges and apprehension she felt when she first came to work in this area, Christina said, “When I first got here, I thought that there would be a language barrier as the majority of the people at this area are Muslims. I thought that they would not take my word or advise as a pharmacist but after a while, you just got to blend in. I got to know their customs, practice and religion so that I would not say anything to offend anyone during my counselling sessions. Besides that, this is a small and rural place so I travel back and forth every day from the main city for an hour. Bumpy roads and a long stretch of 1 lane only road but I have no complaints as I am sure some others will have had worse than me.”
Remembering the good times at IMU