Balance out Research with Patients’ Rights-Dr. Aslam Afghani


 Second Int. Medical Research Conference by Health RAB

Balance out Research with
Rights - Dr. Aslam Afghani

Health RAB is a good initiative for clinical research in Pakistan

Since we do not have enough money and time,
we need to collaborate with each other - Paul Barach

KARACHI: Healthcare professionals should balance out Research with Patient Rights and formation of Health Research Advisory Board was a good initiative for clinical research in Pakistan. This was stated by Dr. M. Aslam Afghani Chief Operating Officer of Drug Regulatory Authority of Pakistan (DRAP). He was speaking at the second international medical research conference organized by Health RAB here on October 29th where he was the chief guest. He further stated that it has been noticed that private hospitals are not taking serious patients to reduce their mortality figures. He also laid emphasis on problem based research and their outcome.

Continuing Dr. Aslam said that it was heartening to note that standardization and Registries are being developed. When we have standard protocols, from data the outcome will be useful and help strengthen the registries. We can reduce errors by looking at innovations while designing clinical research. He also questioned whether it was ethical to deprive patients from treatment in placebo control trials? We need to have a research culture. Research should be based on our own problems to find a solution. There are various commercial and professional interests which will be there but we have to move forward with a positive mindset. He laid emphasis on cost effective healthcare and any new treatment, procedure should be patient centered. He also disclosed that now they have established a Pharmacovigilance center and all the data generated will go there. DRAP and Federal Health Ministry has also recently approved Code of Ethics, biosafety rules for protection of patients while we have also established a Clinical Trials Registry, he added.

Prof. Paul Barach from Wayne State University United St6ates who is a noted researcher in his presentation on improved care Research Evidence and Strategies discussed in detail the proposal development, systematic performance and Health Outcome of Research.  One has to look at how good is the quality of care at present? How to achieve Better Healthcare? Better health, he opined, will reduce cost. He also talked about generating evidence to build learning health systems. Doctors in Pakistan, he opined, have lot of passion to improve healthcare but they lack capacity. We need to care better but the question arises how to do it? How to reduce the number of drugs a patient is taking? No one should be referred if not needed and no investigations should be done which were not required. Essential components of Research include Question or Hypothesis, leading to study and then publication. Implications of research findings are that it leads to changes in practice. There is very little evidence or no evidence for certain procedures but still we go on doing it, he added.

Doctors, nurses, Prof. Paul Barach stated do make mistakes. We need to see how we can improve this situation and how to improve the overall systems. We need to understand how we can do it better. We also need to understand the expectations of the patients. We need to create awareness that patients demand utilization of care. He also talked about effects on time utilization, patients related issues and how Electronic Medical Records (EMR) can be implemented. We need better research methods. Since we do not have enough money and time, we need to collaborate with each other, he remarked.

Prof. Ole Tjomsland from Norway talked about Unwarranted variations in Health care: Present and future challenges. He pointed out that because of under use, misuse and overuse of the facilities, services we waste almost 34% of our spending. We tend to overuse because of lack of collaboration. Strategies are not implemented to improve quality of care so as to reduce overuse. He called for reducing unacceptable practices and adherence to compliance. Because of documentation and Registry thirty days mortality from stroke and hip replacements has been reduced as shown by various studies. Similarly comparison of open vs. laparoscopic surgery for colorectal cancer has also shown reduced morbidity and mortality with the later. Registry is a cost effective measure and patient safety is doing right thing on right patient, he remarked.

Earlier Prof. A.G. Billoo Chairman of Health RAB in his welcome address talked about the health and medical research issues facing Pakistan. We have 149th ranking out of 188 countries. We failed to achieve Millennium Development Goals and are now struggling for Sustainable Development Goals. Health Research is nowhere in our research agenda in Pakistan. We have over 125 medical colleges and what is their research output he asked? PHRC did establish some Research Centers but it has not enough funding. HEC did support some PhDs. Publications are now necessary but not many of the research being done in Pakistan translates into Policy to call action. Health RAB was established to work with institutions, doctors, created funding to grapple with problems of research which will translate into policy making, he added.

Dr. Zakiuddin Ahmed Secretary of Health RAB shared the accomplishments and achievements of Health RAB so far and pointed out that it has ninety Chartered and thirteen hundred regular members. It has organized two international medical research conferences, conducted six online research courses, created research fund, support selected research projects, was working on formation of various registries and has also established a few Clinical Research Centers in Pakistan. He thanked PharmEvo for their unlimited financial grant for Health RAB.

Prof. Ejaz Ahmad Vohra participating in the discussion said that we should do research relevant to our own country and not for promotion. We should improve the quality and standard of our medical journals, offer incentives to researches and create posts of Physician Scientists to accelerate research. President PM&DC Prof. Shabbir Lehri said that unfortunately medical education in Pakistan has become a business though there are some good medical colleges both in public and private sector.  A mafia has emerged in the name of preparing students for entry test of medical colleges. We need to correct the systems. We started central induction policy which was being opposed by the vested interests. It was all meant to uphold merit, he added. Others who spoke on the occasion included Prof. Hafeez Ullah Khan, Dr. Zaigham Abbas, Dr. Shahid Noor. Prof. Abdul Basit Vice Chairman of Health RAB conducted the meeting and also briefly talked about the Diabetes Registry as well as National Diabetes Survey which they have conducted recently. Later mementoes were presented to the speakers and organizers.

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