by Dhivia Naidoo
What is Compounding?
Compounding is method of preparing tailor-made prescriptions on a per patient per prescription basis using back to basics methods, whilst combining latest technology. It addresses specific needs of the patient and health care provider and treats each patient as an individual rather than a “one size fits all “approach of conventional pharmacies.
Why is Compounding Important?
The traditional role of the pharmacist progressed from being the “medication preparer” in the early to being the “dispenser” of manufactured medications.
As a compounding pharmacist, one needs to work closely with the prescriber to achieve the best possible outcome with the most suitable formulation for the particular patient.
This greatly improves patient compliance as it considers patient preferences wrt dosage forms. It also has increased the pharmacist’s role in the healthcare team and has highlighted that the pharmacist is the most knowledgeable on formulations of medications.
Patient intolerance of manufactured product such as preservatives and dyes and allergies create non-compliance and hence decreases the therapeutic outcome of the drug.
Compounding can ensure customized dosage systems for individuals who cannot tolerate the standard manufactured drug, e.g., older folk who cannot swallow pills.
Products are not readily available or not commercially available.
How does Compounding work?
The compounding process allows one to make unique dosage forms using specialized facilities, skills, and equipment. The pharmacy has to build a specialized GMP compliant laboratory, which has stringent procedures in place to ensure sterility during all processes. The pharmacist must possess special skills and training to enable one to fulfil this role effectively. These skills are unique and hard to find, hence compounding pharmacists are very valued members of a team.
The compounding laboratory must include state of the art equipment and building monitoring systems to ensure all operating procedures are followed as per SA Pharmacy Council requirements.
The Value of Compounding
The value can best be explained by comparing the Manufacturing process to the Compounding process. Compounding vs Manufacturing
Compounding pharmacies can be specialised in certain areas eg Compounding using Functional Medicine principles. To illustrate this, a comparison of conventional medicine vs Functional Medicine has been made :
CONVENTIONAL MEDICINE
In this model, Health is considered as the absence of disease.
- Medical school education teaches about the ability to diagnose thousands of diseases and assign pharmaceutical treatments to those disease states.
- This approach does little or nothing to treat the underlying causes of disease.
- Disease Management system where symptoms are suppressed.
- Uses a specialist approach to treat organs.
- Treatment starts only when symptoms become evident.
- One size fits all approach that matches the disease with the drug.
- Very limited knowledge of nutrition
FUNCTIONAL MEDICINE
In this model , Health is not just the absence of disease – it is attaining complete and optimal vitality
- It focuses on disease prevention and reversal
- Treats the root cause of the disease using a holistic approach
- It is patient centric using biochemical individuality
- Encompasses nutrition, diet and exercise its treatment protocols
- Matches the drug to the patient
- Restores full function to the person by bringing about equilibrium