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For the past seven years, I have been a Pharmacovigilance Pharmacist at the Liverpool School of Tropical Medicine – but how did I get here?
After four years at university and a one-year internship, I qualified as a Pharmacist and took the first step on my career ladder as a hospital Pharmacist. Within the first couple of years, I studied for my postgraduate diploma in Clinical Pharmacy and whilst studying and working was a struggle at times, it gave me the strong foundation I needed to take the next step.
But I wasn’t sure what the next step was…most pharmacists in my position were looking to specialise and whilst I understood the attraction of getting to know a particular clinical subject really well, I was also really enjoying the diversity and spontaneity of my current work and didn’t want to give that up quite so soon.
At this time, I met a Pharmacist who had not long completed a Voluntary Services Overseas placement in Tanzania. After talking to her and with her encouragement, I took the plunge and applied. After a lengthy but insightful application process, I was offered a placement in Uganda and just short of a year later, I found myself at work in a busy city hospital in the Pearl of Africa.
In the two years I spent in Uganda, I was on a steep learning curve. I was suddenly witnessing life-threatening diseases which had only been theoretical in my career up to that point. I learnt a lot about the challenges associated with providing healthcare in those settings and how the issues are viewed by the people primarily affected by them. It was a tough and challenging two years, but it was about to define the next stage in my career path.
There are many challenges associated with healthcare and treatment provision in Uganda. One of my observations was the lack of systematic monitoring of patients to ensure they were improving and not experiencing any adverse effects from the treatment they were receiving. This is a notoriously difficult process in any setting and there are many reasons why this is particularly challenging in Uganda – cost, logistics, time, limited staffing – but without this follow up or the patient knowing how to report suspected issues with medication (or no such system being in place), we can never be sure our patients are not being inadvertently harmed by our good intentions to treat them.
As my two years came to an end, I’ll admit I was keen to get home, to live in the UK again with its familiarity and my family close by. But I was also keen not to forget what I had learned and to somehow make sure that I put my new-found knowledge, skills and awareness into practice. An ideal opportunity presented itself when the Liverpool School of Tropical Medicine (LSTM) advertised for a position researching potential harms associated with antimalarials.
I applied and suddenly I was taking the plunge into the world of research, a world I had little experience in. I have now been at LSTM for seven years as a Pharmacovigilance Pharmacist and in that time I have helped co-ordinate the safety activities of various studies within two antimalarial Consortia (the Malaria in Pregnancy Consortium and the ACT Consortium) and consequently on a number of other studies. The role has widened my knowledge of pharmacovigilance and drug safety monitoring, particularly in challenging circumstances, and has given me an interest in the methodology of safety monitoring and the role of harmonisation of safety data collection methods. My role at LSTM has developed over the years to include non-malaria studies and non-drug interventions – after all, monitoring of safety and participant wellbeing is relevant to all research activities. I am currently involved in a study on the implementation of menstrual cups in Kenya – it is important that any study that implements a novel intervention is monitored adequately to ensure that it is as safe as expected – absence of harms is not proof of safety, especially if you didn’t look for the harms in the first place, and the safety of an intervention should never be assumed.
Researching pharmacovigilance in the global setting has given me the opportunity to collaborate with many people around the world, in a variety of different contexts and I look forward to continuing this work.
