PERIPHERALl Neuropathy is common, affecting 1 in 2 people with Diabetes Mellitus, 1 in 10 adults, and as many as 58 percent of diabetic patients in the Philippines.  Photograph courtesy of isens-usa/Unsplash
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Pharmacists take frontline role in nerve health under new APAC guideline

Stephanie Mayo

In a first-of-its-kind move for regional healthcare, leading Asia-Pacific pharmacist experts and P&G Health have launched the first-ever clinical guideline specifically designed to empower community pharmacists to tackle Peripheral Neuropathy (PN).

Announced in the Philippines on 16 April during a virtual media roundtable, this consensus signals a major shift in how nerve damage is detected and managed right at the neighborhood drugstore.

A new standard

The “Empowering Community Pharmacists — Expert Consensus Guidelines for the Effective Management of Peripheral Neuropathy with Neurotropic B Vitamins” was developed by a panel of APAC experts to standardize care. This matters because the statistics are staggering: 1 in 2 diabetics and 1 in 10 adults suffer from PN. In the Philippines alone, the prevalence among diabetic patients is as high as 58 percent.

Because community pharmacists are the most accessible point of healthcare contact, they are often the first to catch symptoms like numbness and tingling before they become irreversible. Dr. Yolanda R. Robles, lead author and president of the Federation of Asian Pharmaceutical Associations, noted that the guideline “translates the best available evidence into simple steps for pharmacists to spot PN earlier, guide patients confidently, and partner with physicians to improve long-term outcomes.”

Proactive care partners

The heart of the guideline is the “MEDIC” mnemonic — a simple tool to help pharmacists identify at-risk patients (Medication, Elderly, Diabetes, Infection, Chronic). Instead of just waiting for a prescription, pharmacists are now encouraged to lead the conversation.

Contributing author Dr. Apt. Lusy Noviani explained the shift: “I am moving from behind the counter to the front line of care. Across Australia, Singapore, Malaysia and Southeast Asia, pharmacists are increasingly recognized as primary care extenders... We are often the first healthcare professional patients meet, especially in community pharmacy settings.”

Micro-counseling

One of the biggest challenges in the Philippines is the cultural tendency to dismiss nerve symptoms like tingling or numbness in the hands and feet. Dr. Kenny James P. Merin, contributing author and vice president for academic affairs at Lyceum of the Philippines University Davao, emphasized that pharmacists must take the lead.

“Symptoms like this are often shrugged off as something normal, or just because of aging, or just because they’re sick. And therefore, awareness should come from a pharmacist, not just waiting for them to mention the symptoms, but really asking direct questions, leading questions,” Dr. Merin said.

When DAILY TRIBUNE asked how this guideline can be applied in the reality of busy Philippine pharmacies with long queues, the experts pointed to practical adjustments. Dr. Merin acknowledged the heavy flow but highlighted a focused approach:

“Well, if you talk about the queue, in a busy hour, it takes around 20 minutes for a patient to fill their prescription inside a pharmacy. So it’s really right to say that it’s busy. But to support what was mentioned earlier, we also practice what you call micro-counseling, where you don’t have to make it so extensive. You just focus on the important points. And when patients need more counseling, we ask them to come back during off-peak hours so we have more time to talk to them.”

Expanding the role through policy

This development is further bolstered by the evolving legal and professional landscape in the Philippines. “Under Republic Act No. 10918, the role of pharmacists is being expanded, including the gradual creation of plantilla positions in government health settings such as RHUs and other local health units. While this is still slowly happening, it is a strategic direction that places pharmacists closer to the community where prevention and early intervention can happen,” Dr. Merin told DAILY TRIBUNE.

“With pharmacists embedded in LGUs and RHUs, they can support medicine management, patient counseling, chronic disease monitoring, health education and early screening or referral for conditions such as peripheral neuropathy. This strengthens the healthcare system by allowing pharmacists to contribute beyond dispensing and into more proactive primary care roles. This is also greatly supported by our Philippine Pharmacy Practice Standards 2.0, giving emphasis on primary care.”

Dr. Robles added that simplified communication is key: “I think the use of ‘laymanized,’ simplified infographics on peripheral neuropathy... will encourage them to seek help. Okay, so I think when we simplify the information, more people will understand it and more will be helped to seek advice from the pharmacists.”

By using standardized screening tools and recommending therapeutic-dose neurotropic B vitamins (B1, B6, B12), pharmacists are now equipped to ensure patients get the right care at the right time — transforming the pharmacy into a vital hub for nerve health.