Local Pharmacist Involvement in Physician’s Work Essay
Community pharmacists may be regarded as the health professionals most accessible to the public1 and whose services are coveted by the public and patients. Round the world, millions of people visit community pharmacies for their daily health care requirements. Pharmacists are placed as the first point of contact in the healthcare system because of their ease of approach2. They dispense medications in accordance with a prescription or without prescription when permitted, as in the case of OTC medicines. In addition to the supply of medicines the professional services of a community pharmacist should also cover patient counseling, drug information to healthcare professionals, patients and public, participation in healthcare program mes.3local Pharmacist Involvement in Physician’s Work Essay
The main activities of community pharmacists include: 3, 4, 5
- Processing of prescriptions
The pharmacist checks for the legality, safety and appropriateness of the prescription order and decides whether the medication should be handed to the patient with appropriate counsel ling, by a pharmacist. The community pharmacist is in a unique position to be fully aware of the patient’s past and current drug history and, consequently, can provide essential advice to the prescribe r.
- Care of patients or clinical pharmacy
The pharmacist seeks to collect and integrate information about the patient’s drug history, clarifies the patient’s understanding of the intended dosage regimen and method of administration, and advises the patient of drug-related precautions.
- Monitoring of drug utilization
The pharmacist can participate in arrangements for monitoring the utilization of drugs, such as practice research projects, and schemes to analyze prescriptions for the monitoring of adverse drug reactions.
- Extemporaneous preparation and small-scale manufacture of medicines
New developments in drugs and delivery systems may well extend the need for individually adapted medicines and thus increase the pharmacist’s need to continue with pharmacy formulation. Pharmacists engage in the small-scale manufacture of medicines, which must accord with good manufacturing and distribution practice guidelines.local Pharmacist Involvement in Physician’s Work Essay
- Traditional and alternative medicines
In some countries, as in India, pharmacists supply traditional medicines and dispense homeopathic prescriptions.
- Responding to symptoms of minor ailments
The pharmacist receives requests from members of the public for advice on a variety of symptoms and, when indicated, refers the inquiries to a medical practitioner. If the symptoms relate to a self-limiting minor ailment, the pharmacist can supply a non-prescription medicine, with advice to consult a medical practitioner if the symptoms persist for more than a few days. Alternatively, the pharmacist may give advice without supplying medicine.
- Informing health care professionals and the public
The pharmacist can compile and maintain information on all medicines, and particularly on newly introduced medicines, provide this information as necessary to other health care professionals and to patients, and use it in promoting the rational use of drugs, by providing advice and explanations to physicians and to members of the public.local Pharmacist Involvement in Physician’s Work Essay
- Health promotion
The pharmacist can take part in health promotion campaigns, locally and nationally, on a wide range of health-related topics, and particularly on drug-related topics (e.g., rational use of drugs, alcohol abuse, tobacco use, discouragement of drug use during pregnancy, organic solvent abuse, poison prevention) or topics concerned with other health problems (diarrhea l diseases, tuberculosis, diabetes care, leprosy, HIV-infection/AIDS), nutritional counseling and family planning. They may also take part in the education of local community groups in health promotion, and in campaigns on disease prevention, such as the Expanded Program me on Immunization, and malaria and blindness program mes.
- Domiciliary services
In a number of countries, the pharmacist provides an advisory as well as a supply service to residential homes for the elderly, and other long-term patients. In some countries, policies are being developed under which pharmacists will visit certain categories of house-bound patients to provide the counsel ling service that the patients would have received had they been able to visit the pharmacy.
- Agricultural and veterinary practice
Pharmacists supply animal medicines and medicated animal feeds.
Global setting of Community Pharmacy
Community pharmacy practice evolved in a period after Second World War. A pharmacist began to perform functions that were new to pharmacy. The popular motto of “patient oriented practice” and “drug use control” came into practice.6
Around the world there are community pharmacists who are drug experts providing patient care in their community pharmacies. In many countries community pharmacies are places where individuals may obtain health advice & assistance with managing their disease status with medication.
In UKpharmacist have role in primary care & public health. In community pharmacies the concept of “responsible pharmacist” is adopted from 2005. In Canada community pharmacies offer professional services like home delivery of prescription, in store blood pressure monitoring device, in store screening/risk assessments, patient library, in store educational seminar/programs, trial prescriptions, patients call back system, in store disease management, home visits, out of store educational seminars/program & documented care plans.local Pharmacist Involvement in Physician’s Work Essay
In Brazil community pharmacies provide pharmaceutical services like drug dispensing, blood pressure measurement, capillary glucose test, cholesterol/triglyceride test, nebulization, administration o injectables & compounding. In Germany community pharmacists contributes to health promotion & promote rational prescribing and appropriate use of medicine along with this they provide drug information, pharmaceutical care& preventive care services.
In Finland medication counseling by community pharmacists was made mandated by law in 1983. In Australia, disease state management in asthma & diabetes is being considered for reimbursement & in Portugal, programs exists for diabetes, asthma & hypertension. In Sweden all pharmacies have an information technology-based drug related problem documentation system & a new national drug related problem database.8
Community Pharmacy in India
The genesis of community pharmacy practice in India can be traced back to the Colonial period when allopathic drugs were introduced and were made available through drug stores towards the end of the nineteenth century. The pharmacy practice scenario and especially community pharmacy practice during per-independence era was highly unregulated and there were no restrictions on the practice of pharmacy in India.7
When we look into our country, as compared with the global setting, things are totally different and honestly it is quite disturbing. More or less, with very few exceptions, pharmacies are the drug selling shops and not yet healthcare settings. The true community pharmacy concept is not developed yet. Although community pharmacist is of key importance in providing better healthcare, the situation and condition of the community pharmaceutical service has stood where it was in its commencement.6
Today, community pharmacists play an important role in any country as they take responsibility for patient’s medicine related needs for access to healthcare. However, in India only the supply of medicines remains the core activity of the community pharmacist. Most community pharmacists in the country still hardly offer patient-oriented service. The role of the pharmacists in the community, and with it their medicine management, may change in the wake of the rapid growth of domestic medicine output and national healthcare expenditure.7local Pharmacist Involvement in Physician’s Work Essay
The profession of pharmacy in India can seize the opportunity and respond to changes in the health care system, in part, by making pharmaceutical care its mission. Good Pharmacy Practice Guidelines aim to set standards for practice of pharmacy as a profession in India. It is also an affirmative statement conveying that we ourselves control our profession’s standards, not anyone else. These guidelines aim to provide the framework to meet the criteria that has the potential to make pharmacy profession relevant to the society. Hence it is necessary that every individual pharmacist should be aware of the guidelines and uplift their profession.
Prevalence of diabetes and the role of community pharmacist in diabetes care
According to recent estimates, approximately 285 million people worldwide (6.6%) in the 20–79 year age group will have diabetes in 2010 and by 2030, 438 million people (7.8%) of the adult population, is expected to have diabetes9. Between 2010 and 2030, there will be a 69% increase in numbers of adults with diabetes in developing countries and a 20% increase in developed countries.10
It is estimated that the total number of people with diabetes in 2010 to be around 50.8 million in India, rising to 87.0 million by 2030. According to the World Health Organization (WHO) criteria, the prevalence of known diabetes was 5.6% and 2.7% among urban and rural areas, respectively. India is ranked first among the top10 countries for estimated numbers of adults with diabetes, 2010 and 2030 11.local Pharmacist Involvement in Physician’s Work Essay
Several studies have reported the role of pharmacists in diabetes care. Community Pharmacists for diabetes patients intervention study in Japan showed a marked increase in HbA1C levels.12 A Study conducted in Tamil Nadu has turned out to show that community pharmacists are in a unique position to monitor and counsel rural patients with diabetes. This study demonstrates the positive impact that the community pharmacist can have in achieving the primary therapeutic goal in diabetes patients of overall diabetes control. 13
It is evident that community pharmacy in its broad meaning has not yet come into practice and the community pharmacist has a major role to play in diabetes care. An evaluation will reflect how far our pharmacists are aware of their role and will help to improve themselves in their profession. Hence our study aims at assessing the knowledge, attitude and practice of the community pharmacist towards Good Pharmacy Practice and diabetes with an objective of imparting academic and professional updation through professional development initiatives.
The relationship between the pharmacist and doctor is a historically tenuous one. Typically, there is very little in the way of structured interaction resulting in both parties being regarded as completely autonomous bodies with the pharmacist responsible for compounding and dispensing medication and screening for errors whilst the doctor being responsible for diagnosing, prescribing and management. However as budgets become more and more strained and the focus of ill health sways towards chronic diseases requiring long term management, doctors are becoming increasingly overrun both in primary and secondary care terms. Therefore, the pharmacist is the obvious choice to try and share and alleviate this load. However, both parties must first strive to overcome their problems. The pharmacist is in a prime location to do so, as at present, as a profession, they are seeking greater responsibility and a wider variety or roles which often encroach on those of the doctor. The pharmacist should endeavour to have a clearer role specification so that the doctor understands their relative position. Also, the pharmacist should review their relationships with doctors, both in the hospital and community pharmacy setting, regarding them as peers who they can learn from and interact with, rather than just anonymous voices to consult via a phone call when an error occurs on a prescription.local Pharmacist Involvement in Physician’s Work Essay