Several years ago, pharmacists were known to be compounders and dispensers of medication prescribed by the physicians. Today pharmacy profession has gone a long way in establishing itself in the health care system. This evolution gave birth to what is called “Pharmaceutical care”.
What is Pharmaceutical care?
Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improves a patient’s quality of life. Pharmacy profession is a bridge between the physician and the patient
As a pharmacist, we say pharmaceutical care is our mission but has it become a standard of practise in our society.
Look at the pharmacies around whether in the hospital or in the community, how many of them deliver patient related information and care? In fact you can find some pharmacy operating without a professional pharmacist. These result in inappropriate drug therapy, non-compliance and medication errors such as irrational alternative medicine recommendations.
I am not instigating that pharmaceutical care is not practised but they are not in the majority. The need has been created because of the following:
1. Complex drug therapy
2. Poly pharmacy
3. Multiple disease condition
4. Geriatrics and paediatrics population
5. Pregnancy and lactation
However the demand is minimal as the physicians, patient’s and the government have no clear understanding on the outcome of pharmaceutical care in minimizing health care cost, improving patient’s quality of life and satisfaction.
I was privileged being a student pharmacist studying in India to observe and learn the practice of pharmacy in my country Nigeria at a reputed hospital in northern Nigeria. To my utmost surprise every prescription was dispensed by nurses, while the pharmacist was engaged in managing the drug inventory, so tell me how the importance of the profession in providing pharmaceutical care can be communicated to the public and be of value to the patient.
I will share one of many experiences I came across at the hospital:
An asthmatic patient was rushed into the hospital by his mother, the child was breathless and he gasped for air. The doctor directed the nurse to administer salbutamol (bronchodilator) via nebulizer delivery system over 15 minutes which was administered to the child. The child symptoms diminished as time lapsed but the patient role in achieving maximum outcome was not played because they were not educated and aware on the dos and don’ts which resulted in inappropriate siting posture and conversation between the mother and child in the course of therapy. However maximum amount of medication will not reach the small airways and these decreases the medication effectiveness.
There is a standard procedure in administration of nebulizer and it is the role of a pharmacist to educate the patient on how to take the nebulized treatment, thereby maximizing the patient’s outcome and quality of life.
With the advancement in technology so many individuals have lost their jobs because these technology increases accuracy and efficiency. We shouldn’t be ignorant that this type of technology is gaining momentum and market space in pharmacy which is known as “prescription automation dispenser” example is the RxSafe 1800 system.
A basic important thing pharmacist should do to sustain its Practise is
Build patient- pharmacist relationship
Helper and Strand defined Pharmaceutical care as “the responsible provision of drug therapy for the purpose of achieving definite outcomes that improves a patient’s quality of life” and stated that, among other criteria, “the provider of pharmaceutical care must be able to develop the relationships with the patient and other health care professionals needed to provide pharmaceutical care”.
I have observed in many retail pharmacy outlet that the pharmacist don’t bother to know the needs of the patient and provide value added services such as:
1. Patient counselling
2. Medication therapy management
3. Preventive therapy
Several studies have shown that effective patient- pharmacist relationship and communication improves patient’s compliance with treatment regimens. Every human strive for reciprocal relationship but we should understand that in health care it’s a covenant and a code of ethics to serve the needs of patients and understanding that they are not there to serve our needs. We should create an atmosphere of care, concern, integrity and trust. This understanding goes miles in making our practise valuable to the community and patients would be more submissive in providing information you need to make better therapeutic decisions and more compliant to their medication.
“Effective relationship is essential in sustaining the practise of pharmacy and provision of pharmaceutical care”
1. Helper CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Pharm Educ. 1989;53(winter suppl):7S-15S
2. Bruce A. Berger, PhD, RPh. Communication Skills for Pharmacists: Building relationships, Improving Patient Care. American pharmaceutical Association. Nancy Tarleton Landis. Available at www.pharmacist.com