Pharmacist Role As Per WHO Guidelines
WHO has acknowledged the importance of pharmacist . Profession of pharmacy is better utilised by developed countries in drug research and patient counselling, whereas many developing countries are lacking in utilising pharmacy professionals.
We will give role of pharmacist as per WHO guidelines here in various sectors from industry to retail pharmacy. If you want to read role of pharmacist in India Kindly visit here Role Of Pharmacist In India.
- 1 Pharmacist Role As Per WHO Guidelines
- 1.1 Regulatory control and drug management
- 1.2 Role Of Pharmacist In Community pharmacy
- 1.3 Pharmacist Role In Hospital pharmacy
- 1.4 Role Of Pharmacist In pharmaceutical industry
- 1.5 Responsibility Of Pharmacist In Academic activities
- 1.6 Training other health care workers
- 1.7 Aspects of pharmaceutical care
Regulatory control and drug management
Role Of Pharmacist In Health and drug policy
Each ministry of health has a section dealing with pharmaceutical affairs. In view of the importance of drugs in government health services, and of the related expertise within the pharmaceutical section, it is important that the pharmaceutical affairs section should have equal prominence with other sections of the ministry. Pharmacists in administration participate in formulating health and drug policies, particularly those on the selection, procurement and distribution of drugs. They serve as sources of information for health care professionals and the public, and participate in the preparation of pharmacopoeias and other official documents. They cooperate with educators and the professional body of pharmacists in establishing and modifying the curricula of schools of pharmacy and continuing education programmes. In some countries, pharmacists have roles in environmental health control and in control of the quality of food and of cosmetics and medical devices.
Pharmacists do not perform these functions in all countries. A prerequisite to their widespread adoption is the involvement of pharmacists with the appropriate expertise in the determination and implementation of national health policy, which provides the context for policies related to drugs and pharmacy. In view of the special knowledge and expertise of pharmacists, they should be given the responsibility at a senior level for the determination and implementation of policy on drugs and pharmacy manpower and for the drafting and administration of legislation. Pharmacists in such senior positions should preferably have postgraduate training and a qualification in public health.
In some countries, potent medicines and related products may be supplied or dispensed by non-pharmacists and without the supervision or control of pharmacists. For the safety of the public, such transactions should be performed or supervised by pharmacists, to ensure the supply of correct medicines of acceptable quality.
In some countries the management of drug procurement and supply, and drug control, registration and enforcement, do not meet satisfactory standards. To achieve acceptable standards, pharmacists with suitable postgraduate training should be appointed to senior positions, and standards should be assured by comprehensive pharmaceutical legislation and its effective enforcement.
Role Of Pharmacist In Management
Government-employed pharmacists are responsible for drug management, which includes the selection of essential drugs, the determination of drug requirements, the procurement and distribution of drugs and their rational use, as well as the design and use of information systems. Also, they collect and collate data required by their national government agencies and by international bodies, such as the International Narcotics Control Board.
Pharmacist And Administration
In some countries, tenders for the import and supply of drugs are awarded to non-pharmaceutical businesses. The management of such businesses is not capable of applying professional standards and is influenced solely by commercial considerations. Procedures for inviting, accepting and awarding tenders for the supply of pharmaceuticals should be separate from those for non-professional commercial tenders, and should be managed by pharmacists.
Role Of Pharmacist In Educational policy
Pharmacists cooperate with educators in establishing and implementing policies with regard to undergraduate and continuing education, in-service training, and other aspects of manpower development.
Role In Regulatory and enforcement agencies
Pharmacists are employed by regulatory agencies concerned with the approval, registration and quality control of drugs, cosmetics and medical devices, and with enforcement agencies, including customs departments, that control the distribution of drugs through licit and illicit channels, and as inspectors of the manufacture, importation, distribution and sale of drugs.
Pharmacist In Professional registration authorities
Pharmacists are prominently engaged in agencies, such as boards of pharmacy, that establish criteria for the registration of pharmacists or licensing requirements, register pharmacies and pharmacists, and monitor the way pharmacies are operated and the professional conduct of pharmacists.
Participation In International agencies and professional bodies
Pharmacists employed in these bodies perform a variety of technical and administrative functions in professional bodies and in drug- and health-related agencies, e.g., the World Health Organization, the International Narcotics Control Board, the United Nations Division of Narcotic Drugs, the United Nations Commission on Narcotic Drugs, the United Nations Fund for Drug Abuse Control, Interpol, national pharmacopoeial committees, and pharmaceutical societies.
Role Of Pharmacist In Community pharmacy
Community pharmacists are the health professionals most accessible to the public. They supply medicines in accordance with a prescription or, when legally permitted, sell them without a prescription. In addition to ensuring an accurate supply of appropriate products, their professional activities also cover counselling of patients at the time of dispensing of prescription and non-prescription drugs, drug information to health professionals, patients and the general public, and participation in health-promotion programmes. They maintain links with other health professionals in primary health care.
Today, an increasingly wide range of new and analogous products are used in medicine, including high-technology biological products and radio-pharmaceuticals. There is also the heterogeneous group of medical devices, which includes some products analogous to medicines, some of which demand special knowledge with regard to their uses and risks (e.g., dressings, wound management products, etc.).
Pharmacists have progressively undertaken the additional task of ensuring the quality of the products they supply.
The main activities of community pharmacists are described below.
Processing of prescriptions
The pharmacist verifies the legality, safety and appropriateness of the prescription order, checks the patient medication record before dispensing the prescription (when such records are kept in the pharmacy), ensures that the quantities of medication are dispensed accurately, and decides whether the medication should be handed to the patient, with appropriate counselling, by a pharmacist. In many countries, 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 prescriber.
Care of patients or clinical pharmacy
The pharmacist seeks to collect and integrate information about the patient’s drug history, clarify the patient’s understanding of the intended dosage regimen and method of administration, and advises the patient of drug-related precautions, and in some countries, monitors and evaluates the therapeutic response.
Monitoring of drug utilization
The pharmacist can participate in arrangements for monitoring the utilization of drugs, such as practice research projects, and schemes to analyse prescriptions for the monitoring of adverse drug reactions.
Extemporaneous preparation and small-scale manufacture of medicines
Pharmacists everywhere continue to prepare medicines in the pharmacy. This enables them to adapt the formulation of a medicine to the needs of an individual patient. 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. In some countries, developed and developing, pharmacists engage in the small-scale manufacture of medicines, which must accord with good manufacturing and distribution practice guidelines.
Traditional and alternative medicines
In some countries, pharmacists supply traditional medicines and dispense homoeopathic 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.
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 (diarrhoeal diseases, tuberculosis, leprosy, HIV-infection/AIDS) 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 Programme on Immunization, and malaria and blindness programmes.
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 counselling 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.
Pharmacist Role In Hospital pharmacy
Hospitals and other institutions and facilities, such as outpatient clinics, drug-dependency treatment facilities, poison control centres, drug information centres, and long-term care facilities, may be operated by the government or privately. While many of the pharmacist’s activities in such facilities may be similar to those performed by community pharmacists, they differ in a number of ways. Additionally, the hospital or institutional pharmacist:
- has more opportunity to interact closely with the prescriber and, therefore, to promote the rational prescribing and use of drugs;
- in larger hospital and institutional pharmacies, is usually one of several pharmacists, and thus has a greater opportunity to interact with others, to specialize and to gain greater expertise;
- having access to medical records, is in a position to influence the selection of drugs and dosage regimens, to monitor patient compliance and therapeutic response to drugs, and to recognize and report adverse drug reactions;
- can more easily than the community pharmacist assess and monitor patterns of drug usage and thus recommend changes where necessary;
- serves as a member of policy-making committees, including those concerned with drug selection, the use of antibiotics, and hospital infections (Drug and Therapeutics Committee) and thereby influences the preparation and composition of an essential-drug list or formulary;
- is in a better position to educate other health professionals about the rational use of drugs;
- more easily participates in studies to determine the beneficial or adverse effects of drugs, and is involved in the analysis of drugs in body fluids;
- can control hospital manufacture and procurement of drugs to ensure the supply of high-quality products;
- takes part in the planning and implementation of clinical trials.
Role Of Pharmacist In pharmaceutical industry
Statutory provisions in some countries may require that certain positions be held by pharmacists. The main activities of industrial pharmacists are described below.
Research and development
Pharmacists contribute to research, and their expertise in formulation development is of particular relevance to the biological availability of active ingredients.
Manufacture and quality assurance
The pharmacist’s broad knowledge of the pharmaceutical sciences ensures an integrated approach to quality assurance (including good manufacturing practice) through the validation of the various stages of production and the testing of products before release.
Role Of Pharmacist In Drug information
The pharmacist has the knowledge and expertise to provide detailed information on medicines to members of the health professions and the public. Also, pharmacists provide an information service within the company.
Patent applications and drug registration
The pharmacist is ideally qualified to understand and collate the diverse information required for patent and authorization submissions.
Clinical trials and post-marketing surveillance
The pharmacist has the knowledge of drugs and health care provision required to facilitate collaboration between companies, health professionals and governments in relation to clinical trials and surveillance.
Sales and marketing
The pharmacist, whose professional ethics demand a concern for the interest of patients, can make a contribution to proper marketing practices related to health care and to the provision of appropriate information to health professionals and the public.
The inclusion of pharmacists in all levels of management promotes an ethical approach within management policies.
Responsibility Of Pharmacist In Academic activities
Academic pharmacists engage in education, pharmaceutical practice, and research in schools of pharmacy. These three aspects of academic activity are interrelated, and at the same time connected with manpower planning and management. Undergraduate, postgraduate and continuing education require the educators to have expertise in the various pharmaceutical sciences, but, in view of the professional and vocational goals of pharmacy education and the necessary interaction of education and research with service, the academic staff must also include a substantial component of pharmacists with appropriate postgraduate education.
Training other health care workers
Training provided by pharmacists may include efforts to optimize drug therapy, by promoting the rational use and storage of drugs and methods of reducing drug abuse, and is directed to medical and other prescribers or suppliers of drugs, including community health workers who handle drugs. Pharmacists with training responsibilities should receive some training in the planning and management of training programmes in relation to the educational and health goals being served.
Aspects of pharmaceutical care
The elements of pharmaceutical care for individual patients, taken together, describe comprehensivepharmaceutical care, the delivery of which requires an ongoing, covenantal relationship between the pharmacist and the patient. The pharmacist must use his clinical judgement to determine the level of pharmaceutical care that is needed for each patient. Examples of situations which call for comprehensive pharmaceutical care include:
– Patients who are particularly vulnerable to adverse effects because they are physiologically compromised (e.g. infants; the elderly; those with kidney, liver or respiratory failure)
– Patients with medical conditions that require ongoing evaluation and manipulation of drug therapy to achieve optimal results (e.g. diabetes mellitus; asthma; hypertension; congestive heart failure).
– Patients who are taking multiple medication thereby placing them at higher risk for complex drug-drug or drug-disease interactions and for drug-food interactions.
– Patients requiring therapy with drugs that can be extremely toxic, especially if they are dosed, administered or used improperly (e.g. cancer chemotherapeutic agents, anticoagulants, parenteral narcotics.
– Patients whose acute illnesses can become life threatening if the prescribed medications are ineffective or used improperly (e.g. certain infections, severe diarrhoea).
Pharmaceutical Care For Individual Patients
The following are the various actions that comprise the application of pharmaceutical care to individuals. If undertaken, in whole or in part, they will result in added value to drug therapy by making a positive contribution to the safe and cost effective use of drugs, leading to positive outcomes and improved health care.
– Obtain and maintain medication records and relevant health information, if they do not already exist. This information is essential to assess individualized drug therapy.
– Identify, evaluate and assess:
(i) drug related problems (side effects; drug interactions; improper drug use);
(ii) symptoms described by patients;
(iii) self-diagnosed conditions;
and decide whether pharmacist action is appropriate or collaboration with other health professionals is needed.
– Initiate or modify drug/non drug therapies by:
(i) independent action (drugs that can be provided by pharmacists without a prescription; non drug therapies, e.g. life style changes, medical devices); and
(ii) collaborative action (always for medically prescribed drugs).
– Prepare and supply medication for use (including selection of drug products, prescription assessment, dispensing, compounding, packaging, labelling)
– With prescriber and/or patient, as the case may be. – set goals of therapy
– Design and implement pharmaceutical care plan (education, counselling)
– Monitor for therapeutic outcomes and take appropriate follow up actions (begin the pharmaceutical care cycle again)
Pharmaceutical Care For The Community
Pharmacists individually and as a profession have important roles to play in positively influencing drug policy, drug use and outcomes as well as other aspects of health care. In many instances this will be through collaboration with other health professionals at a community level.
(a) Participate in the formulation of drug policy including drug regulation
(b) Develop guidelines and criteria for formularies
(c) Collaborate with other health care professionals to develop treatment guidelines
(d) Design and monitor procurement and drug distribution systems, including storage and disposal (e.g. country wide, local, institutional)
(e) Formulate and manufacture quality medications within pharmacy practice
(f) Serve as a source of objective drug information: establish poison and drug information systems, e.g. poison and drug information centres
(g) Initiate and undertake research in e.g. pharmacotherapeutics including clinical trials; pharmacoepidemiology; pharmacy practice; health economics; and evaluate and document the results of such research in order to improve all aspects of pharmaceutical care.
(h) Educate all health professionals who participate in pharmaceutical care
(i) Develop, evaluate and document pharmaceutical care practices
(j) Participate in health screening (e.g. diabetes, cholesterol)
(k) Participate in health promotion and education (e.g. the proper use of medication; smoking cessation; immunization; prevention of drug abuse; hygiene; family planning; AIDS prevention)
(l) Develop professional standards and audit procedures
(m) Establish and maintain an appropriately qualified pharmacy workforce.
The above laws and guidelines make it clear that pharmacist role is indispensable in healthcare. Pharmacist are playing vital role in industry, but as healthcare providers there skills are not utilised by many countries including India. Laws should be strictly implemented. Doctors and pharmacists communication protocols should be set up, and Pharmacists should be allowed to work more independently in the patient interests.
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