The Transformative Role of Community Pharmacy in Pakistan.

Community pharmacy plays a crucial role in healthcare delivery, particularly in countries like Pakistan where access to primary care services remains limited. Community pharmacists are readily accessible and can provide a wide range of services, including medication dispensing, counseling, and health screening. However, despite their potential, community pharmacies in Pakistan are often underutilized and face several challenges.

A. The Current Landscape of Community Pharmacy in Pakistan:

The pharmacy profession in Pakistan is young and still in the growth phase, with the first three-year Bachelor of Pharmacy degree initiated in 1948, then B. Pharmacy, and now PharmD. While the Pharmacy Act of 1967 defined the regulations and job descriptions for pharmacists, the full potential of the profession remains untapped. On the other hand, the developed world is thinking of allowing the prescription for some common illnesses in Community Pharmacy.

Currently, Community pharmacies in Pakistan are primarily focused on dispensing medications. While this is an essential service, there is a growing need for pharmacists to expand their roles and provide more comprehensive healthcare services.

Community pharmacies in Pakistan operate in a complex and challenging environment. Most pharmacies are privately owned and unregulated, leading to variations in the quality of services provided. Pharmacists often lack adequate training and resources to provide comprehensive healthcare services. Additionally, the cost of medicines is often unaffordable for many Pakistanis, leading to self-medication and medication non-adherence. Some of the facts to share are;

a)???? There is a shortage of qualified pharmacists in Pakistan. The estimated pharmacist-to-population ratio is 1:10,000, which is much lower than the recommended ratio of 1:2,000 (As per recommendations of WHO).

b)???? The majority of pharmacies in Pakistan are privately owned and unregulated. This can lead to variations in the quality of services provided.

c)???? Pharmacists often lack adequate training and resources to provide comprehensive healthcare services.

d)???? The cost of medicines is often unaffordable for many Pakistanis, leading to self-medication and medication non-adherence.

B. Challenges Facing Community Pharmacy in Pakistan: Several challenges hinder the effective utilization of community pharmacies in Pakistan:

a)??? Non-recognition of pharmacists as healthcare professionals: Pharmacists are often not recognized as full-fledged healthcare providers, limiting their integration into primary care teams.

b)??? Limited training and education: The current pharmacy curriculum in Pakistan may not adequately prepare pharmacists for expanded clinical and community roles so far.

c)??? Under-utilization of pharmacists' expertise: Patients and healthcare providers (Especially Doctors) often underestimate the range of services that pharmacists can provide.

d)??? Regulatory and legal barriers: The existing regulatory framework may not fully support the expansion of pharmacists' roles, even if there are no Job Descriptions made for the separate roles of the pharmacists working in public institutes.

C. A Different Perspective for Better Health at the Primary Level: Community pharmacies have the potential to play a transformative role in improving primary healthcare in Pakistan. By expanding their roles and providing more comprehensive services, pharmacists can contribute to:

a)???? Improved medication adherence: Pharmacists can provide patient counseling and monitoring to ensure that patients are taking their medications correctly, leading to better health outcomes.

b)???? Prevention and early detection of diseases: Pharmacists can conduct health screenings and provide education to help prevent and detect chronic diseases such as diabetes and hypertension.

c)???? Management of chronic conditions: Pharmacists can provide ongoing care for patients with chronic conditions, helping them manage their medications and lifestyle factors.

d)???? Access to healthcare in underserved areas: Community pharmacies are often the only accessible healthcare providers in rural and remote areas.

D. Suggestions/Recommendation.

To fully realize the potential of community pharmacy in Pakistan, several recommendations can be implemented:

a)??? Strengthen the recognition of pharmacists as healthcare professionals: Pharmacists should be recognized as integral members of primary care teams and their contributions should be valued.

b)??? Review and refine regulatory frameworks: The regulatory framework should be reviewed to remove any barriers to pharmacists' expanded roles.

c)??? Standardization and Regulation: Establish standardized training and practice guidelines for community pharmacists. Implement a comprehensive regulatory framework to ensure the quality of services provided.

d)??? Enhanced Training and Resources: Provide comprehensive training programs for pharmacists to equip them with the necessary skills and knowledge to deliver advanced clinical services. Enhance the availability of resources, including medicines, diagnostic tools, and patient education materials.

e)??? Integration into Primary Healthcare: Integrate community pharmacies into the primary healthcare system, establishing clear referral pathways and collaborations with other healthcare providers.

f)????? Patient Education and Awareness: Raise public awareness of the role of pharmacists and the range of services they can provide. Encourage patients to consult pharmacists for medication-related queries and health advice.

To conclude, as discussed above, community pharmacies play a crucial role in providing medication counseling and other preventive care services to patients. They are the most accessible healthcare providers for many people, especially in rural and underserved areas. Pakistan has many community pharmacies, but they face several challenges that hinder their ability to provide optimal care. A stakeholder's strategic alliance between PPA, DRAP, Pakistan Pharmacy Council (PPC), and other pharmacist organizations can work together to make a positive impact on the lives of patients in Pakistan.

To address these challenges, these organizations should work together to develop a long-term strategy for community pharmacy in Pakistan. This strategy should focus on the following key areas:

a)???? Advocacy: PPA and other pharmacist community organizations should advocate for the role of pharmacists in the healthcare system and promote the development of high-quality community pharmacy services.

b)???? Education: DRAP and PPC should provide continuing education opportunities for pharmacists to help them keep their skills and knowledge up to date.

c)???? Research: These organizations should support research on the effectiveness of community pharmacy interventions.

d)???? Collaboration: These organizations should build relationships with other healthcare providers, policymakers, and the public.

e)???? Implementation and Action: After several meetings, research, and discussions, a clear policy should be formed, and responsibilities should be assigned to different stakeholders. There should be clear guidelines for implementation, action, and monitoring to ensure the outcome.

By working together, these organizations can help to improve the quality of healthcare for all Pakistanis. Here are some additional things that these organizations can do to emphasize issues of Community Pharmacy and Pharmacists:

1. Publish reports and white papers on the state of community pharmacy in Pakistan.
2. Conduct research on the effectiveness of community pharmacy interventions.
3. Develop and implement community pharmacy practice guidelines.
4. Provide training and support to community pharmacists.
5. Advocate for government and non-government funding for community pharmacy programs.

Young pharmacists are the future of the profession, and it is important to encourage them to get involved in community pharmacy. Community pharmacy is a rewarding and challenging field, and it offers a variety of career opportunities. Pharmacists play a vital role in the healthcare system, and they are in high demand. Pharmacy Mentors is a virtual platform that can help young pharmacists develop the skills and knowledge they need to succeed in community pharmacy. The platform provides access to a network of experienced mentors and consultants who can offer guidance and support. Mentors can provide advice on a variety of topics, including Clinical Practice, Business Management, Leadership Development, Career planning, etc.

Pharmacists Federation (Pakistan ) Reg. under Society Registration Act 1960 Pakistan Pharmacists Association The Pakistan Society of Health-System Pharmacists (PSHP) Pakistan Pharmacist Technocrat Society Pakistan Pharmacist Federation Pakistan Pharmacist Association PAKISTAN PHARMACISTS COMMUNITY Drug Regulatory Authority of Pakistan Dr. Sue Ojageer PharmD, CPGx Dr. Mahesh Kumar .K. Maheshwari