The Pharmacist: More Than You Think

Introduction

Hello there, it’s nice to have you here again! Before I proceed, I will like to encourage you to read this article till the end. Whether you are a pharmacist, a healthcare professional or not, the information here is necessary for you to have because it deals directly with your health. You need to be aware of the roles your healthcare professionals (particularly the Pharmacist in focus), play in ensuring that quality healthcare is administered to you and your loved ones.

For most people, the role of pharmacists is simply to interpret prescriptions and then, package and dish out drugs to patients or the person purchasing the drugs. Some people don’t see much difference between the pharmacist and a casual sales person at a store. Some better learned persons understand that pharmacists are also charged with the role of compounding and production of medications. But the vast majority of people do not know the unique, critical, highly important and irreplaceable clinical roles pharmacists play in ensuring a quality healthcare delivery process.

This article aims to enlighten its readers on who pharmacists really are, a brief history about them, their unique place in the healthcare system as the drug experts and the roles they place in improving the health and lives of people.

A brief history

The history of pharmacy as an independent profession dates back to the first third of the 19th century. Before then, pharmacy evolved from antiquity as part of medicine. The history of pharmacy coincides well with the history of medicine, but it is important that there is a distinction between the two topics. Before the advent of pharmacists, there existed apothecaries that worked alongside priests and physicians in regard to patient care.

The earliest evidence of pharmacy practice – prescriptions carved on 4,600-year-old clay tablets – was found in Mesopotamia. It was only in the Middle Ages that the roles of the physician and the pharmacist (then known as apothecaries or herbalists) were differentiated.

In the Greek legend, Asclepius, the god of the healing art, delegated to Hygieia the duty of compounding his remedies. She was his apothecary (or you can say, ‘pharmacist’).

The physician-priests of Egypt were divided into two classes: those who visited the sick and those who remained in the temple and prepared remedies for the patients. In ancient Greece and Rome and during the Middle Ages in Europe, the art of healing recognized a separation between the duties of the physician and those of the herbalist, who supplied the physician with the raw materials from which to make medicines.

The Arabian influence in Europe during the 8th century AD, however, brought about the practice of separate duties for the apothecary (or pharmacist) and physician. The trend toward specialization was later reinforced by a law enacted by the city council of Bruges in 1683, forbidding physicians to prepare medications for their patients. In America, Benjamin Franklin took a pivotal step in keeping the two professions separate when he appointed an apothecary to the Pennsylvania Hospital.

Still today, pharmacists are the only professionals authorized to sell medication, apart from “over-the-counter” products that can also be purchased in other stores. Having initially been specialists in the composition and preparation of medication, over the years, the duties performed by pharmacists have constantly evolved in order to adapt to each particular era. Modern pharmacy has become much more than pill counting, pharmacists are now also experts in the effects pharmaceutical drugs have on the body and in the possible interactions between substances.

So then, who is a Pharmacist?

A pharmacist is a healthcare professional who deals with the composition, properties, interactions, proper use and distribution of medicines. The pharmacist provides pharmaceutical information and clinical advice to the public, patients, physicians and other healthcare professionals, as well as offer primary healthcare services.

Using the knowledge of the mechanism of action of drugs (i.e, the process through which the drug works in our body to perform its work), the pharmacist understands how they should be used to achieve maximum benefits, minimal side effects and to avoid drug interactions.

Pharmacists are therefore the drug experts (having the widest and most elaborate training and knowledge about drugs among all healthcare professionals), and are the ones responsible for optimizing the use of medications for the benefit of the patients.

Unique role of the pharmacist in the healthcare delivery process.

Aside production, distribution and dispensing of medication, pharmacists have a unique role to play in ensuring that right healthcare is delivered to you and your loved ones. This unique role is called ‘Pharmaceutical care”.

Pharmaceutical care is defined as the responsible provision of drug therapy for the purpose if achieving definite outcomes that improves a patient’s quality of life (Helper and Strand, 1990).

Pharmaceutical care involves; Identifying actual and potential drug-related problems, resolving actual drug-related problems and preventing potential drug related problems. This is where your pharmacist helps in ensuring that when you’re placed on any particular drug therapy to treat a particular ailment, it is not only suitable for that ailment, but that it is also going to be effective and safe for you, while minimizing costs and side/adverse effects.

A drug-related problem may be defined as an actual or potential sign or symptom related to drug therapy that is undesirable to the patient, and interferes with the desired health outcome or goal. These includes, wrong drug, wrong dosage, unnecessary drug therapy, contraindications, adverse drug reaction, drug interactions, non-adherence, etc.

Pharmacists being charged with this irreplaceable role of pharmaceutical care, therefore work in collaboration with the patients and their doctors/physicians in ensuring that these unwanted drug therapy problems are removed and that patients receive the best drug therapy aimed at achieving a particular treatment outcome at the least possible costs and at the best safety.

Areas of the pharmacy practice

To appreciate the pharmacist better, here is a brief summary of the diverse scope of the pharmacy practice:

1.??????Clinical pharmacy: This is the branch of pharmacy where clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness and disease prevention. There are two major arms of the clinical practice aspects of the pharmacy profession. These are:

a.??????Community pharmacy: This is practiced in the common pharmacies or pharmacy stores that are closest to you. This is where you usually get prescription and non-prescription medicines. Pharmacists who practice here are called ‘community pharmacists’ (previously known as general pharmacy practitioners). Community pharmacists are NOT ordinary drug sellers. They are the closest healthcare professionals to you, and beyond just dispensing of medications, they also perform pharmaceutical care, attend to your healthcare needs, proffer solutions to them and refer you to a physician where applicable.

b.??????Hospital pharmacy: This involves the practice of pharmacy in a hospital setting. The roles of pharmacists in hospitals go beyond casual sales and compounding of medications, they work together with the healthcare team to ensure optimal patient care. They go on ward rounds with physicians and other healthcare professionals, and are responsible for advising other healthcare professionals on the best drug therapy for different patients. They also help in monitoring drug therapy to ensure that the treatment outcome is achieved, while minimizing adverse drug effects and costs. This is pharmaceutical care.

In the modern practice of clinical pharmacy and due to the diversity in this area, clinical pharmacists have begun to specialize in various areas of healthcare, to ensure specialized patient care. The currently recognized pharmacy specialties areas include;

????????????????????????????????i.???????????Ambulatory care pharmacy

??????????????????????????????ii.???????????Critical care pharmacy

????????????????????????????iii.???????????Nutrition support pharmacy

????????????????????????????iv.???????????Oncology pharmacy (i.e, cancer-related)

??????????????????????????????v.???????????Pediatric pharmacy

????????????????????????????vi.???????????Pharmacotherapy

???????????????????????????vii.???????????Psychiatric pharmacy

2.??????Industrial pharmacy:

These involves various aspects like production of safe and effective medications, marketing & distribution and research into new drugs and drug formulations. Pharmacists in this field are called industrial pharmacists.

3.??????Pharmaceutical Research:

This involves research spanning the entire spectrum of drug discovery, development, evaluation and regulatory approval.

4.??????Academia:

Academic pharmacists educate, train, assess and develop pharmacy students, pharmacists and other healthcare professionals on various pharmaceutical sciences and practices and usually practice in formal educational settings like Universities. Most academic pharmacists are also researchers.

5.??????Administrative pharmacy:

This involves the social, regulatory, advocacy and management aspects of the pharmacy practice.

Other areas include, public health, technology, etc.

Conclusion

Pharmacy is a very dynamic profession and the role of the pharmacist is improving with the expansion of the scope of services and the introduction of new subspecialties over time. Moving from being medication dispensers to outcome-oriented and patient-focused care providers; pharmacists will carry more responsibility and commitment to improve their knowledge and practice.

Dear reader, I believe this article has helped improve your understanding of who the pharmacist is and his peculiar role in the healthcare system. Hence, this is to encourage patients or the general public reading this to trust the pharmacist more regarding your medications, listen to their professional advice and refrain from self-medications when you can easily visit a pharmacy close to you.

To the physicians and other healthcare professionals reading this, this serve as a call for better friendly collaboration with the pharmacist to ensure optimal patient care.

Finally, to the pharmacist, this is to encourage you to develop yourself to live up to the expectation as a pharmacist in your various field, all for the benefit of the patient and the public at large.

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