Pharmaceutical Care is a term that has been evolving for a couple of decades now. In 1990 Hepler and Strand first defined the term as “the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life”.[1] Many universities, pharmaceutical organisations as well as the World Health Organisation still make reference to this definition.
2013 saw the Pharmaceutical Care Network Europe redefine the term as “the pharmacist’s contribution to the care of individuals in order to optimize medicines use and improve health outcomes”. There is no question about accountability in that definition! But what does this statement actually mean? Are we solely and directly responsible for the deliverance of pharmaceutical Care for every patient we care for? How is this contribution assessed?
Looking at it holistically we may say the pharmacist’s contribution will take many avenues: from ensuring a proper, updated and validated IT system is in place to access all necessary patient information; making sure staff are fully trained and competent to meet the demands of the pharmacy; being up to date yourself with the necessary skills and knowledge identified through your own CPD; and making sure your communication channels with other health care professionals are open and there is a free flow of information. This relationship building and networking amongst other health care professionals is something many pharmacists in the community shy away from. Possibly because we, more often than not, are lone health care professional workers with no one to collaborate with except our trusted BNF and now, in the more IT developed world, online access! We are also quite possibly the only health care professional that may never see the patient! We could receive a prescription, (electronically or paper-based), via our Repeat Prescription Service, (developed in the name of convenience and better accessibility for the patient) and clinically screen it against the patients record and treatment history. It is then dispensed, checked by either yourself, (the pharmacist), or an Accredited Checking Technician, stored awaiting the patient’s arrival and then given out by prescription reception with the necessary advice to go alongside it.
Every pharmacist knows that within our busy, dynamic environment we face on a daily basis, it can sometimes be impossible to have direct contact with every patient we care for. However, behind the scenes there may have been numerous calls to the surgery querying doses and directions or legal requirement checks for the appropriateness of certain quantities of schedule 2 or 3 drugs.
Pharmaceutical care as displayed by many of us every day, involves the attitudes, behaviours, commitments, concerns, ethics, functions, knowledge, responsibilities and skills of the pharmacist on the provision of drug therapy.[2] All of this whilst collaborating with different health care providers helps achieve the goal of improved health outcomes and quality of life. As subjective as this may be, an improved health outcome and quality of life is highly dependent on an integrated health system and pharmacists can certainly not stand alone in achieving that goal!
[1] Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. American Journal of Health Systems Pharmacy 1990;47:533-43
[2] WHO, ‘The Role of the pharmacist in the health care system’
Written by Puvehni Pillay