Development of Pharmacy Practice from 1940's up till Now
Development of Pharmacy Practice from 1940's up till Now
Author:
Dr. Mohamed Ahmed A. Moustafa
Professor of Medicinal Chemistry
In the beginning, I am very pleased to start sharing in the activities of this important site aiming to help in creating bright future for Pharmacists and Pharmacy Practice.
Pharmacy practice has faced several changes in responsibilities and developments along the period started from the end of the Second World War up till now. In fact, these evolutions in the responsibilities of Pharmacists were necessary to meet development in industry, technology, and the impact of the societies needs to improve health care system. Unfortunately, I should emphasize that pharmacy practice in most of the Arabic countries does not cope with international development in this field.
1940s and 50s
Pharmacists compounded drugs used to treat patients. Pharmacy lab was very rich in raw materials of available drugs, chemicals and extracts and it was the primary source of simple and compound medicines. Pharmacists were able to prepare powdered drugs in the form of packages, cachets and pills. Syrups, solutions and elixirs beside creams and ointments were currently dispensed in the pharmacy.
" كان يقال ان الحنفية فى اجزاخانة الدكتور موافى ، اللة يرحمة، فى ميدان المحطة بالمنصورة بتنزل ماء دّهب"
1960s and 1970s
Rapid growth of Pharmaceutical industries that began to take over the role of drug production.
Pharmacist role is becoming more technical:
n Pharmacist as dispenser
n Focus on product
n Ethics prohibit Pharmacist from discussing drug effect or Rx with patient.
"للاسف هذا هو الحال بالنسبة للصيادلة فى معظم الوطن العربى حتى الان"
Hospital Pharmacy
In the 1960s, hospital pharmacists implemented unit-dose drug distribution systems to reduce medication, dispensing and administration errors. Hospital pharmacists assumed responsibility for compounding parenteral admixtures in the 1960s and 70s.
In the 1970s pharmacists began maintaining medication profiles to review patient medications for drug related problems. Computerized systems for automatically reviewing prescriptions for allergies, drug interactions, appropriateness of the dosage, and other common drug related problems have since evolved.
• Drug information centers were created in hospitals to provide drug information to physicians and other health care providers.
• The role of pharmacists as drug information providers led to decentralization of pharmacists to provide drug information.
"من هنا بدات علاقة حقيقية بين الاطباء والصيادلة من اجل تقديم خدمة افضل للمرضى"
1970s and 1980s
Clinical Pharmacy
Most hospitals in USA began to develop clinical pharmacy services. Pharmacists were decentralized to patient care units to provide clinical services.
Ambulatory clinical services also began in clinics and a few community pharmacies.
In the 1980s most states required pharmacists to provide patient medication counseling to outpatients on new prescriptions. Verbal, written and computerized printed education materials to supplement verbal patient counseling have since evolved.
Clinical Pharmacy rules could be summarized in the following points:
n Scientific knowledge brought bedside
n Drug use control (social role)
n Drug therapy experts
n Consulted and extension with physicians in hospital setting
n Most communication with physicians and nurses
n Little communication with patient
1990s to Now
Pharmaceutical Care and Pharmacotherapy (Pharmacist as Patient Care Provider)
Pharmacist became part of the health care system. It has real relation with patient. Now, Pharmacy practice trends are:
v Increased emphasis on patient care services as well as drug distribution.
v Increased emphasis on continuity of care (home-office practice-hospital-long term care, etc.)
v Increased emphasis on preventive care (use of OTCs, alternative medicines, self-diagnostic kits, diet, screening procedures, immunizations, etc.)
v Increased use of automation for pharmacy dispensing.
v Increased use of information technology.
v Increased evidenced based use of alternative and complimentary medicines
v Increased collaborative practices with other health professionals.
v Better documentation of the value of pharmaceutical care
v Greater use of pharmacist reimbursement methods tied to patient care services and patient outcomes.
Pharmacists are becoming key players in developing systems of care (automated treatment protocols) and employed by the pharmaceutical industry, pharmaceutical benefits managers, third party payers and the government to develop systems of care.
In Primary care services, pharmacists take responsibility for the primary care of patients. Pharmacists will not likely become independent prescribers and primary care providers but may be delegated significant responsibilities using collaborative practice agreements. Organized ambulatory care, collaborative practices in community pharmacies.
Physicians and nurses continue to refer to pharmacists as clinical pharmacists. They think of clinical pharmacists being pharmacists who focus on how to optimize the use of drugs in patient care as opposed to drug dispensers. This overlap of terms
really makes no difference which term is used as long as pharmacists are focused on improving patient care as well as assuring safe drug distribution and administration.
It is important to point out that the reshaping of pharmacy practice had begun with the reshaping of pharmacy education.
Bachelor Degree of Science in Pharmacy (5 year program)
is replaced by Pharm D. program which provide Doctor in Pharmacy Degree. Pharm. D. program is six years educational program of which 5 years of pharmaceutical and medical courses are covered followed by one year of at least clinical rotations in different medical areas. Post graduate residency training to develop knowledge and skills are very important.
Pharmaceutical educationin in the Pharm. D. program is focused on preparing pharmacists as patient care providers (emphasis on pharmacotherapy role)
Importance of Education and Training for Pharmacists to Prepare for Roles Today and in the Future relies on
• Intensive courses in pathophysilogy and Therapeutics
• Clinical professional skills
• Professional experience program
"There is no future in counting pills. The future for pharmacists is in providing optimal value services to society"
Finally, Pharmacists now can act as health care provider in Wards, Clinics, Hospital Pharmacy, Satellite Pharmacy, and Community Pharmacy.
Thank You
Dr. Mohamed A. Moustafa
03.09.2006
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Source: Future pharmacist English Forum
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