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  Pharmacy Practitioners as Better Drug Information Specialists

 

 

Shoaib Ahmad*, Md. Tausif Qudsi

*Faculty of Pharmacy, Jamia Hamdard, New Delhi 110062 India
Smartanalyst India Pvt. Ltd, DLF Cyber City, Gurgaon 122002 India

 

Correspondence to: Dr. Shoaib Ahmad, M. Pharm., Ph. D.
Email: shoaibpharm@rediffmail.com, sahmad_ph@jamiahamdard.ac.in


Drug Information Service is a desirable component of healthcare delivery system. The qualifications, training and job profiles of Drug Information Specialists manning such service have recently been discussed (Aqil and Ahmad, 2004). We would like to add some advantages of qualified post graduate pharmacy practitioners for induction into Drug Information Service.
Pharmacy practitioners are specialist pharmacists trained in pharmacy practice -  a branch of pharmaceutical sciences involving direct application of unique knowledge and skills of pharmacist aimed at improving the health of people (NIPER website)
Pharmacy practice offers specialized learning in three aspects:
  1. Hospital pharmacy
  2. Comunity Pharmacy
  3. Clinical pharmacy

Pharmacy practice is based on the principle of pharmaceutical care which may itself be defined as a responsible provision of drug therapy for achieving definite outcomes aimed at improving quality of patient life (NIPER website)
The four outcomes of pharmaceutical care are as follows:

  1. Cure of disease
  2. Elimination of symptoms
  3. Arresting or slowing the disease process
  4. Preventing a disease or symptoms.

Pharmacy practitioner is responsible for patient's medication related needs. Practically his/her duties include (NIPER website):

  1. Evaluation of need for drugs.
  2. Determining whether patient has any rational or potential drug related problems.
  3. Working with patient population and health care practitioners to implement and monitor therapeutic plan.

The drug related problems needing the pharmacy practitioners intervention include any one or combination of the following:

  1. Untreated indications.
  2. Improper drug selection.
  3. Sub-therapeutic dosage.
  4. Failure to receive drugs.
  5. Over-dosage.
  6. Adverse drug reactions (ADRs).
  7. Drug Interactions (DIs)
  8. Drug use without indication.

ADRs have been responsible for significant number of hospital admissions, increased health care costs, morbidity and mortality (Lee and Thomas, 2003).
DIs increasingly contribute to ADRs. The magnitude of the drug interactions potential has been increased by improved availability of the complex therapeutic agents and polypharmaceuticals (Lee and Stockley, 2003).
Pharmacy practitioners are also involved in therapeutic drug monitoring (TDM) processes which can improve patient outcomes.  TDM is necessary in case of drugs with low therapeutic index, good concentration response relationship and when there is no measurable physiological parameter (Fitzpatrick, 2003).
The disease management (DM) is a comparatively newer concept and it differs from pharmaceutical care. DM centers around the patients with specific diseases and is widely utilized in practice of managed care. The community pharmacists are potent role-players in disease management (Holdford et al, 1998).
The results of 2001 American Society of Health-system Pharmacists (ASHP) survey of pharmacy practice in hospital settings have indicated that pharmacy practitioners have very well attained the position to improve the prescribing and medication use processes (Pedersen et al, 2001).
It has been reported that the potential willingness to pay for service can help in improving the social efficiency in health care (Olsen  and Smith, 2001).
The economic benefit of the clinical pharmacy services has already been reported (Schumock et al, 2003).
A previous study concluded that a cultural change which forces the health care professionals to share patient information on high priority is required. With the advent of information technology that era is already on doorsteps (Hampson et al, 1996).
There are sometimes flaws in the implementation of evidence-based guidelines for sale of antifungal OTC products in community pharmacy setting (Watson et al, 2002).
Such studies clearly indicate the need for better pharmacy practitioners which can only be achieved by promoting the pharmacy practice education. Furthermore, such trained pharmacy practitioners are ideal input for grooming into drug information specialists.

References
  1. Aqil M and Ahmad S (2004) Grooming a competent drug information specialist. Indian J Pharmacol. 36: 96-98.
  2. NIPER, Chandigarh website: http://www.niper.ac.in
  3. Lee A and Thomas SHL (2003) Pharmacovigilance. In Walker R, Edwards C, editors. Clinical Pharmacy & Therapeutics. 3rd Ed. London: Churchill Livingstone; p. 33.
  4. Lee A and Stockley IH (2003) Drug Interactions. In Walker R, Edwards C, editors. Clinical Pharmacy & Therapeutics. 3rd Ed. London: Churchill Livingstone; p. 21.
  5. Fitzpatrick R (2003) Practical Pharmacokinetics. In Walker R, Edwards C, editors. Clinical Pharmacy & Therapeutics. 3rd Ed. London: Churchill Livingstone; p. 3.
  6. Holdford D, Kennedy DT, Bernadella P and Small RE (1998) Implementing disease management in community pharmacy practice. Clin Ther. 20: 328-339.
  7. Pedersen CA, Schneider PJ and Santell JP (2001) ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing – 2001. Am J Health Syst Pharm. 58:2251-66.
  8. Olsen JA and Smith RD (2001) Theory versus practice: a review of willingness-to-pay in health and health care. Health Economics. 10: 39-52.
  9. Schumock GT, Butler MG, Meek PD, Vermeulen LC, Arondekar BV and Bauman JL (2003) Evidence of the economic benefit of clinical pharmacy services: 1996-2000. Pharmacotherapy. 23: 113-132.
  10. Hampson JP, Roberts RI and Morgan DA (1996) Shared care a review of the literature. Family Practice. 13:264-279.
  11. Watson MC, Bond CM, Grimshaw JM, Mollison J, Ludbrook A and Walker AF (2002) Educational strategies to promote evidence-based community pharmacy practice; a cluster randomised controlled trial. Family Practice. 19 (5): 529-536.
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FIRST PUBLISHED AUGUST 2006