INTRODUCTION TO COMMUNITY PHARMACY - PowerPoint PPT Presentation

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INTRODUCTION TO COMMUNITY PHARMACY

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Title: INTRODUCTION TO COMMUNITY PHARMACY


1
INTRODUCTION TO COMMUNITY PHARMACY
  • BAREERA RANA
  • M PHIL PHARMACEUTICS

2
The role of the pharmacist
  • Pharmacists are allied health professionals who
    practice in pharmacy, the field of health science
    focusing on safe and effective medication use
  • The role of the pharmacist has shifted from the
    classical "lick, stick, and pour" dispensary role
    to being an integrated member of the health care
    team directly involved in patient care.

3
Specialities of Pharmacists
  • Expert in Science Clinical use of medications.
  • Knowledge about Composition Properties of drug
  • Various categories of diseases Classification
    of drugs
  • Therapeutic dose of drug
  • Structure Activity Relationship of drug

4
  • Understand the Pharmacological Mechanism of
    Action of Drug
  • Have analytical skills clinical knowledge
  • Information about Adverse Drug Reaction toxic
    effects of Drug
  • Familiar with Medical terminologies

5
More common roles
  • The most common pharmacist positions are
  • A community pharmacist (also referred to as
    "retail pharmacist" or dispensing chemist"),
  • Or
  • A hospital pharmacist (also known as a clinical
    pharmacist).

6
The breakdown (2006)
76 community 15 hospital 9 others
7
(No Transcript)
8
What is Community Pharmacy?
  • Practice of pharmacy based within the community
  • Primarily located within a retail setting
  • Centre for healthcare

9
  • Retail Business
  • Income comes from
  • dispensing
  • retail sales
  • Average distribution is 70 Rx / 30 retail
  • services under Community Pharmacy Agreements eg.
    Medschecks, Clinical Interventions
  • A MedsCheck provides an in-pharmacy review of a
    patient's medicines
  • Miscellaneous - aged care homes, medical
    certificates

10
Quality Care Pharmacy Program
  • Quality assurance program for community pharmacy
  • Community Pharmacy Quality Assurance analysis
    and establishment of a patient-specific
    adherence program 
  • Aim to provide quality professional services
    and customer care
  • Re-assessed every 2 years

11
Community pharmacy definition
  • Interface between public/consumer/patient and a
    retail facility from where consumer can access
    his/her pharmaceutical and health related needs
    (supplies/services) from a team of trained
    personnel working under direct/indirect
    supervision of a pharmacist.
  • Patient pharmacist interface
  • An inevitable interaction in health care
  • An overwhelming number and reach in masses
  • An ideal area for designing PHA (public Health
    awareness)

12
ALSO CALLED
  • Chemist and druggist shop
  • Drug store
  • Pharmacy
  • Medical store
  • Retail pharmacy

13
THE TWO DRUG AREAS IN SOCIETY
  • PHARMACY PRACTICE
  • Pharmacist
  • Physician
  • Other health care professionals
  • Patients

Health Systems Pharmacy
Community Pharmacy
  • Pharmacist
  • Patient/Consumer

14
BUSINESS CONCEPT
  • Distributors
  • Wholesaler
  • RETAILER
  • Direct interaction
  • An advanced role
  • And greater responsibility
  • More than a business transaction

15
The Community Pharmacy
  • Joining the professional transformation
  • SERVICE
    CARE

16
COMMUNITY PHARMACY
  • A lot more than prescription filling
  • Compounded pharmaceuticals
  • Pharmaceutical care
  • A recent advancement in pharmacy practice
  • Research and documentation is what makes us see
    things happen.

17
COMMUNITY PHARMACY
  • A hybrid concept
  • Well developed professional skills
  • Clinical knowledge
  • Management skills
  • Communication skills
  • Queries , advice, education
  • Prescription drugs
  • OTC (over the counter) drugs
  • Health Care supplies and medical equipment

18
The CONFLICT
  • INVESTOR CONCEIVES
  • PHARMACIST AS MANAGER
  • PHARMACIST CONCIEVES HIS ROLE AS
  • SERVICE PROVIDER

19
THE MANAGEMENT OF PHARMACY
  • INVENTORY MANAGEMENT
  • HUMAN RESOURCE MANAGEMENT THE INVESTOR
  • FINANCIAL MANAGEMENT
  • QA/DOCUMENTATION THE REGULATORY
    INSPECTORS
  • THE PROFESSIONAL ROLE PROFESSIONAL
    SATISFACTION


  • SOCIETAL ROLE OF PHARMACY


  • ETHICAL CONCERNS

20
PHARMACIST AT THE COMMUNITY PHARMACY
  • The qualified person/license
  • The manager
  • The shift manager
  • The intern/apprentice
  • The observer
  • The owner/investor
  • The more your interest is at stake the better you
    understand functioning and sustainability of the
    pharmacy

21
COMMUNITY PHARMACY
  • Is the most important tool for improving health
    indicators of the country
  • Health promotion
  • Disease management state and drug monitoring
  • Public health awareness
  • Drug information
  • Poison control

22
THE COMMUNITY PHARMACY
  • CREDIBLE
  • A relation more than a business transaction
  • A concept that can change the face of health
    system in Pakistan

23
PROFESSIONAL SERVICES
24
Compounding
  • Why and who needs it most
  • Art and science of compounding
  • Good compounding practices
  • Diverse dosage form
  • For special drugs and population

25
PHARMACEUTICAL CARE IN COMUNITY
  • COMPOUNDING
  • DUR (DRUG UNILIZATION REVIEW)
  • Disease stage management
  • Drug monitoring
  • Collaborative practice agreements
  • OBRA 90 (Omnibus Budget Reconciliation Act of
    1990) requires that minimum pharmaceutical care
    can be performed with every prescription.

26
CLASSICAL PARADIGM
  • Appropriate drug and dose for the patient
  • Drug allergies
  • Drug interaction
  • Contraindications
  • Dose scheduling

27
ADDITIONALLY
  • Assurance of efficacy in dispensing and labeling
  • Provide storage information
  • Potential risk and benefits
  • What to do when dose is missed?
  • What to do when ADRs (adverse drug reactions)
  • Assessment of patients understanding

28
CONTEMPORARY
  • Appropriateness of entire pharmacotherapy care
    plan
  • Pharmacogenomic considerations
  • Monitoring of results of pharmacotherapy care
    plan

29
ASHEVILLE PROJECT
  • 12 pharmacies
  • 85 diabetes patients
  • Started in march 1997
  • Include pharmacy services
  • Patients education and training
  • clinical assessment
  • Monitoring
  • Follow-up
  • referal

30
ASHEVILLE PROJECT
  • Better than comparison group
  • Lower health cost
  • Missed few days of school
  • Required less intensive care

31
ImPACT Project
  • Impact Persistence and Compliance with Therapy
  • 26 pharmacies
  • 469 patients with dyslipidemias
  • 30 minute counseling session
  • RESULTS
  • Explain lab reports
  • Life style changes
  • Importance of following prescription

32
ImPACT Project
  • IV. Attainment of clinical goals was demonstrated
    by pharmaceutical care
  • 84 patients showed compliance
  • VI. 50 has achieved their cholesterol lowering
    goals

33
DISEASE STATE MANAGEMENT
  • Pharmacist monitor
  • Disease progression
  • Drug related problems
  • Screening clinics
  • Blood pressure
  • Blood glucose
  • Lipid testing
  • Advice in co administration of
  • Nutritional supplements
  • Immunization
  • OTC preparation

34
COLLABORATIVE PRACTICE
  • Pharmacist is driving force in decision making
  • Pharmacist run clinic
  • Medication care planning, follow up and
    monitoring under the limits of collaborative
    agreement
  • Here physicians refers patients to pharmacist
    clinic.

35
THE LOYALTY ISSUES
36
PHARMACIST
  • Fails to visualize the drug sale outlet as a
    commercial venture
  • Does not take retail pharmacy as his willing
    full opted career
  • Escapes from the responsibilities as manager

37
Limitations for the improvement of professional
services
  • Law
  • Current practice absence of model settings
  • Level of autonomy in decision making
  • Fear of professional/career development

38
Silence needs to be broken
  • The curriculum
  • The law
  • The practice model

39
Way to go forward
  • Learn at student age
  • Hands on experience
  • Paid apprenticeship
  • Documentation , SOPs and SOP based system
  • Focus viability offer professional services, aim
    for credibility and positive change norms.

40
Grey areas..
  • Drug shortages-Black marketing, over pricing
  • The refills (Rx)
  • Stamp of prescription dispensed
  • Ambiguous prescriptions
  • Absence of prescriber identity on Rx order, no
    PMDC Reg. no. is given
  • Legal rights to prescription checking
  • Prescribers knowledge of legal issues of
    prescription order.
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