(1994; 60 pages)
4.2 Community pharmacy
Community pharmacists are the health professionals most accessible to the public. They supply medicines in accordance with a prescription or, when legally permitted, sell them without a prescription. In addition to ensuring an accurate supply of appropriate products, their professional activities also cover counselling of patients at the time of dispensing of prescription and non-prescription drugs, drug information to health professionals, patients and the general public, and participation in health-promotion programmes. They maintain links with other health professionals in primary health care.
Today, an increasingly wide range of new and analogous products are used in medicine, including high-technology biological products and radio-pharmaceuticals. There is also the heterogeneous group of medical devices, which includes some products analogous to medicines, some of which demand special knowledge with regard to their uses and risks (e.g., dressings, wound management products, etc.).
Pharmacists have progressively undertaken the additional task of ensuring the quality of the products they supply.
The main activities of community pharmacists are described below.
Processing of prescriptions
The pharmacist verifies the legality, safety and appropriateness of the prescription order, checks the patient medication record before dispensing the prescription (when such records are kept in the pharmacy), ensures that the quantities of medication are dispensed accurately, and decides whether the medication should be handed to the patient, with appropriate counselling, by a pharmacist. In many countries, the community pharmacist is in a unique position to be fully aware of the patient’s past and current drug history and, consequently, can provide essential advice to the prescriber.
Care of patients or clinical pharmacy
The pharmacist seeks to collect and integrate information about the patient’s drug history, clarify the patient’s understanding of the intended dosage regimen and method of administration, and advises the patient of drug-related precautions, and in some countries, monitors and evaluates the therapeutic response.
Monitoring of drug utilization
The pharmacist can participate in arrangements for monitoring the utilization of drugs, such as practice research projects, and schemes to analyse prescriptions for the monitoring of adverse drug reactions.
Extemporaneous preparation and small-scale manufacture of medicines
Pharmacists everywhere continue to prepare medicines in the pharmacy. This enables them to adapt the formulation of a medicine to the needs of an individual patient. New developments in drugs and delivery systems may well extend the need for individually adapted medicines and thus increase the pharmacist’s need to continue with pharmacy formulation. In some countries, developed and developing, pharmacists engage in the small-scale manufacture of medicines, which must accord with good manufacturing and distribution practice guidelines.
Traditional and alternative medicines
In some countries, pharmacists supply traditional medicines and dispense homoeopathic prescriptions.
Responding to symptoms of minor ailments
The pharmacist receives requests from members of the public for advice on a variety of symptoms and, when indicated, refers the inquiries to a medical practitioner. If the symptoms relate to a self-limiting minor ailment, the pharmacist can supply a non-prescription medicine, with advice to consult a medical practitioner if the symptoms persist for more than a few days. Alternatively, the pharmacist may give advice without supplying medicine.
Informing health care professionals and the public
The pharmacist can compile and maintain information on all medicines, and particularly on newly introduced medicines, provide this information as necessary to other health care professionals and to patients, and use it in promoting the rational use of drugs, by providing advice and explanations to physicians and to members of the public.
The pharmacist can take part in health promotion campaigns, locally and nationally, on a wide range of health-related topics, and particularly on drug-related topics (e.g., rational use of drugs, alcohol abuse, tobacco use, discouragement of drug use during pregnancy, organic solvent abuse, poison prevention) or topics concerned with other health problems (diarrhoeal diseases, tuberculosis, leprosy, HIV-infection/AIDS) and family planning. They may also take part in the education of local community groups in health promotion, and in campaigns on disease prevention, such as the Expanded Programme on Immunization, and malaria and blindness programmes.
In a number of countries, the pharmacist provides an advisory as well as a supply service to residential homes for the elderly, and other long-term patients. In some countries, policies are being developed under which pharmacists will visit certain categories of house-bound patients to provide the counselling service that the patients would have received had they been able to visit the pharmacy.
Agricultural and veterinary practice
Pharmacists supply animal medicines and medicated animal feeds.