Regulatory control and drug management - central pharmaceutical administration
The division of the ministry of health concerned with pharmaceutical services should have a position within the organizational structure comparable with that of other divisions.
All countries should enact drug legislation, which should be periodically updated and strictly enforced.
Pharmacists with appropriate expertise should be involved in the formulation of new drug legislation and in the revision and updating of existing legislation, as well as in all aspects of the enforcement of regulations.
Procurement, storage and distribution of drugs
The management of drug procurement, storage and distribution should be the responsibility of pharmacists, and adequate facilities should be provided.
Pharmacists in government should be encouraged and given support to establish national drug information systems concerned with all aspects of the nature and use of medicines. The information should be produced in a way suitable for dissemination to health professionals and the public. Such systems should be linked with hospital information systems, as regards both receiving and transmitting information.
Quality control laboratory
The establishment of a national, drug quality-control laboratory is essential to the assurance of the quality, safety and efficacy of medicines available to the public. Pharmacists with additional training in all aspects of quality control should be in charge of this service.
Community and hospital pharmacy
The consultative group had before it the draft report and recommendations of a meeting organized by the WHO Regional Office for Europe, held in Madrid in October 1988 (4). Many of the recommendations of that meeting, with regard to community and hospital pharmacy, were largely identical with those that this group wished to set forth. They are therefore reproduced below, with minor changes to set them in a global perspective.
1. Physicians and pharmacists within communities and hospitals should work together to establish common approaches to the choice of medicines to be used, and the role of the pharmacist in advising the physician and other health care professionals should be developed in community care as well as in hospitals.
2. The pharmacist should play a central role in the provision of advice and information to patients and the general public on the use of medicines, and the pharmacist should cooperate effectively with prescribers to ensure a common approach to patients in the provision of advice and information.
3. Pharmacists should participate in a multidisciplinary approach to promotion of the rational use of medicines.
4. Pharmacists should adequately inform patients and the general public about unwanted effects of medicines, and should monitor such unwanted effects and their consequences in collaboration with other health care professionals and the appropriate authorities.
5. Pharmacists should continue to contribute to the promotion of healthy lifestyles and to the prevention of illness by, inter alia, participating in screening activities, such as for example, blood pressure measurement and determination of blood sugar.
6. Pharmacists should provide appropriate and adequate services and levels of support to the community through, for example, domiciliary services, services to nursing homes and aspects of primary health care.
7. To meet changing needs, there should be progressive adaptation of the legal requirements relating to the equipment, size, functioning, staffing and distribution of pharmacies.
8. Government policies should provide for pharmacists in both the public and the private sectors to be adequately remunerated for their advisory services, as well as for their supply functions.
9. Pharmacists’ expertise should be used in the quality assurance and distribution of products similar to medicines and of medical devices.
10. The extemporaneous preparation of medicines to meet individual needs should be maintained and developed in accordance with guidelines for good manufacturing and distribution practices.
11. Pharmacists should have responsibility for checking prescriptions to ensure that they are clear and in accordance with legal requirements, and also for ensuring that prescriptions are dispensed in accordance with prescribers’ intentions.
12. Pharmacists should maintain adequate documentation resources in their pharmacies and have access to necessary information from central information systems.
13. Pharmacists should communicate and cooperate effectively with the other members of the health care team.
14. Pharmacists should continue to develop their advisory service in response to symptoms which are described by members of the general public, by referring Such persons for medical advice when appropriate, and in other cases providing suitable advice with or without the sale of a medicine.
15. Pharmacists should develop their role in the supply and/or control of animal medicines and medicated animal feeds.
16. Pharmacists should provide their professional advisory service, associated with the dispensing or sale of medicines, in a quiet area within the pharmacy.
17. Pharmacists should actively participate in national health programmes such as family planning, tuberculosis control, diarrhoeal disease control, EPI, leprosy, malaria, blindness and AIDS.
18. Clinical pharmacy should be promoted as a hospital discipline to, inter alia, ensure rational use of drugs and reduction of costs.
19. Hospital pharmacists should play an active part in patient care by making their expertise available to other disciplines and departments.
1. The pharmaceutical industry should employ pharmacists for tasks in departments for which pharmaceutical responsibility is crucial - for example, quality assurance services, marketing, clinical trials, and post-marketing surveillance.
2. The pharmaceutical industry should employ pharmacists in various departments and at various management levels.
3. The industry should employ properly trained pharmacists in the area of drug marketing and promotion in order to maintain high professional standards, in accordance with ethical criteria, in the promotion of drugs and medical devices.
1. The membership of academic faculties should be suitably balanced with regard to pharmacists and other scientists. In view of the professional and vocational nature of pharmacy education, the majority of the academic staff should consist of pharmacists with appropriate postgraduate education and qualifications.
2. The undergraduate pharmacy course should adequately cover the principles of national health and drug policies.
3. Faculties and schools of pharmacy should ensure that:
• academic staff are committed to research;
• that they are competent teachers - preferably with training in education, concerned with curriculum planning and design in relation to health service and community needs, the management and evaluation of curricula, and the assessment of student performance and competence; and
• that they remain in touch with pharmacy administration and practice - as educational resources and by research.
Training other health care workers
Pharmacists should participate in training of medical and other health personnel, including community health workers.
Methods of drug-utilization research should be developed in community and hospital pharmacy, and collaboration promoted with other health professionals, and between pharmacists in practice and those in schools and faculties of pharmacy.
The health care team
Pharmacists should be members of health care teams and their roles in the team should be recognized, including those in district health systems. In district health systems based on primary health care, the pharmacist should be a member of the district health management team.
1. The report has demonstrated the integral place of the pharmacist within all aspects of health care related to the use of quality drugs, disease prevention and health promotion. It is therefore essential that pharmacists be adequately represented on the staff of international health agencies