Who is a Pharmacist?
I realize that the populace are oblivious of the pharmacy profession in health care.
They basically see pharmacist as drug sellers or business men.
I will take my time here to explain the role of pharmacists in health care.
First of all let me start with a brief history.
A BRIEF HISTORY OF PHARMACY
According to Greek legends written centuries ago, the Greek god of Medicine, Asclepius, delegated the compounding of his remedies to Hygieia, his apothecary or pharmacist.
As such healing and pharmacy went hand-in-hand and were often thought of as the same practice.
The line between pharmacy and medicine began to be defined by the eighth century and was firmly established in the 17th century as physicians could no longer prepare medications for their patients themselves.
The field transformed yet again with the onslaught of World War II where new drugs were constantly introduced into the market broadening the role of the pharmacist.
THE ROLES OF PHARMACISTS IN HEALTHCARE
Today’s pharmacist performs multiple vital roles making them indispensable to health care.
1. ROLE IN DISPENSING
The tasks bestowed on pharmacists include identifying and providing people with the right medication, stocking/restocking of all essential medicines, staying ahead of medicine expiry dates, patient counseling, compounding, drug information etc.
A contributing factor to why some people might be oblivious to the role of a pharmacist in health is due to their familiarity with patent medicine ventors/chemists who are not professionals.
A lot of people do not know that there is a draconian difference between a chemist and a pharmacy.
Pharmacy:
A Pharmacy is a premise overseen by a licensed pharmacist that carry out activities like counseling, patient care, compounding and preparation of medicines along with dispensing of medical prescriptions (prescription , controlled and over-the-counter medicines) from a Registered Medical Practitioner.
Pharmacies are generally larger in size and carry a wider range of medicines and consumables not found in a chemist.
Chemist:
Patent medicine stores/chemist are lower-tier retail outlets, with no pharmacist , who sell over-the-counter drugs(those sold directly to a consumer without a prescription), chemical products and household remedies.
They might also sell over-the-counter family planning methods, especially condoms, oral contraceptives, and emergency contraception.
They usually have storefronts, product displays, and a counter. Many have a small room in the back, separated by a curtain or door, for examinations and treatment.
2. ROLE IN QUALITY ASSURANCE
The menace of counterfeit (fake) and adulterated drugs have been linked to illegal drug distributors.
In their quest for cheap drugs patent medicine vendors might end up acquiring substandard drugs which leads to a patient getting a sub therapeutic dose. Those who operate patent medicine stores do not have grounded knowledge in drugs and as such are oblivious to the nature, mechanism of action, interactions and contraindications of most drugs.
When I was in pharmacy school I went to buy mist magnesium Trisilicate tablets popularly known by the acronym MMT. The Parent Medicine vendor instead gave me tetracycline capsules. When I received the medicine I felt the presence of capsules in the white paper Dispensing envelop rather than a tablet. I immediately alerted her that the drug she gave me was wrong, she then ask me what I wanted buying and when I told her she went silent for about 10 seconds then she was like , " oooh she usually confuse MMT with tetracycline"
This is just a single incident among the many more blunders made by unprofessionals.
In addition they do not know how to authenticate many drugs gotten from distributors as such more prone to dish out adulterated, substandard or fake drugs unknowingly.
They might also be oblivious to the proper storage of thermolabile drugs as such may end up dispensing denatured drugs.
3. ROLE IN CURTAILING SUBSTANCE ABUSE
Pharmacists have played a role in curtailing the menace of drug abuse in Nigerian. Drugs like Codeine, Tramadol, Pentazocine, Promethazine, Benzodiazepine class, etc have been prone to addiction. Drug addicts try to maneuver their way to get those drugs, some have went to the extent of forging prescription with the doctor signature.
I once caught an addict who forged a doctor's signature demanding a pack of Pentazocine. On seeing the oddity of the prescription I asked where he was coming from and when he told me, I escorted him to see the doctor or at least the nurse in charge . However, he only went and showed me an in-patient lying on bed that it was intended for. I went quickly to consult the nurse on duty to get more information and clarity on the patient and what is going on. Only for me to turn around and can't find the patient , he ran away without a trace.
Pharmacists are also actively involved in patient education and counseling to enlighten them on the dangers of drug abuse, misuse and addiction and have participated in campaign to discourage them from engaging in it.
4. ROLE IN SAFETY AND EFFICACY OF DRUGS
The pharmacist is the drug expert trained in the correct and safe use of drugs.
Drugs are one of the greatest inventions known to man. A drug is "a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease."
However, a common paradox in disease management is: every drug is a potential poison. The dose determine that a thing is not poison.
So when does a drug becomes a poison? Simply put, when it is misused or abused.
This is done by using medicines other than how it is prescribed by a licensed medical practitioner( called Self medication)
In self medication, the illnesses may not be correctly recognized by individuals due to lack of training. Hence, the drugs may not be the right one as such the possibility of drug harm is largely increased.
Conversly, a patient might know the illness but demographics might discourage the use of the drugs . There are drugs pregnant women or children should not take, or that people with certain diseases should not take. Such drugs can become poisons to those individuals when taken.
Another problem is taking improper dosages. Drugs are precisely dosed so they are not harmful. If improperly taken, such drugs become poisonous and deadly.
Considering the several variables that may make a drug poisonous, the pharmacist is in the best place to give advice regarding drugs.
5. ROLE IN DRUG DISTRIBUTION
Pharmacists and other bodies have worked tirelessly to curtail the chaotic drug distribution problem in Nigeria.
In 2012, the New Drug Distribution System was established to increase access to high-quality, low-cost medications at all levels of health-care delivery while also reducing the activities of charlatans( those who distribute counterfeit. or adulterated drugs).
Noncompliance with regulatory agencies such as the Pharmacy Council of Nigeria (PCN) and the NAFDAC results in disciplinary measures.
6. ROLE IN PHARMACEUTICAL CARE
Helper and Strand (1990) defined pharmaceutical care as “the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life”.
These outcomes are curing a disease, eliminating or reducing symptoms, arresting or slowing a disease process, and preventing a disease or symptoms.
Just as a Doctor provide medical care, and a nurse provides nursing care, a Pharmacist provide pharmaceutical care to the patient to ensure the safety and effectiveness of that drug.
To achieve pharmaceutical care, pharmacists cooperate with patients and with other health care professionals in designing, implementing and monitoring a care plan aimed at preventing and resolving drug therapy problems (DTP).
DTP includes unnecessary drug therapy, wrong drug, dose too low, dose too high, adverse drug reaction, inappropriate adherence, additional drug therapy.
The presence of Pharmacists ensures that DTPs are solved.
7. ROLE IN PUBLIC HEALTH
Globalization, urbanization, trends towards unhealthy diets,obesity, sedentary lifestyles and unhealthy habits are public health problems resulting in an increased burden of chronic noncommunicable diseases such as diabetes, cardiovascular and lung diseases, cancer and psychiatric disorders and their associated risk factors.
Balanced diets are no longer considered in the diets of children as most mothers feed their children with fast foods and artificially flavoured drinks.
Public health is concerned with prevention of ill-health at three levels: Primary, Secondary and Tertiary.
Primary prevention involves activities and actions aimed at preventing people from contacting a disease, while secondary and tertiary prevention are important to reduce complications, morbidity, disabilities and death as well as improve the quality of life of individuals.
Pharmacists take part in:
- Obesity/Hypertension/Diabetes management
- Promote healthy eating and increase in physical activity.
- Teach stress reduction techniques and lifestyle modification.
8. ROLE IN PRIMARY HEALTH CARE
The community pharmacist is a key primary care provider recognized by WHO and provides screening services that actively improve the health of individuals and communities.
Pharmacists promote, advocate and offer adult immunization.
Trained Community pharmacists participated in Vaccinating adults during the Covid-19 pandemic. This further reveals a lot of untapped potential of pharmacists as primary health care providers. Proper integration of community pharmacists into primary healthcare program will improve the quality of health in the country.
As the most easily accessible healthcare provider, and in many cases the first point of contact with the healthcare system, the community pharmacist is especially suited for primary health care. Pharmacists have gain confidence from members of the public as many persons both healthy and sick consult community pharmacists on daily basis for advice on a wide range of health issues, including medication related problems.
9. ROLE IN HEALTH PROMOTION
Health promotion, an integral part of pharmaceutical care, which is a public health strategy has been defined operationally as a style of pharmacy practice in which the pharmacist teams up with individuals and communities to improve their health status (WHO, 1997).
Whenever and wherever a pharmacist takes actions or provides services that actively improve the health of individuals and communities thereby empowering them to have increased control over their health, he is involved in health promotion.
Health promotion activities may sometimes be drug related but the majority of activities do not necessarily have to do with medications.
Below are Population Groups and Health promotion Activities carried out by Pharmacists:
a. INFANTS AND PRESCHOOL
- Promoting and encouraging immunization.
- Determination of immunization needs.
- Promoting proper handling and storage of vaccines.
- Ensuring availability of good quality vaccines.
- Immunization delivery/vaccine administration.
b. SCHOOL AGE, ADOLESCENTS AND TEENS
- Promoting dental health, promoting good nutrition at home and in school.
- Promoting sugar-free products.
- Encouraging increased physical activity.
- Substance abuse reduction. Stop smoking services.
- Promoting safe sex practices including abstinence. Providing and encouraging emergency contraception
- Chlamydia screening and treatment.
- HIV/AIDS education encourage screening, counsel cases, promote adherence to HAART where appropriate.
c. FEMALE POPULATION, CHILD BEARING AGE AND OTHERS
- Promoting breast feeding, folic acid supplementation, family planning.
- Encourage breast self-examination, breast cancer awareness,calcium/vitamin D supplementation
- Pap screening (cervical smear), and osteoporosis awareness.
d. ELDERLY
- Encourage self-care, Teach self-management of chronic diseases in collaboration with physicians.
- Promote adherence to medication.
- Increase awareness of and provide mobility aids, incontinence aids etc.
- Promote proper nutrition.
10. ROLE IN DRUG INFORMATION SERVICES
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