In 1999, I was invited to talk in a class of Pharmacy students about the "Problems and Prospects of an Improved Hospital Pharmacy Practice in the Philippines." I refused the invitation at first because I know that I am not in the best position to speak about the subject matter. The students, however, begged that I give them my time or they might fail in that subject. I finally agreed.
The discussion was informal. Their professor was there, too. Most of what I told this class was based on my personal experience, observation, reading and interaction with pharmacy interns. Nevertheless, it was still not an expert's opinion.
The students later asked for a summary of what I discussed with them. I have already forgotten what I wrote. I don't even remember where I keep the copy but early this year I found it somewhere in one of my files. This is what it says...
The greatest challenge facing hospital pharmacists in the Philippines today is the establishment of a clinical pharmacy program that is comparable to the standards of other countries where clinical pharmacy has reached a level of maturity.
The current concept of pharmaceutical care all over the United States further overwhelms our pharmacists in hospital settings.
The problems confronting us are many and any attempt to improve our present status is not easy. It greatly depends on the attitude of every practicing pharmacist.
The fact is, we lack skilled pharmacists for clinical functions. "If we can just see the problem and admit to it, we can fix it..." (Bleech and Mutchler)
More so, the future of our profession (at least, in our country) will be influenced also by the way we educate our future pharmacists.
The qualities of our graduates, according to Milap C. Nahata, a doctor of Pharmacy, should be the following:
1. knowledgeable
2. creative
3. effective communicator
4. motivated professional who is ready to learn new concepts, and
5. must be able to function as a team player
The probable future (i.e., the prospect/s) of a more advanced hospital pharmacy practice in our country will find our pharmacists actively and directly participating in patient care with other health professionals in a clinical setting if decentralization of our medication distribution system is applied...
We have to improve on our medication distribution system with emphasis on our unit dose drug distribution. I consider it an effective first step in bringing the pharmacy service closer to its clients. How to keep it even closer is another [step].
We have to remember that "many administrators as well as other professionals view drug distribution as the primary reason for a pharmacist's existence and poor performance in this area can undermine support for all other pharmacy programs."
Whether we admit it or not, support from outside the boundaries of pharmacy practice is vital. We need it even more towards pharmaceutical care, the future of clinical pharmacy.
Support is our first requirement if we must meet the challenge of pharmaceutical care. It is best exemplified by establishing a program that focuses on the improvement of the current systems in clinical pharmacy. Such program should consider not only the type of training and education, but the time a staff pharmacist should spend in a given clinical area, and entirely functioning as a clinician. Exposure and experience are provided in this setting and would facilitate greater advancement in the learning process.
Lack of incentive is often a problem in encouraging staff pharmacists to pursue further training. It is another hindrance to the concept of pharmaceutical care and is one of the major reasons why pharmacists are still reluctant to embrace clinical functions.
Availability and access to technology that would render the fastest, most accurate and up-to-date delivery of information will enhance the capability to provide pharmaceutical care. The establishment of a comprehensive and reliable drug information service is not only necessary but truly indispensable to its application.
The current concept of pharmaceutical care all over the United States further overwhelms our pharmacists in hospital settings.
The problems confronting us are many and any attempt to improve our present status is not easy. It greatly depends on the attitude of every practicing pharmacist.
The fact is, we lack skilled pharmacists for clinical functions. "If we can just see the problem and admit to it, we can fix it..." (Bleech and Mutchler)
More so, the future of our profession (at least, in our country) will be influenced also by the way we educate our future pharmacists.
The qualities of our graduates, according to Milap C. Nahata, a doctor of Pharmacy, should be the following:
1. knowledgeable
2. creative
3. effective communicator
4. motivated professional who is ready to learn new concepts, and
5. must be able to function as a team player
The probable future (i.e., the prospect/s) of a more advanced hospital pharmacy practice in our country will find our pharmacists actively and directly participating in patient care with other health professionals in a clinical setting if decentralization of our medication distribution system is applied...
We have to improve on our medication distribution system with emphasis on our unit dose drug distribution. I consider it an effective first step in bringing the pharmacy service closer to its clients. How to keep it even closer is another [step].
We have to remember that "many administrators as well as other professionals view drug distribution as the primary reason for a pharmacist's existence and poor performance in this area can undermine support for all other pharmacy programs."
Whether we admit it or not, support from outside the boundaries of pharmacy practice is vital. We need it even more towards pharmaceutical care, the future of clinical pharmacy.
Support is our first requirement if we must meet the challenge of pharmaceutical care. It is best exemplified by establishing a program that focuses on the improvement of the current systems in clinical pharmacy. Such program should consider not only the type of training and education, but the time a staff pharmacist should spend in a given clinical area, and entirely functioning as a clinician. Exposure and experience are provided in this setting and would facilitate greater advancement in the learning process.
Lack of incentive is often a problem in encouraging staff pharmacists to pursue further training. It is another hindrance to the concept of pharmaceutical care and is one of the major reasons why pharmacists are still reluctant to embrace clinical functions.
Availability and access to technology that would render the fastest, most accurate and up-to-date delivery of information will enhance the capability to provide pharmaceutical care. The establishment of a comprehensive and reliable drug information service is not only necessary but truly indispensable to its application.
Standardization in the practice of our profession should be made visible. The lack of it prevents pharmacists to view themselves on a professional level that encourages re-evaluation of systems that might drastically change the ever-existing picture of pharmacists as mere sellers and/or providers of medicines.
The present status of clinical pharmacy in the Philippines badly needs some overhauling before meeting the challenge of pharmaceutical care. The call for change is addressed not only to practicing pharmacists in hospitals, but in other fields within the pharmacy profession, especially in the academe.
What future pharmacists need is an improved curriculum that permits in-depth and hands-on training and not just concepts presented and confined within the classroom.
The demands of students for improved teaching methods, modernized technical facilities and upgraded reference materials, among others, should be taken into consideration. Pharmacy interns, either in community, hospital or pharmaceutical laboratory, are continually dissatisfied with their training. Some are even doing activities that are totally irrelevant and far less important to the practice of pharmacy. I believe that the change should make its mark in the way we educate our future pharmacists and how we view this profession in general.
"Success in clinical pharmacy can only come about by change in atttude and by the ability of the pharmacists to communicate with members of the health care team." This is still true in the concept of pharmaceutical care. If we are dedicated to the advancement of pharmacy practice in our country, our contributions to the present trends will make it a reality.
_______________
References:
1. Bleech, James M. and Mutchler David G., Let's Get Results, Not Excuses! Hollywood: Lifetime Books, Inc., 1997.
2. Brown, T.R. and Smith, M.C. Handbook of Institutional Pharmacy Practice, 2nd ed. Baltimore, MD: Williams & Wilkins, 1986.
3. Bailey, David E. and Plein, E.M. "A study of clinical pharmacy practice in a small private hospital," Lippincott's Hospital Pharmacy, vol. 5 No. 8 (August 1970): 5-14.
4. Durgin, Sr. Jane and Hanan, Zachary. Pharmacy Practice for Technicians. New York: Delmar Publishers, Inc. 1994.
5. Nahata, Milap C. "Issues Facing Clinical Pharmacy Education for Undergraduate Students." DICP: The Annals of Pharmacotherapy, vol 23 no. 3 (March 1989): 250-251.
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