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Pharmacist

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For the precursor profession, see Apothecary.
The pestle and mortar is an international symbol of pharmacists and pharmacies.

Pharmacists are health professionals who practice the science of pharmacy. Pharmacists also participate in disease-state management, where they optimize and monitor the drug therapy or interpret medical laboratory results – in collaboration with physicians and/or other health professionals. Advances into prescribing medication and in providing members of the public with health advice and services are occurring in many countries. Pharmacists have many areas of expertise and are a critical source of medical knowledge in clinics, hospitals, medical laboratories and community pharmacies throughout the world. Pharmacists also hold positions in the pharmaceutical industry as well as in pharmaceutical education and research and development institutions.

History

In ancient Japan, the men who fulfilled roles similar to pharmacists were respected. The place of pharmacists in society was settled in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.[1]

Nature of the work

Historically, the fundamental role of pharmacists as a healthcare practitioner is to distribute drugs that have been prescribed by a prescriber to patients. In more modern times pharmacists advise patients and health care providers on the selection, dosages, interactions, and side effects of medications, and act as a learned intermediary between a prescriber and a patient. Pharmacists monitor the health and progress of patients to ensure the safe and effective use of medication. Pharmacists may practice compounding (mixing ingredients to form medications); however, most medicines are produced by pharmaceutical companies in a standard dosage and drug delivery form. In many jurisdictions, pharmacists have prescriptive authority to either independently prescribe under their own authority or in collaboration with a primary care physician through an agreed upon protocol.[2]

Pharmacists are educated in pharmacology, pharmacognosy, chemistry, organic chemistry, biochemistry, pharmaceutical chemistry, microbiology, pharmacy practice (including drug interactions, medicine monitoring, medication management), pharmaceutics, pharmacy law, physiology, anatomy, pharmacokinetics, pharmacodynamics, drug delivery, pharmaceutical care, nephrology, hepatology, and compounding of medications. Additional curriculum covers diagnosis with emphasis on laboratory tests, disease state management, therapeutics and prescribing (selecting the most appropriate medication for a given patient).

One of the most important roles that pharmacists are currently taking on is one of pharmaceutical care.[3] Pharmaceutical care involves taking direct responsibility for patients and their disease states, medications, and the management of each in order to improve the outcome for each individual patient. Pharmaceutical care has many benefits that include but are not limited to:

  • Decreased medication errors
  • Increased patient compliance in medication regimen
  • Better chronic disease state management
  • Strong pharmacist-patient relationship
  • Decreased long-term costs of medical care

Pharmacists are often the first point-of-contact for patients with health inquiries. This means that pharmacists have large roles in the assessing medication management in patients, and in referring patients to physicians. These roles may include, but are not limited to:

  • clinical medication management
  • the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical medication management required.
  • specialized monitoring of disease states
  • reviewing medication regimens
  • monitoring of treatment regimens
  • delegating work
  • general health monitoring
  • compounding medicines
  • general health advice
  • providing specific education to patients about disease states and medications
  • oversight of dispensing medicines on prescription
  • provision of non-prescription medicines
  • counseling and advice on optimal use of medicines
  • advice and treatment of common ailments
  • referrals to other health professionals if necessary
  • dosing drugs in renal and hepatic failure
  • pharmacokinetic evaluation
  • education of physicians and other health care providers on medications and their proper use
  • limited prescribing of medications only in collaboration with other health care professionals
  • providing pharmaceutical information
  • promoting public health by administering immunizations

UK peculiarity

In much of the United Kingdom and the British Commonwealth pharmacists are customarily sometimes referred to as chemist (or dispensing chemists),[4] a usage which can, especially without a context relating to the sale or supply of medicines, cause confusion with scientists in the field of chemistry. This term is a historical one, since some pharmacists passed an examination in Pharmaceutical Chemistry (PhC) set by the then Pharmaceutical Society of Great Britain in 1852 and these were known as "Pharmaceutical Chemists". This title is protected by the Medicines Act 1968 section 78.

The 1852 Pharmacy Act, June 30 established a Register of Pharmaceutical Chemists in Great Britain , restricted to those who had taken the Society’s exams. However, the Act did not restrict the practice of pharmacy to examined and registered people, nor provide a legal definition for the trade and practice of pharmacy. This was first done by the Pharmacy Act of 1868.[5]

In the near future it is proposed by the Draft Pharmacy Order 2009 that the title "pharmacist" be restricted to those who register with a new Regulatory body - the General Pharmaceutical Council - due to be established to take this role over from the Royal Pharmaceutical Society of Great Britain in 2010.

Qualifications and registration

Main article: Pharmacy school

The role of pharmacy education, pharmacist licensing and graduate continuing education vary from country to country and between regions/localities within countries. In most countries, prospective pharmacists study pharmacy at a pharmacy school or related institution. Upon graduation, they are licensed either nationally or by region to dispense medication of various types in the settings for which they have been trained.

In the United States, a pharmacist must complete 4 years of graduate level training at a pharmacy school, usually after receiving a bachelors degree. A bachelors degree is not required as most pharmacy schools only require two years of undergraduate education and the completion of a list of prerequisites. Competition to obtain entry into pharmacy school, however, limits the number of students admitted without a bachelors degree. There are currently 116 accredited pharmacy schools in the United States, ( late 2009 ) and 6 of these schools offer "accelerated" 3 year PharmD programs by attending school almost year round - with less breaks for summer and holidays. There also is one fully accredited "distance/online" 4 year PharmD program offered by Creighton University. Pharmacists receive a PharmD (Doctor of Pharmacy) upon graduation, and licensure after passing the NAPLEX and MPJE.

In Australia, a pharmacist must complete 4 years of university at a Bachelor level or, alternatively, an undergraduate degree in a science or health field followed by a 2-year graduate entry Masters level course. At the completion of the entry level qualification, a one-year compulsory pre-registration year of at least 1824 hours is undertaken in hospital or community. There are two specified post-graduate level units at university, three written exams during this year, culminating in an oral exam with two examiners. It is only after at least 4 years of undergraduate study, and the pre-registration year that a person is entitled to use the protected title, pharmacist.

Australian pharmacists have the option to complete further postgraduate qualifications. In particular, those working in the hospital sector often choose to do so. Common postgraduate qualifications include the Master of Clinical Pharmacy (MClinPharm), an MBA, or a PhD.

Earnings and Wage

2010 Pharmacy Compensation Survey"[6]

  • Directors of Pharmacy $125,200
  • Retail Staff Pharmacists $113,600
  • Hospital Staff Pharmacists $111,700
  • Mail Order Staff Pharmacists $109,300
  • Clinical Pharmacists $113,400

(United States Bureau of Labor Statistics - Occupational Outlook Handbook, 2010-11 Edition):

Median annual wages of wage and salary pharmacists in May 2008 were $106,410. The middle 50 percent earned between $92,670 and $121,310 a year. The lowest 10 percent earned less than $77,390, and the highest 10 percent earned more than $131,440 a year.

Wages for pharmacists in Australia appear to have stagnated. The award wages are very low with an experienced pharmacist manager only entitled to $997 a week. Most pharmacists do earn above award wages, but the wages have stagnated, and even gone backwards in recent times. This is due to the large numbers of pharmacy graduates in recent years. 40% of the pharmacist workforce are now under 35 years. Contract and casual work is becoming more common. A contract pharmacist is self-employed and often called a locum; these pharmacists may be hired for one shift or for a longer period of time. The standard rate is $40 an hour for a locum. There are accounts of underemployment and unemployment emerging recently.

Specialties

Practice specialization

Specialties include:

Speciality practice accreditation

Australia

In Australia, accreditation exists only for certain specialties and is provided by professional bodies for the following:

France

Portugal

In Portugal a pharmacist can become certified in recognized professional specialty practice areas by passing an examination administered by the Order of Pharmacists. The Order of Pharmacists certifies pharmacists in five specialties:

Spain

In Spain a pharmacist can become certified in recognized professional specialty practice areas by passing an examination in addition to spent two to four years of residency period in accredited hospital services and/or academic departments. The Minister of Health certifies pharmacists in eight specialties:

United States

In the United States, a pharmacist can become certified in recognized specialty practice areas by passing an examination administered by one of several credentialing boards.

See also

Wikiversity has learning resources about Pharmacy

References

  1. ^ Titsingh, Isaac. (1834) Annales des empereurs du japon, p. 434.
  2. ^ Pharmacist prescribing RPSGB.org
  3. ^ Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice. 2nd ed. Toronto: McGraw-Hill; 2004.
  4. ^ Definition of chemist on Dictionary.com retrieved 2008 December 28.
  5. ^ "The History of the Royal Pharmaceutical Society" (PDF). Museum of the Royal Pharmaceutical Society of Great Britain. Retrieved June 23, 2009.
  6. ^ 2010 Pharmacy Compensation Survey - Spring Edition PharmacyOneSource.com
  7. ^ Board of Pharmaceutical Specialties
  8. ^ ABAT Certification Examination Credentialing Information

Public Domain This article incorporates public domain material from websites or documents of the United States Government.

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