Nature of work
Historically, the fundamental role of pharmacists as a healthcare practitioner was to check and distribute drugs to doctors for medication that had been prescribed 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; however, many medicines are now produced by pharmaceutical companies in a standard dosage and drug delivery form. In some 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 called a collaborative practice agreement.
Increased numbers of drug therapies, ageing but more knowledgeable and demanding populations, and deficiencies in other areas of the health care system seem to be driving increased demand for the clinical counselling skills of the pharmacist. One of the most important roles that pharmacists are currently taking on is one of pharmaceutical care. Pharmaceutical care involves taking direct responsibility for patients and their disease states, medications, and management of each to improve outcomes. Pharmaceutical care has many benefits that may include but are not limited to: decreased medication errors; increased patient compliance in medication regimen; better chronic disease state management, including hypertension and other cardiovascular disease risk factors; strong pharmacist–patient relationship; and decreased long-term costs of medical care.
Pharmacists are often the first point-of-contact for patients with health inquiries. Thus pharmacists have a significant role in assessing medication management in patients, and in referring patients to physicians. These roles may include, but are not limited to:
- clinical medication management, including reviewing and monitoring of medication regimens
- assessment of patients with undiagnosed or diagnosed conditions, and ascertaining clinical medication management needs
- specialized monitoring of disease states, such as dosing drugs in kidney and liver failure
- compounding medicines
- providing pharmaceutical information
- providing patients with health monitoring and advice, including advice and treatment of common ailments and disease states
- supervising pharmacy technicians and other staff
- oversight of dispensing medicines on prescription
- provision of and counseling about non-prescription or over-the-counter drugs
- education and counseling for patients and other health care providers on optimal use of medicines (e.g., proper use, avoidance of overmedication)
- referrals to other health professionals if necessary
- pharmacokinetic evaluation
- promoting public health by administering immunizations
- constructing drug formularies
- designing clinical trials for drug development
- working with federal, state, or local regulatory agencies to develop safe drug policies
- ensuring correctness of all medication labels including auxiliary labels
- member of interprofessional care team for critical care patients
- symptom assessment leading to medication provision and lifestyle advice for community-based health concerns (e.g. head colds, or smoking cessation)
- staged dosing supply (e.g. opioid substitution therapy)
Education and credentialing
The role of pharmacy education, pharmacist licensing, and continuing education vary from country to country and between regions/localities within countries. In most countries, pharmacists must obtain a university degree at a pharmacy school or related institution, and/or satisfy other national/local credentialing requirements. In many contexts, students must first complete pre-professional (undergraduate) coursework, followed by about four years of professional academic studies to obtain a degree in pharmacy (such as Doctorate of Pharmacy). 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 may cover diagnosis with emphasis on laboratory tests, disease state management, therapeutics and prescribing (selecting the most appropriate medication for a given patient).
Upon graduation, pharmacists are licensed, either nationally or regionally, to dispense medication of various types in the areas they have trained for. Some may undergo further specialized training, such as in cardiology or oncology.