A pharmacist, also known as a chemist in Commonwealth English (excluding Canada), is a healthcare professional who is knowledgeable about preparation, mechanism of action, clinical usage and legislation of medications in order to dispense them safely to the public and to provide consultancy services. A pharmacist also often serves as a primary care provider in the community and offers services, such as health screenings and immunizations.
Pharmacists undergo university or graduate-level education to understand the biochemical mechanisms and actions of drugs, drug uses, therapeutic roles, side effects, potential drug interactions, and monitoring parameters. In developing countries, a diploma course from approved colleges qualifies one for pharmacist role. This is mated to anatomy, physiology, and pathophysiology. Pharmacists interpret and communicate this specialized knowledge to patients, physicians, and other health care providers.
Among other licensing requirements, different countries require pharmacists to hold either a Bachelor of Pharmacy, Master of Pharmacy, or a Doctor of Pharmacy degree.
The most common pharmacist positions are that of a community pharmacist (also referred to as a retail pharmacist, first-line pharmacist or dispensing chemist), or a hospital pharmacist, where they instruct and counsel on the proper use and adverse effects of medically prescribed drugs and medicines. In most countries, the profession is subject to professional regulation. Depending on the legal scope of practice, pharmacists may contribute to prescribing (also referred to as "pharmacist prescribers") and administering certain medications (e.g., immunizations) in some jurisdictions. Pharmacists may also practice in a variety of other settings, including industry, wholesaling, research, academia, formulary management, military, and government.
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, aging 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 counseling 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 inter-professional 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). In the European Union, pharmacists are required to hold a Master of Pharmacy, which allows them to practice in any other E.U. country, pending professional examinations and language tests in the country in which they want to practice. 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, pathophysiology , physiology, anatomy, 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 or long-term care. Specialties include:
Academic pharmacist Clinical pharmacy specialist Community pharmacist Compounding pharmacist Consultant pharmacist Long-term care pharmacist Drug information pharmacist Home health pharmacist Hospital pharmacist Industrial pharmacist Informatics pharmacist Managed care pharmacist Military pharmacist Nuclear pharmacist Oncology pharmacist Regulatory-affairs pharmacist Veterinary pharmacist Pharmacist clinical pathologist Pharmacist clinical toxicologist
Training and practice by country Armenia The Ministry of Education and Ministry of Health oversee pharmacy school accreditation in Armenia. Pharmacists are expected to have competency in the WHO Model List of Essential Medicines (EML), the use of Standard Treatment Guidelines, drug information, clinical pharmacy, and medicine supply management. There are currently no laws requiring pharmacists to be registered, but all pharmacies must have a license to conduct business. According to a World Health Organization (WHO) report from 2010, there are 0.53 licensed pharmacists and 7.82 licensed pharmacies per 10,000 people in Armenia. Pharmacists are able to substitute for generic equivalents at point of dispensing.
Australia
The Australian Pharmacy Council is the independent accreditation agency for Australian pharmacists. The accreditation standards for Australian pharmacy degrees include compulsory clinical placements. with an emphasis on encouraging rural experiences to develop a rural workforce. It conducts a written examination on behalf of the Pharmacy Board of Australia towards eligibility for registration. The Pharmacy Board of Australia conducts an oral examination at the end of the intern year as the last hurdle prior to registration. The Pharmaceutical Society of Australia provides continuing education programs for pharmacists. The number of full-time equivalent pharmacists working in Australia over the past decade has remained stable. Pharmacy practice is described by the practice standards and guidelines including those from the Pharmaceutical Society of Australia.
The Australian Pharmacy Council is developing accreditation standards for pharmacists to prescribe and for pharmacists to work in aged care. The aged care accreditation standards are being developed in preparation for pharmacists working in residential aged care settings to ensure that they are adequately prepared.
There is a shortage of pharmacists at present leaving many jobs unfilled. Despite many pharmacists leaving the profession, pharmacists remain optimistic about their profession. 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 number of pharmacists has stayed stable over a number of years.
Canada The Canadian Pharmacists Association (CPhA) is the national professional organization for pharmacists in Canada. Specific requirements for practice vary across provinces, but generally include a bachelor's (BSc Pharm) or Doctor of Pharmacy (PharmD) degree from one of 10 Canadian universities offering a pharmacy program, successful completion of a national board examination through the Pharmacy Examining Board of Canada (PEBC) (Quebec being the exception), practical experience through an apprenticeship/internship program, and fluency in French or English. International pharmacy graduates can begin their journey of becoming licensed to practice in Canada by enrolling with the National Association of Pharmacy Regulatory Authorities (NAPRA) Pharmacists' Gateway Canada. The vast majority (~70%) of Canada's licensed pharmacists work in community pharmacies, another 15% work in hospital, and the remainder work in other settings such as industry, government, or universities. Pharmacists' scope of practice varies widely among the 13 provinces and territories and continues to evolve with time. As a result of pharmacists' expanding scope and knowledge application, there has been a purposeful effort to transition the professional programs in Canadian pharmacy schools to offer doctors of pharmacy over baccalaureate curriculums to ensure graduates have the most up to date level of training to match the increasing practice requirements.
European Union