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Essay on role of pharmacist in public health

A cross-sectional descriptive study was conducted, applying a self-administered questionnaire to health care professionals. The sample included 763 professionals 40. The most common activity performed by pharmacists was the distribution of medications or the drug supply management 51. Pharmaceutical care practice was considered as poor by the professionals, and only 15. For nurses and physicians, interprofessional communication occurs sometimes 56.

Pharmacists' integration into the health team was considered as fair 50. A total of 70. The main expectations these health care professionals expressed were that pharmacists provide more education about medication 97. Therefore, the mission of the pharmacy profession must be to address the drug-related needs of society and individual patients. Over the past 40 years, the pharmacist's role has been changing from that of compounder and dispenser of medicines to one of "drug therapy manager" World Health Organization, International Pharmaceutical Federation, 2006.

This professional practice model or new approach to patient care is being called pharmaceutical care, medication therapy management or cognitive services, and essay on role of pharmacist in public health a major transformation in the social responsibility of pharmacists. It is a paradigmatic change that redefines the identity of the pharmacist as a health care provider which has the patient as the focus of practice Ramalho de Oliveira, 2009.

Also, there is an increasing interest among health care professionals to optimize patient care by applying a teamwork approach Florentinus et al. Through this alliance, over 20 million health care professionals can be reached worldwide, providing a valuable source of knowledge and experience. The health care team consists of the patient and all the health care professionals who have responsibility for patient care.

This team needs to be well defined, and collaboration needs to be actively sought. It is believed that pharmacists have an important role to play in this team. However, they will need to adapt their knowledge, skills and attitudes to this new role, which integrates traditional pharmaceutical science knowledge with clinical aspects of patient care, namely clinical, management and communication skills, ability to actively collaborate with medical teams, and competence to prevent and resolve medicine-related problems WHO, IPF, 2006.

It should be highlighted that the practice of pharmaceutical care does not exist and should not exist in isolation from other health care services. It must be provided in collaboration with patients, physicians, nurses, and other health care providers. The pharmaceutical care practitioner develops a partnership with the patient and other providers in order to ensure patients get the most benefit from all their medications Dupotey, Ramalho de Oliveira, 2009.

The Cuban Health System has a remarkable reputation in the public health services, showing excellent indicators in Latin America, almost comparable with those of developing countries worldwide.

However, pharmaceutical care practice has not yet been developed by pharmacists in their daily practice. Despite the fact that this practice model was introduced in Cuban pharmaceutical policies in 2005, through the handbook "Norms and Proceedings' for Community and Hospital Pharmacies" Cuban Ministry of Public Health, 2005; Cuban Ministry of Public Health, 2006; Medication National Program, 2007there are some implementation barriers to pharmaceutical care, which must be investigated and overcome so that this practice essay on role of pharmacist in public health be developed and systematically available throughout the entire Cuban health care system.

As Ramalho de Oliveira and Shoemaker 2006 wrote: Members of the profession must be open to learn with and from the patient and develop a holistic comprehension of patients' understandings, beliefs, attitudes, and behaviors toward health, disease, and medications. This can also be considered a piece of the humanistic component and of the psycho-social aspects associated with pharmaceutical care practice.

In this regard, in recent years, several studies have explored interprofessional perspectives of pharmacists' role, which have gained an increased prominence in the pharmacy literature. Some of the most recent studies include the analysis of physicians' perceptions of pharmacists' provision of medication therapy management services to outpatients in Chicago, United States Padiyara, Rabi, 2006doctors' and nurses' perceptions of pharmacists' activities in university teaching hospitals in Nigeria Olubunmi, Oyedepo, Erhun, 2009and pharmacists' contributions to basic health care from the perspectives of professionals of the familial health care teams in Santa Catarina, Brazil Loch-Neckel, Crepaldi, 2009etc.

In fact, nowadays, the knowledge of the meanings of pharmacists' work and roles by physicians and nurses acquires a special significance in the exploration of the status of pharmacy practice. These perspectives can assist the profession to better understand pharmacists' situation in the health care system so that it can be enhanced, changed and advanced to better meet our patients' drug-related needs. This study was conducted in response to this social need.

Its goal was to reveal pharmacists' roles in the health care system through the eyes of physicians and nurses in community and hospital settings in Santiago de Cuba. METHODS Study characteristics, setting, sample and ethical considerations This was a descriptive and cross-sectional study, carried out during the months of February, March, and April of 2007 and 2008.

The sample included 763 professionals, 361 from hospitals and 402 from primary health care clinics in Santiago de Cuba City.

More specifically, this study included physicians and nurses who work at 12 hospitals in several municipalities Santiago de Cuba, San Luis, Songo La Maya, Palma Soriano, and Contramaestre and at some primary health clinics located in the surroundings of the Principal Municipal Pharmacy of Santiago de Cuba, which includes 4 districts.

For the hospital settings, the sample size was calculated from a finite population of 5,960 professionals, and for primary health care services the sample size was calculated considering an unknown population size this information was not accessible to the research team. All participants were clarified about the objectives and methods of the study by means of reading and explaining the informed consent form and having it signed. This research did not present risks for its participants; they were assured about confidentiality essay on role of pharmacist in public health received reassurance that the results will be shared with them.

Variables, instruments and procedures to analysis The data was collected through a self-administered questionnaire by the professionals. Before its application, this instrument was analyzed by 10 experts and tested for validation with 160 practicing community and hospital professionals, who accepted to collaborate with the project.

Therefore, the final questionnaire was formulated based on the comments of experts and professionals, and included five topics: The frequency of execution of the following professional activities was considered: The interprofessional relationship was categorized into four categories: The frequency of communication between these professionals was also obtained. In the case of unsatisfactory responses, the main barriers were identified. Descriptive statistics was used to characterize the professionals' samples.

A total of 47. The mean of years of professional experience was 12. From physicians' and nurses' perspectives, the most common activities carried out by pharmacists were drug supply management 70. Table I shows the frequencies of professionals' perceptions of the various activities performed by pharmacists in different health care settings.

In general, there is a low perception about the performance of clinical functions of pharmacists, as these activities appear in the lowest frequencies of physicians' and nurses' perspectives. Significant differences were found in health care settings, and pharmacists' clinical activities in community pharmacists and other primary care settings had the lowest frequencies.

The pharmacist's participation in hospital rounds does not occur from the perspective of 83. Education on drug use, health promotion, disease prevention and lifestyle modification are activities usually performed at the community level and that have a public health focus.

In this case, as shown, these functions are performed monthly, generally in the primary care settings 43. In hospitals, a daily review of patients' prescriptions by a pharmacist is necessary. It is well known that most of the drug-related morbidity and mortality in this setting is predictable and can be avoided, which would reduce the duration of hospitalization and, consequently, the overall cost of health care, while improving the quality of care Traynor, 2009; Abdel-Qader, Harper, Cantrill, Tully, 2010.

However, this daily expected pharmacist intervention is not observed by the majority of the participants in this study. A study that examined medical practitioner's experiences with the role of hospital-based pharmacists in Sudan shows similar results.

The Roles of Pharmacy and Clinical Pharmacy in Providing Healthcare Services to the People

One half of respondents never or rarely had interactions with pharmacists with regard to their patients' medications, 36. Awad, Matow, Capps, 2007. In this study, only 15. Only 12 professionals participated in pharmaceutical care programs in hospitals. These differences were significant. Regarding professional qualification, only 13. Collaboration with pharmacists in preventing and resolving negative outcomes associated with medication was low 17.

Pharmacists collaborate in the education of pharmacy students in 27. A structured instrument was applied and the following five areas were analyzed: These results illustrate how pharmacists' practice is still focused on drugs and not on patients.

Precisely, these clinical functions, which have the potential to encourage the social recognition of pharmacists, are rarely carried out, both from physicians' and nurses' perspectives. Similar findings were found in a previous study performed to characterize the professional practice of pharmacists in Santiago de Cuba, from their essay on role of pharmacist in public health points of view.

In this research, the most frequent activities observed were administrative functions and dispensing. It is troublesome that this is still the reality today. Pharmaceutical care practice is scarce and not systematic in Cuba. The analysis of Cuban pharmacists' contexts of practice could explain this phenomenon. There are no legislation or pharmaceutical policies regulating the provision of pharmaceutical care services.

Pharmacists' activities are regulated by the National Direction of Pharmacy, through the "Norms and Proceedings for Community and Hospital Pharmacies". This document presents gaps and misconceptions about the definition of pharmaceutical care, its implementation and evaluation, according to the most recent and basic understandings of this practice model. On the other hand, there is a document that regulates the legal functions of pharmacists in Cuba, called "Qualifier of Charges for Pharmacists" Cuban Ministry of Public Health, 2005which states a list of many different functions that should be carried out by pharmacists and are completely disconnected from the reality of a clinical practice model such as pharmaceutical care.

  • These differences were significant;
  • Baum F, Kahssay HM;
  • However, the realities of much of American pharmacy practice are ample evidence of the points previously asserted;
  • Additional arguments were focused on another aspect of social purpose, namely, should higher education be only for the privileged e;
  • Manual de Normas y Procedimientos para Farmacia Comunitaria;
  • It is troublesome that this is still the reality today.

Furthermore, these activities have no connection to a social need and to the requirements described in the "Norms and Proceedings for Community and Hospital Pharmacies. There are structural aspects under analysis that limit the development and delivery of services such as pharmacotherapy follow-up.

For instance, many pharmacies do not have a private room for patients' consultations; moreover, they have a small number of pharmacists dedicated to clinical functions and a large number of pharmacists performing several functions at the same time.

The Municipal Pharmacy, which is the main community pharmacy of the territory and controls the activities that take place in all the other pharmacies, is the only pharmacy that has a clinical pharmacist in its staff as a legal determination. In the other community and hospital pharmacies, this function is expected from the pharmacist in response to a specific situation or a requirement of the boss.

  1. Although the Pharmaceutical Society has the authority, it has not yet made either a minimum requirement for continuing education or demonstration of continuing competence a pre-requisite for continuing registration.
  2. Rather than simply dispensing medication, Pharmacists are increasingly expected to be compensated for their patient care skills.
  3. Medicinal Chemistry and Pharmacognosy 3. What I have just described can now, virtually, occur anywhere in the world.

The pharmacists' integration with the health care team was considered by physicians and nurses as fair 50. In a hospital environment, pharmacists are more integrated with the health care team. There was a large number of pharmacists who perform clinical functions daily in hospitals. In the hospital setting, pharmacists have an excellent opportunity to interact with patients, to access patients' clinical records including medication therapiesand to have more interaction with physicians and nurses, which permit the establishment of common strategies to optimize patients' medication therapies.

Hospital pharmacy has led the way to expand the role of pharmacy technicians so that pharmacists can have a bigger role in direct patient care Royal Pharmaceutical Society of Great Britain, 2006. Pharmacists participate in key committees at these institutions, including the Pharmacy and Therapeutics Committee, antibiotic monitoring committees, and medication safety committees. Pharmacists also practice in many other settings such as ambulatory care clinics, managed care, and long-term care, and partici-pate in a number of pharmaceutical services Zeind, Mc Closkey, 2006.

Table II shows the barriers identified by participants with regard to establishing professional relationships. The most important barriers perceived by professionals in establishing a relationship with pharmacists were: Statistical differences were found in health settings and professional qualification. Specifically, in primary health care clinics, the professionals considered the lack of pharmacists' time as the main barrier to the relationship 65. In the hospital setting, professionals did not know who the pharmacist is 48.

Regarding professional qualification, 34. Ethical issues in interprofessional communication appear in 15.