THE ROLE OF PHARMACIST

IN PUBLIC HEALTH Dr. Mokhtar A. Alhrani

(M.B.B.S - M.Sc. - MD)
SCOPE OF PRACTICE ‫مجال الممارسة ؟‬
Pharmacist Scope of Practice

Drug Patient-Focused
Distribution Pharmacy
Services Practice
Pharmacist Scope of Practice Drug Distribution
Services
▪ Consistent Duties
• Product-Oriented: Focused on
product management.
• Includes the practice of and
responsibility for:
• Interpreting prescription
orders
• Compounding Medications
• Dispensing Medications
• Labeling
• Distributing of drugs and
devices
• OTC Recommendations
Patient-Focused
Pharmacy Practice
▪ Dynamic profession (changes from
time to time)
• Patient-Oriented: Focused on
patient care.
• Describe a pharmacist whose
primary job was to:
• Interact with the health care team
• Interview and physically assess
patients
• Make specific therapeutic
recommendations
• Monitor patient response to drug
therapy
• Provide drug information “drug
experts”.
Pharmacist Scope of Practice Patient-Focused
▪ Consistent Duties
• Product-Oriented: Focused on Pharmacy Practice
product management.
• Includes the practice of and ▪ Dynamic profession (changes
responsibility for: from time to time)
Clinicalprescription
• Interpreting Pharmacy
orders • Patient-Oriented: Focused on
historically described patient care.
• Compounding Medications • Describe a pharmacist whose
patientMedications
• Dispensing oriented rather primary job was to:
than
• Labeling product-oriented • Interact with the health care
pharmacy
• Distributing practice,
of drugs and devices team
practiced by a Clinical • Interview and physically assess
• OTC Recommendations
Pharmacist. patients
• Make specific therapeutic
recommendations
• Monitor patient response to
drug therapy
The Pharmaceutical Care • Provide drug information “drug
experts”.
 The Pharmaceutical Care
▪The responsible provision of drug therapy for the
purpose of achieving definite outcomes that
improve a patient’s quality of life.
▪The four outcomes identified include the following:
❖Cure of disease
❖Elimination or reduction of symptoms
❖Arrest or slowing of a disease process
❖Prevention of disease or symptoms Could we add these duties to a pharmacist in
order to improve the pharmaceutical Care?!
❖Medication Administration?
❖Ordering/ Interpreting Laboratory Tests ?
❖Prescription Authority ?
 Pharmacy Practice
❑RCW 18.64.011 (Washington state law)
❑Definitions: Pharmacist Scope of Practice
(11) "Practice of pharmacy" includes the practice of and responsibility
for: Interpreting prescription orders; the compounding, dispensing,
labeling, administering, and distributing of drugs and devices; the
monitoring of drug therapy and use; the initiating or modifying of
drug therapy in accordance with written guidelines or protocols
previously established and approved for his or her practice by a
practitioner authorized to prescribe drugs; the participating in drug
utilization reviews and drug product selection; the proper and safe
storing and distributing of drugs and devices and maintenance of
proper records thereof; the providing of information on legend drugs
which may include, but is not limited to, the advising of therapeutic
values, hazards, and the uses of drugs and devices.
Continuum of Pharmacist Prescriptive Authority

Collaborative Prescribing Autonomous Prescribing

Patient Population Statewide

Specific Specific Protocol Unrestricted
CPA CPA

Most Restrictive Least Restrictive

Requires a partnering prescriber Does not Requires a partnering prescriber

Used for chronic disease management Currently used for preventive care/public health
What determines a pharmacists’ scope of practice?

State of Law

Certification
Legal flexibility & Provider responsibility
THE ROLE OF PHARMACIST
IN PUBLIC HEALTH
The importance of public health in pharmacy, particularly the community, cannot
be overstated. However, from a global perspective, there are great disparities
in the distribution of pharmacies and pharmacists; in low- income countries, the
density of pharmacies is greater than the density of pharmacists, which suggests
that there are issues in access to and supply of medicines, needing a skilled
workforce, and appropriate supervision of pharmaceutical services.
Pharmacists are not formally classified as a profession within the public health
work force, unlike public health nutritionists, nurses and physicians.

The pharmacist's role is expanding beyond the traditional product-oriented

functions of dispensing and distributing medicines and health supplies. The
pharmacist's services of today include more patient-oriented, administrative
and public health functions.

There are many functions of public health that can benefit from pharmacist's
unique expertise that may include pharmacotherapy, access to care, and
prevention services.
WHY PHARMACISTS?
❑ Pharmacists offer an accessibility that is rare among health care
professionals; to provide public health services, in some cases 24
hours per day.
❑ No appointment is needed at most community pharmacies.
❑ Pharmacists work in a variety of public settings, including hospitals,
pharmacies, drug stores, and nursing homes.
❑ Further, pharmacists in the community are in an ideal position to act
as information resources on lifestyle changes that can influence
healthy outcomes.
HOW PHARMACISTS IMPROVE HEALTHCARE?
PRIMARY & SECONDARY PREVENTION
❑Accessible Preventive Services:
▪ Vaccinations
▪ Cardiovascular risk reduction
▪ Smoking cessation
▪ Health screenings (e.g. diabetes, cholesterol, osteoporosis), Pain control,
▪ Participatory and clinical research, and counseling/ health education.

❑Optimizing Disease management:

▪ Providing information on self-management (e.g. hypertension, asthma, HIV)
▪ Care team involvement
▪ Follow up care
HOW PHARMACISTS IMPROVE HEALTHCARE?
DISEASE MANAGEMENT
❑Provide additional access to care for patients with:
▪ Diabetes
▪ Cardiovascular diseases
▪ Pulmonary diseases
▪ Infectious diseases (e.g. HIV, HCV)

❑Improving Medication Adherence with more:

▪ Blood pressure control
▪ Reduction in emergency visits
 Information &
Communication
about COVID

Chronic
Diseases Triage at the
Medication community
Availability level

Role of
Community
Pharmacist
during COVID

Promoting Supporting
Medication Rational Use
Adherence of Drugs

Medication
Review &
Follow up