The pharmacist is an integrated health care provider who will facilitate the patient in a comprehensive manner in collaborations with other health care providers. The patients when they have a symptom of illness, normally visit the pharmacist and seek his/her advise to resolve the symptoms. The pharmacist being expert in health sciences trained in skills of differentiating minor ailments to a major disease shall advise the patients appropriately. He may dispense the over the counter (OTC) medicine to relief from suffering and may advice patient to visit a doctor for detailed diagnosis and treatments.
The dispensing of the OTC medicines are also describable as informed self medication where the patients are advised in the matter of drug disease and lifestyle changes, which are suitable for their health and relief. For e.g., if the patient had hyper acidity, then the pharmacist shall dispense antacids and H2 blockers and advise the patient to avoid caffeine ingredients like coffee and Pepsi which aggravates the acidity and to eat balanced diet at appropriate intervals so that rigour of GIT gets restored. If the patient is suffering from loose motions the pharmacist shall dispense anti diarrheas along with probiotics. The advice of the pharmacist to the patients is to drink plenty fluids containing water. He may also advise the patient for using oral dehydration salts in case the patient is feeling weakness to restore electrolyte balance. They shall not dispense any antibiotics or antibacterial drugs to the patient as this is not only irrational and may be inappropriate. The pharmacist shall not dispense the prescription only medicine to the patient on his own as this is unprofessional and unethical. He also shall advise the patient to visit primary health care centres or register medical practitioner if the condition worsens.
In order to carry the practice of pharmacy profession, pharmacists need to know good understanding of professionalism. The professionalism and professional judgment can be described as one’s occupation which is staged by the community and a representative of professional commitment, which has its own standards and courts of membership. A professional can be a member of the profession on professional behaviours and acts by practice of professional judgment and has professional values, attitudes and behaviour.
Pharmacy profession could have followed attitudes and has gained the public trust by due diligence while performing duty, owner and integrity and respect for follow pharmacist and other health care professionals including the patients. The pharmacist being the benefactor of patients is supposed to be taking the responsibility for a ownership for the patients. He needs to practice across verity of patients ranging from infants to children and aged population. He should be smart enough to understand the needs of the patients and act with skill to comfort patients by his gesture and body language. He should never discriminate or dislike any patients who has approached for help and service. He should treat all patients with equal compassion and love so that the patient develops a sort of bondage resulting in more trust and confidence. While receiving the prescription the pharmacist should start a dialogue in a friendly manner in order to get the patient into a comfort zone, so that a patient opens up to speak with a pharmacist and ask what exactly he wants regarding the information relevance to medications prescribed for him. After getting the sufficient information about the prescription the pharmacist shall start with preparing the dispensing and evaluating the important points to educate the patient regarding the medicine, diet and lifestyle modifications. While dispensing, he confirms for himself the indication for each prescribed medicine. He also scans quickly any drug-drug interactions, drug-diet interactions happening while using the medicine. He quickly makes the alerts to patient how to mitigate the interaction. In case the interaction is of serious magnitude and can not be resolved, than he alerts the prescriber regarding the causality that may happen while using the medicine, without bringing to the knowledge of the patient. Here the pharmacist does it deliberately in order safeguard the dignity of health care profession as such. In case he expresses remarks or caution openly to patient he may become suspicious about the ability of the doctor and trust between patient and doctor may be eroded. It is very much important to safe guard the professional dignity, as this would have direct impact on professional practice of health care in general. Pharmacist after consulting the doctor shall make appropriate changes in the prescription as governed by the principles of science and practice. Here one should not misunderstand that pharmacist is inferior to doctor or the doctor is final authority in therapeutics. The practice of therapeutics is a team work and cooperation and co ordinations are fundamentals for the patient centered care. Irrespective of who says what, the patient interest are to be given prime importance and should remain as guiding principles of all health care professionals. He shall prepare the bill for the medicine and hand over the medicine after ensuring that the patient has received adequate knowledge regarding the safe handling of the dispensed medicine. Many people do not recognize the difference between the sale and dispense of medicine. The dispensing involves handing the medicine to patient after educating the patient to ensure the patient does not end up with issues of drug accidents and poor outcomes due to wrong administration.
The patient counseling should not be considered as just informing the patients passively. It should be considered as a motivational activity for the patient who feels his responsibility in participating in improving his own health. The pharmacy practice is much involving in bringing an enthusiasm among patients and removing the pessimism and incorporating the optimisms.
This is very much important for the pharmacy practice, where in a pharmacist experiments the change of practice, by providing knowledge and bringing in hope and positive thinking among patients due to attitudinal changes. The interventions in pharmacy practice like - medication therapy management, home medication review ambulatory care - are efforts in this direction to establish the legitimate role of the pharmacist in heath care delivery.
(The authors are with Manipal College of
Pharmaceutical Sciences, Manipal, Karnataka 576 104)