Health is a word very known but it carries a lot of complications and troubles. According to the WHO, health is a state of complete physical, mental and social well-being and not merely absence of any illness.
Health care system depends upon a health care team. A health care team is the group of community who contribute to a common health goal and common objectives determined by community needs.
India with the greatest cultural diversity, health though an important issue is being neglected due to many hindrances. The condition is more worsened due to inappropriate drug use problems. It is in the hands of the pharmacist particularly the community pharmacist, to take up the challenge for providing better health care and better outcomes reasonably.
Although community pharmacist is of key importance in providing better health care the patient, in India, Pharmacist has no any recognition in the health care system as compare to other well-established countries.
The community pharmacist can take part in health promotion campaigns, locally and nationally, on a wide range of drug related and health related topics. A community pharmacist involvement could play an important role in the following areas of health care.
Pharmacists are dynamic, patient-oriented professionals committed to fulfilling the health care needs of their patients. Pharmacy is a profession that is expanding in new directions to meet the health care needs. There is a movement amongst pharmacists beyond the traditional compounding and dispensing of medication, towards a more professional advisory and primary health care role.
Pharmacists can apply their knowledge and skill to become directly involved in the healing and education of patients. Pharmacists form an integral part of the community and serve as an important source of knowledge. A modern-day pharmacist should be trained in providing the knowledge concerning:
1. Optimal drug therapy for patients with a focus on drug interactions and potential side effects
2. Counseling on various disease conditions
3. Education and promotion of the general health of the public
4. Information on immunization.
World over pharmacist is one of the important member of the health-team including clinical research. If Indian pharmacist is not fulfilling this role, then he should be appropriately trained and be oriented as a health-care provider to the vast rural population. He can be used intelligently as an alternative manpower towards the sacred goals of:
1. as a communicator
2. as a quality drug supplier
3. as a health promoter
4. as a collaborator
5. as a trainer and Supervisor
The remark of the standing committee that “Pharmacist is the main hurdle in easy accessibility of medicines” is certainly unfounded. With the kind of political, administrative and social structure in our country. The WHO report on “‘The, role of the pharmacist in the health care system” states that the competence of the pharmacist is already proven and evident:
1. In the direction and administrative of pharmaceutical services
2. In drug regulation and control
3. In the formulation and quality control of pharmaceutical products
4. In the inspection and assessment of drug manufacturing facilities
5. In the assurance of product quality through the distribution chain
6. In drug procurement agencies and
7. In National and institutional formulary committees.
The main role of community pharmacist is studied under the following category with and without club with health care team.
A. As Pharmacist and health promoter
(a) Immunization
(b) Minor dressing
(c) Preventing tropical diseases
(d) Providing drug-information
(e) Monitoring adverse drug reactions
(f) Monitoring and minimizing adverse drug interactions
(g) Preventing misuse of drugs
(h) Preventing medication errors
B. Health educator
1. Nutrition Counseling
2. Individualization of Drug Therapy
3. Family Planning
4. Alcohols, Drug Abuse and Smoking Cessation
5. Sexually Transmitted Diseases – AIDS
6. Rational Use of Drugs
7. Women Welfare – Pregnancy and Infant Care
1. Nutrition Counseling
Community pharmacist can play significant role in assuring adequate nutrition by advising his patients about basic food needs, keeping to correct improper food habits in children, advising on special requirements, suggesting special diet instructions for diabetic patients and people with food allergy and participating in school lunch programs and schemes like mid-day meals etc., in rural areas.
There are certain facts such as women who often eat fish or omega-3-fatty acids are less likely to suffer stroke, symptoms of hyper vitaminosis result in irregular menstrual cycle and excessive intake during pregnancy may cause birth defects, products and their standardization.
2. Women Welfare – Pregnancy and Infant Care
Women health care is the first priority in India. Women are the corner stone for effective public health and investing in women translate into investing in family, community and the Nation.
The pharmacist who understands the normal course of pregnancy and infancy is at a distinct advantage as he or she can guide the mother in simple matters of hygiene and management. The community pharmacist can encourage breast feeding and can play a major role by guiding the mother for the protection of the child by following proper immunization schedule. Efforts are definitely underway in th;s area.
3. Rational Use of Drugs
A community pharmacist can also discuss with administration on the medication, provide information on the storage of the medication and wherever necessary he can counsel the patient.
Drug information system should be set up and access to adverse drug reaction ‘system should be made. A community pharmacist should do therapeutic drug monitoring and he should have a sound knowledge of genotype reporting i.e. predictive pharmacology.
How many amongst the common people know that drugs such as Action 500, Coldarin can increase blood pressure in patients having hypertension. Even pain shows difference between men and women. Where women respond better to the opiods such as morphine, pentazocine and pethidine men respond better to the non-steroidal anti-inflammatory drug, ibuprofen.
In a nut shell there should be rational use of drug i.e., right drug in right patient in right dose at right time. A community pharmacist is one of the inevitable members of the health care team who can help to achieve the goal of rational use of drugs.
4. Sexually Transmitted Diseases – AIDS
India has 3.5 million HIV positive cases, which is about 10% of the global HIV cases and barely second to South Africa. HIV drugs are expensive and beyond the reach of common man.
Huge resource of community pharmacist can educate people in the prevention and information of HIV/AIDS. A sensitive issue is the increasing number of women patients suffering from AIDS.
The number rose from 7% in 1985 to 18% in 1995. Explaining to what HIV is, its transmission, risk reduction, patient counseling are the components of the counseling that a community pharmacist can provide.
5. Alcohols, Drug Abuse and Smoking Cessation
The pharmacist has a play an important role to help individuals who become dependent upon alcohol. Drug abuse is similar to alcoholism yet different because it has been gaining more acceptances among young people. Annual mortality from tobacco use exceeds that from all other causes combined. Smoking is the greatest single preventable cause of morbidity and mortality in India. The pharmacist can advise on the products available to assist the patient in giving up smoking. Counseling sessions can be made by the community pharmacist to stop smoking.
6. Family Planning
Currently, India’s annual population growth rate is 1.74%. India is the second most populous country in the world, contributing about 20% of births worldwide.
In 1952, the Indian Government was one of the first in the world to formulate a national family planning programme, which was later expanded to encompass maternal and child health, family welfare, and nutrition.
All problems are associated tremendously increasing population in India. The community pharmacist plays a very important role in this case to educate the people and advise various methods available in the market helpful in family planning.
7. Individualization of Drug Therapy
Today the latest concept in medicine is towards individualization of drug therapy. Where judicious patient care is needed individualization of drug therapy becomes a need, and a pharmacist can play a vital role in this.
A physician who is preoccupied with patient diagnosis and treatment may not spare time for patient counseling regarding pharmaco- economics, drug information, alternative therapy, moral supporting etc. A pharmacist can set up a separate consultation room and provide counseling to the patient.