APTI ijopp - Indian Journal of Pharmacy Practice

Indian J. Pharm. Pract. 1(2), Jan-Mar, 2009community pharmacies, though theoretically well versedlack the necessary competencies and skills to educate thepatient about the therapy received for the chronic diseaseand to provide pharmaceutical care through services likepharmacovigilance. Even if the retail pharmaoutlets/community pharmacies are manned by pharmagraduates, the situation remains more or less the same.It is because though theoretically better equipped thendiploma holders, they show total lack of clinicalorientation due to industrial orientation of B.Pharmsyllabi & lack of clinical training. Though introduction ofPh.D. programme is heartening yet it is required to giveclinical training to the large pool of existing registeredPharmacists running community pharmacies.Good community pharmacy practicesSince Chronic Disease Management is problematic dueto the administration of multiple drugs to the patients, itrequires speciality pharmacies dedicated to variouschronic diseases like Cancer, AIDS, Diabetes etc.. Thishighlights the need of having super special communitypharmacies. Such Pharmacies will demand pharmacistwith clinical training in super-specialities of chronicdiseases. Though a structured continuing educativeprogramme for registered pharmacists in India is missingyet by attending various workshops in clinical training,symposia, conferences etc. and by means of internet, theregistered pharmacist can stay in touch with latestadvancement in chronic disease management. The superspecialitypharmacies catering to particular chronicdisease patients should provide the related medicines andinformation to the patients. The patients should getindividualized information on therapy. Such pharmaciesshould have the element of professional pharmaceuticalare where pharmacist can act as a warrior and keep undercheck the unwanted adverse drug reactions due topolypharmacy in chronic diseases. These pharmaciesshould cater to the disease specific pharmaceutical needsof chronic disease patients, should have A to Z of therequirement of all drugs, diagnostics and otheraccessories for routine and emergency management ofchronic diseases.All chronic diseases lead to psycho-social problems likeanxiety about hospitalization, restricted diet, diseaseprogression, financial problems, anger, depression,restricted movements etc. These psycho-social problemsand the complex dosage regimens of the drugsadministered, the unstable/serious disease state, nonadherence to therapy highlight the need ofpharmaceutical care and psycho social support ofpharmacist. The community pharmacies should beprojected as places where the chronic disease patients canget the necessary psycho-social support andpharmaceutical care. The Pharmacist should identifyand mobilize the strength and resources of patient toendure and manage their health concerns. This requires avigorous training of such pharmacist for patientcounseling. The retail pharma outlets should put upposters or distribute pamphlets to patients of chronicdisease to inform them about special patient counselingservices of the pharmacy. Such pharmacies should buildthe public opinion on the accessibility andapproachability of the community pharmacist as a wellinformed health care professional. These should also actas platform to spread awareness about the significance ofthe super-speciality pharmacies in provision ofprofessional pharmaceutical care in chronic diseases likehealth care screening services in detection andprevention of chronic diseases at early stages by referringthem to referral services.The patients should be given computer generatedinformation on the medications and the therapy receivedby the patients. The pharmacist should give spontaneousor planned detailed individualized medicationinformation and answer the queries of the patients ofchronic diseases related to prescribed therapy and thedrug product as per individual requirement. Thepharmacist should do value addition to the knowledge ofthe patient regarding proper and safe use of medicines forspecific chronic disease. The pharmacy should impartplanned education to chronic disease patients on themedications received in groups. The education of thegroups of Patients of such diseases can take place throughan interactive learning experience between thepharmacist & patients. Besides, the pharmacist shouldbe groomed to carry out detailed discussions to guide thepatients in management of their disease state and thetherapy prescribed for the same.The focus of counseling to the patients of chronicdiseases should be on active participation of the patientsin safe and proper use of medications & management ofspecific disease states rather than passive participation. Itis very important because of the agony suffered bychronic disease patients and the huge healthcare costsinvolved. This shifting of foci can lend to tremendousreduction in their agony and healthcare cost involved.The Pharmacist should encourage the filling of selfreporting forms of adverse drug reactions of drugsprescribed to chronic disease patient so that these can be19