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A pharmacist, also known as a chemist or a druggist, is a healthcare professional who prepares, controls, formulates, preserves, distributes medicines and advises and guides the public on the correct use of medicines to achieve maximum benefit, minimal side effects and to avoid drug interactions. They also serve as primary care providers in the community. Pharmacists undergo university or graduate-level education to understand the biochemical mechanisms and actions of drugs, drug uses, therapeutic roles, side effects, potential drug interactions, and monitoring parameters. This is mated to anatomy, physiology, and pathophysiology. Pharmacists interpret and communicate this specialized knowledge to patients, physicians, and other health care providers.
Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links health sciences with pharmaceutical sciences and natural sciences. The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered clinical pharmacy.
A prescription drug is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The reason for this difference in substance control is the potential scope of misuse, from drug abuse to practicing medicine without a license and without sufficient education. Different jurisdictions have different definitions of what constitutes a prescription drug.
A Doctor of Pharmacy is a professional doctorate in pharmacy. In some countries, it is a doctoral degree to practice the profession of pharmacy or to become a clinical pharmacist. In many countries they are allowed to practice independently and can prescribe drugs directly to patients. A PhD program has significant experiential or clinical education components in introductory and advanced levels for the safe and effective use of drugs. Experiential education prepares graduates to be practice-ready, as they already have spent a significant amount of time training in areas of direct patient care and research.
Pharmacotherapy is therapy using pharmaceutical drugs, as distinguished from therapy using surgery, radiation, movement, or other modes. Among physicians, sometimes the term medical therapy refers specifically to pharmacotherapy as opposed to surgical or other therapy; for example, in oncology, medical oncology is thus distinguished from surgical oncology. Pharmacists are experts in pharmacotherapy and are responsible for ensuring the safe, appropriate, and economical use of pharmaceutical drugs. The skills required to function as a pharmacist require knowledge, training and experience in biomedical, pharmaceutical and clinical sciences. Pharmacology is the science that aims to continually improve pharmacotherapy. The pharmaceutical industry and academia use basic science, applied science, and translational science to create new pharmaceutical drugs.
Jerome "Jerry" Lewis Avorn is a Professor of Medicine at Harvard Medical School and Chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. He invented the practice of "academic detailing" in which pharmacists, nurses, and physicians educate doctors about cost-effective prescribing practices using the same tactics that drug companies employ to market their products. He received a B.A. from Columbia University in 1969 and M.D. from Harvard Medical School in 1974.
In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. According to the American Pharmacists Association, "PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims." PBMs operate inside of integrated healthcare systems, as part of retail pharmacies, and as part of insurance companies.
Pharmaceutical policy is a branch of health policy that deals with the development, provision and use of medications within a health care system. It embraces drugs, biologics, vaccines and natural health products.
A veterinary pharmacist is a specially trained pharmacist who dispenses veterinary drugs and supplies or products and advice to owners of companion animals and livestock. In addition, they advise the regulatory bodies and are involved in the formulation of veterinary drugs. Veterinary pharmacy is a field of pharmacy practice, in which veterinary pharmacists may compound medications, fill prescriptions, and manage drug therapies for animals. Veterinary pharmacists are licensed pharmacists who specialize in the distribution of medications for animals.
Clinical pharmacy is the branch of pharmacy in which clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often work in collaboration with physicians, physician assistants, nurse practitioners, and other healthcare professionals. Clinical pharmacists can enter into a formal collaborative practice agreement with another healthcare provider, generally one or more physicians, that allows pharmacists to prescribe medications and order laboratory tests.
Pharmacy residency is education a pharmacist can pursue beyond the degree required for licensing as a pharmacist. A pharmacy residency program allows for the implementation of skill set and knowledge acquired in pharmacy school through interaction with the public either in a hospital setting or community practice. The program is done over a span of about 2yrs after graduation from pharmacy school and licensure as a pharmacist. Pharmacy residency helps improve the resume of a pharmacist so as to increase chances of obtaining employment outside community practice. A 2022 review suggested that there is sufficient evidence that residency develops key competencies for junior pharmacists.
Electronic prescription is the computer-based electronic generation, transmission, and filling of a medical prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, physician assistant, pharmacist, or nurse practitioner to use digital prescription software to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records. By sharing medical prescription information, e-prescribing seeks to connect the patient's team of healthcare providers to facilitate knowledgeable decision making.
Medication therapy management, generally called medicine use review in the United Kingdom, is a service provided typically by pharmacists that aims to improve outcomes by helping people to better understand their health conditions and the medications used to manage them. This includes providing education on the disease state and medications used to treat the disease state, ensuring that medicines are taken correctly, reducing waste due to unused medicines, looking for any side effects, and providing education on how to manage any side effects. The process that can be broken down into five steps: medication therapy review, personal medication record, medication-related action plan, intervention and or referral, and documentation and follow-up.
The Leslie Dan Faculty of Pharmacy is a pharmacy school and an academic division of the University of Toronto. The faculty is located on the northwestern corner of College Street and University Avenue, placing it across from the Ontario Legislative Building and at the entrance to Queen's Park station. It is also situated 1–2 blocks away from four internationally renowned hospitals—The Hospital for Sick Children, Princess Margaret Cancer Centre, Toronto General Hospital and Mount Sinai Hospital. It is part of Toronto's Discovery District.
Psychiatric pharmacy, also known as mental health pharmacy, is the area of clinical pharmacy specializing in the treatment of people with psychiatric illnesses through the use of psychotropic medications. It is a branch of neuropsychiatric pharmacy, which includes neurologic pharmacy. Areas where psychiatric pharmacists are found most abundantly are in chemical dependency, developmental disabilities, long-term care facilities, adherence clinics, mental health clinics, and within the prison system. However, psychiatry and neurology are not the only areas where psychiatric pharmacists require comprehensive knowledge. They must also be proficient in clinical problem solving, interprofessionalism, and communication with understanding and empathy for the patient population they serve, as they are a sensitive group.
Deprescribing is the planned and supervised process of intentionally stopping a medication or reducing its dose to improve the person's health or reduce the risk of adverse side effects. Deprescribing is usually done because the drug may be causing harm, may no longer be helping the patient, or may be inappropriate for the individual patient's current situation. Deprescribing can help correct polypharmacy and prescription cascade.
Antimicrobial stewardship is the systematic effort to educate and persuade prescribers of antimicrobials to follow evidence-based prescribing, in order to stem antimicrobial overuse, and thus antimicrobial resistance. AMS has been an organized effort of specialists in infectious diseases, both in Internal Medicine and Pediatrics with their respective peer-organizations, hospital pharmacists, the public health community and their professional organizations since the late 1990s. It has first been implemented in hospitals. In the U.S., within the context of physicians' prescribing freedom, AMS had largely been voluntary self-regulation in the form of policies and appeals to adhere to a prescribing self-discipline until 2017, when the Joint Commission prescribed that hospitals should have an Antimicrobial Stewardship team, which was expanded to the outpatient setting in 2020.
A collaborative practice agreement (CPA) is a legal document in the United States that establishes a legal relationship between clinical pharmacists and collaborating physicians that allows for pharmacists to participate in collaborative drug therapy management (CDTM).
Drug utilization review refers to a review of prescribing, dispensing, administering and ingesting of medication. This authorized, structured and ongoing review is related to pharmacy benefit managers. Drug use/ utilization evaluation and medication utilization evaluations are the same as drug utilization review.
Cara Tannenbaum is a Canadian researcher and practicing physician in the fields of geriatrics, women's health and gender research. Since 2015, Tannenbaum has served as the Scientific Director of Canadian Institutes of Health Research's Institute of Gender and Health. She was appointed as a Member of the Order of Canada on November 17, 2021.
References
- ↑ Soumerai SB, Avorn J (1990). "Principles of educational outreach ('academic detailing') to improve clinical decision making". JAMA. 263 (4): 549–56. doi:10.1001/jama.1990.03440040088034. PMID 2104640. S2CID 1981297.
- ↑ Avorn J, Soumerai SB (1983). "Improving drug-therapy decisions through educational outreach. A randomized controlled trial of academically based "detailing". N Engl J Med. 308 (24): 1457–63. doi:10.1056/nejm198306163082406. PMID 6406886. S2CID 74834805.
- ↑ O'Brien MA, Rogers S, Jamtvedt G, et al. (2007). "Educational outreach visits: effects on professional practice and health care outcomes". Cochrane Database Syst Rev. 4 (4): CD000409. doi:10.1002/14651858.cd000409.pub2. PMC 7032679 . PMID 17943742.
- ↑ "Vermont Academic Detailing Program". The University of Vermont College of Medicine. Archived from the original on 2011-07-20.
- ↑ "Drug Use Research and Management, Oregon State University". July 20, 2011. Archived from the original on 2011-07-20.
- ↑ "South Carolina College of Pharmacy - SCORxE". Archived from the original on 2009-01-06. Retrieved 2008-04-17.
- ↑ "Alosa Health".
- ↑ https://www.pbm.va.gov/PBM/academicdetailingservice/AboutUs.asp (Last accessed: 20 October 2018)
- ↑ "STATEMENT OF DR. CAROLYN CLANCY, M.D. INTERIM UNDER SECRETARY FOR HEALTH VETERANS HEALTH ADMINISTRATION (VHA) DEPARTMENT OF VETERANS AFFAIRS (VA) BEFORE THE COMMITTEE ON VETERANS' AFFAIRS UNITED STATES SENATE" (PDF).
- ↑ Canadian Academic Detailing Collaboration
- ↑ "CEP | Centre for Effective Practice".
- ↑ Jin, Margaret; Naumann, Terryn; Regier, Loren; Bugden, Shawn; Allen, Michael; Salach, Lena; Chelak, Kristen; Blythe, Nancy; Gagnon, Antony (May 2012). "A brief overview of academic detailing in Canada: Another role for pharmacists". Canadian Pharmacists Journal. 145 (3): 142–146.e2. doi:10.3821/145.3.cpj142. ISSN 1715-1635. PMC 3567505 . PMID 23509530.
- Silva, JM; Stein, AT; Schünemann, HJ; Bordin, R; Kuchenbecker, R; de Lourdes Drachler, M (19 March 2013). "Academic detailing and adherence to guidelines for Group B streptococci prenatal screening: a randomized controlled trial". BMC Pregnancy and Childbirth. 13: 68. doi:10.1186/1471-2393-13-68. PMC 3610286 . PMID 23510061.