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Obstacles and the future of pharmacists

In short, clinical pharmacy is patient-oriented rather than drug product oriented. And has been proven to have positive impact for patient health. And is considered as a standard practice in the GPP guideline. Over the years, the pharmacy profession all over the world has attempted to move from an orientation toward a thing, the drug, to a focus on a person, the patient. But this reorientation process has been slow and quite difficult in some countries than others due to a number of reasons. For one, pharmacists are the only profession uniquely associated with medications. And the effective distribution of drugs is a responsibility that is heavy even without taking on other responsibilities.
And, pharmacist may not find the time to perform services other then dispensing, unless this workload is relieved either by employing more pharmacy staff or by introducing automated dispensing technology. And secondly, payment for pharmacists services revolves around the dispensing of the drugs, rather than monitoring and managing the impact of those drugs on patient health outcomes. Thus, the administrations and providers lacks the motivation of pursuing the development of these un-paid services. And third, barriers in health care such as laws and regulations, and perceptions of the public, inadequate technology and structure and financing of the health care system still exists, and generally takes time to overcome. These are also the current challenges for hospitals in Taiwan.
The laws currently forbid medication dispensing to be performed by staff other than pharmacists. Therefore, unlike the current status in the US., we do not have technicians to share the burden of medication distribution. Furthermore, the reimbursement of pharmacy service currently only recognize the number of prescriptions that have been dispensed, and not on any of the clinical pharmacy services that we have mentioned today. This also makes the administrators of hospitals reluctant and lack of motivation to develop clinical pharmacy service models. This is one of the reasons why in Taiwan, hospitals that are providing clinical pharmacy services are mostly the ones with more human or financial resources, such as medical centers and teaching hospitals.
However, under the high self expectation and pursuit of continual advancement of pharmacy practice, the quality and volume of clinical pharmacy services continue to grow in Taiwan, and various forms of clinical services are being developed. And The professional society of health-system pharmacists of Taiwan are now proposing and developing reimbursement programs for clinical pharmacy services. Hoping that in the near future, with the encouragement of direct payment for clinical services, or the financial resources to hire pharmacists to provide these patient oriented services, the development of clinical pharmacy will continue to thrive and accomplish the ultimate goal of improving the safety of medication use.
To summarize this introductory session, We, as pharmacists, must seen the continual of professional development to improve clinical knowledge, skills and performance as a lifelong mission. In the area of clinical pharmacy, Much work is yet to be done. And,Circumstances and environment of pharmacy practice might vary from country to country. But,what is the same is that Pharmacists must continue to engage in providing clinical pharmacy services, collaborate with other health professionals and together, prove that the value of our profession is way beyond medication dispensing. Thank you for listening.

Chen discusses the various obstacles pharmacists face when carrying out clinical pharmacy services and possible future improvements.

Key concepts

The pharmacy profession is shifting from drug product-oriented services to patient-oriented services. However, there are many obstacles to this reorientation process. Such as:

  • Pharmacists are the only profession uniquely associated with medications, and effective drug distribution is a heavy responsibility by itself.

  • Payment for pharmacists’ services also revolves around drug dispensing, not monitoring or managing medication therapy. Thus, administrations and providers lack the motivation to pursue and develop these services.

  • Laws and regulations.

  • Perceptions of the public.

  • Inadequate technology, structure, or financing of the health care systems.

In Taiwan:

Taiwanese laws currently forbid medication dispensing by staffs other than pharmacists. Also, reimbursement of pharmacy service only recognize dispensed prescriptions, and not any of the clinical pharmacy services provided. Currently, efforts are made to encourage direct payment for clinical services, while also increasing the budget to hire more pharmacists to share the workload.

However, regardless of the circumstances, pharmacists must continue to provide clinical pharmacy services and collaborate with other health professionals, to prove that the value of this profession is way larger than medication dispensing.

Share and learn:

  • What are the problems you or your country face when carrying out clinical pharmacy services?

  • How are they resolved?

  • If not, what are the current efforts/measures?

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Good Pharmacy Practice: Introduction to Clinical Pharmacy Services

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