The guidelines of pharmacy practice

Practice standards or practice guidelines are those practices that a profession develops and imposes on itself. Practice standards should be based on the best scientific evidence, and should ideally strive to surpass minimum requirements established by law or regulation. Although elements of practice standards may be adopted or adapted into law or regulation, they are still considered different from laws and regulations, due to the fact that they are developed by the profession that is engaged in the practice for which the standards are developed, they are voluntary, and they surpass minimums. For example in the US, standards for the practice of pharmacy in hospitals and health systems are developed by the American Society of Health-System Pharmacists, and are termed Best Practices.

After we learned the development and current status of pharmacy practice in hospital, the second part of this unit, I’d like to show you what is the WHO/GPP guidelines. What is the origin of the guidelines? The International Pharmaceutical Federation FIP first adopted the guidelines for Good Pharmaceutical Practice in 1993. These guidelines were developed as a reference to be used by national pharmaceutical organizations, governments, and international pharmaceutical organizations to set up nationally accepted standards of Good Pharmacy Practice. A revised version of this document was endorsed by WHO in 1997 and subsequently approved by the FIP Council in 1997. In the year 2011, FIP and WHO adopted an updated version of Good Pharmacy Practice entitled “Joint FIP/ WHO guidelines on

good pharmacy practice: standards for quality of pharmacy services”.

In this document, the aim of pharmacy practice is defined as to “contribute to health improvement and to help patients with health problems to make the best use of their medicines.” By the guideline, the definition of GPP is the practice of pharmacy that responds to the needs of the people who use the pharmacists’ services to provide optimal, evidence-based care. To support this practice, it is essential that there be an established national framework of quality standards and guidelines. These guidelines are intended to provide a description of ways in which pharmacists can improve access to health care, health promotion and the use of medicines on behalf of the patients they serve.

It is the policy of FIP and WHO to provide guidance to national pharmacy professional organizations regarding the development of their national GPP guidelines. The conditions of practice vary widely from country to country and each national pharmacy professional organization is best able to decide what can be achieved and within what time-scale. What is the mission of pharmacy practice? Pharmacists are specifically educated and trained health professionals who are charged by their national or other appropriate authorities with the management of the distribution of medicines to consumers and to engage in appropriate efforts to assure their safety and efficacious use. We know that providing consumers with medication alone is not sufficient to achieve the treatment goals.

To address these medication-related needs, pharmacists are accepting greater responsibility for their outcomes of medicines use and are evolving their practices to provide patients with enhanced medicines-use services. So, the mission of pharmacy practice is to contribute to health improvement and to help patients with health problems to make the best use of their medicines.

There are six components to the mission: The first is “being readily available to patients with or without an appointment”. The second mission is “identifying and managing or triaging health-related problems”. Especially in the community setting, pharmacists should be acknowledged as health-care professionals whom patients can consult for health-related problems. Because health-care products and services are available from the pharmacist, some problems can be managed at this point of care. Problems that require additional diagnostic skill or treatments not available from a pharmacist can be referred to an appropriate health-care professional or site of care, such as a hospital. This should be done in good collaboration between the health-care providers.

The following points are Health promotion, assuring effectiveness of medicines, preventing harm from medicines; and making responsible use of limited health-care resources. To improve the use of medicines, pharmacists have responsibilities for many aspects of the process of medication use. This begins with assuring the integrity of the medicine supply chain, including detecting under quality medicines, ensuring proper storage of medicines and quality preparation of medicines if needed. It also includes assuring the proper prescribing of medicines so that dose regimens and dosage forms are appropriate; instructions for use are clear; drug-drug and drug –food interactions are prevented; known and predictable adverse drug reactions, including allergies and other contraindications, are avoided; unnecessary treatments are minimized and the cost of medicines is considered.

Another important component of this mission is assisting patients and those administering medicines to understand the importance of taking medicines properly, including the correct timing of doses, foods or other medicines to avoid when taking a dose and what to expect about taking the medicine. Monitoring treatment is verified. Effectiveness and adverse drug events is also important parts of the process of use of medicines