Rift Valley University Harar Campus

DEPARTMENT OF PHARMACY

Course title: Pharmacy Practice

I
2: PHARMACIST AS A HEALTH CARE
PROFESSIONAL
For 4th Year BSC Pharmacy Student
By:-MENBERE DEBELE
(BSc. C/Nurse, B.Pharm)
11/14/2023 For 4th Year BSC Pharmacy Student 1
Outline

Evolution of pharmacy practice

Concepts of profession and professionalism

Relationships with other healthcare professions

11/14/2023 For 4th Year BSC Pharmacy Student 2

 2.1 EVOLUTION OF PHARMACY PRACTICE

Objectives ;
Define the main time frames with in history of
pharmacy

Describe key events in history of pharmacy

Examine impacts of historical events on the

pharmacy practices

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Who did start the use of medicine?

The use of medicine is as

old as human history
itself

By trial and error, the folk

knowledge of the healing
properties of certain
natural substances grew

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 Ancient man learned from nature, from
observation of birds and beasts.

Cool water, a leaf, dirt, or mud was his first

soothing application.

 Eventually, he applied his knowledge for the

benefit of others.

The use of medicine is as old as human

history itself
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 Pharmacy (sale and supply of
medicines) is amongst the oldest of
professions

What evidence do we have??

The earliest known prescriptions date
back to at least 2700 BC and were written
by the Sumerians.

Chinese Pharmacy stems from Shen

Nung about 2000 B.C
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300 BC- Greece,
Theophrastus, father of
botany, wrote about
medical uses of herbs
Papyrus Ebers is the best
known and most
important
pharmaceutical record
written about 1500 BC.
It is a collection of 800
prescriptions
mentioning 700 drugs.

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The emergence of pharmacy 50 BC to 1231 AD

The transition of pharmacy into a science

Dioscorides in the first century AD.

Wrote Materia Medica describing nearly

500 plants and remedies prepared from
animals and metals, and gives precise
instructions for collection of drugs,
their storage and use

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 Galen – Experimenter in drug compounding
Introduced principles for
preparing and
compounding
medicines

The term galenicals are

widely used to refer the
pharmaceuticals
prepared by
compounding
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1st apothecary shops

Arabs separated the

arts of apothecary
and physician,
establishing in
Bagdad late in the
eighth century the
first privately owned
drug stores.
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Separation of pharmacy and medicine in Europe
In European
countries, pharmacy
shops began to appear
around the eleventh
century
It was in Sicily and
southern Italy that
pharmacy first became
legally separated from
medicine in 1231 AD

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1st pharmacy in Ethiopia
Paul Merab, a
Georgian physician, pharmacist a
nd researcher of Ethiopia.
who held French nationality

He founded the

first pharmacy in Addis
Ababa which he called
"Pharmacie de la Géorgie".

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STAGES OF EVOLUTION OF PHARMACY PRACTICE
Until late 1800s, in most countries, the
pharmacist was serving the social role of
apothecary by compounding drug products;
preparing elixirs and powders for individual
patients….
However, during the past 100 years, significant
growth and development have occurred in the
field of pharmacy.
These changes have occurred primarily in four
major stages
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First stage
From the late 1850s to early 1900s, the classic form
of the corner drugstore began to emerge.

Drugs began to be manufactured outside of the

actual pharmacy, the work of the pharmacist was
simplified into procuring, preparing, evaluating,
and selling drug products.
Pharmacist was responsible for delivering pure,
unadulterated medications and for providing
good advice to the customers

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Second stage … really bad time
Several new, very effective medications came on
the market during the 1950s, which increased the
number of prescriptions being filled by
50%.........Reduced compounding activity

In addition some restriction e.g American

Pharmaceutical Association (APhA) Code of Ethics
from 1922 to 1969 prohibited pharmacists from
discussing the therapeutic effects to the a
patient during dispensing.

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 All of these factors greatly influenced the decline
of the pharmacist’s responsibilities to that of
“count, pour, and stick,”

However, in this time attention focused

primarily on educational re-form as the
method to advance the profession

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 Third stage
From the late 1960s to 1980s, the pharmacist’s role
was in transition

The functions of the role expanded rapidly,

increasing professional diversity.

Beginning to provide new “clinical” services,

such as pharmacokinetics, drug information,
and drug-use control, primarily in the
institutional setting.

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 In 1969, the APhA Code of Ethics was
revised to encourage pharmacists to
consider the patient’s health and safety
first as they dispensed medications, fully
utilizing all of their abilities and
training as healthcare practitioners.

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Fourth stage
Starting from 1990s the patient care stage
Concept of “pharmaceutical care”
emerged.

Defined as….’’Responsible provision of

drug therapy for the purpose of
achieving definite outcomes that
improve a patient’s quality of life”(Hepler
and Strand )
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 2.2 CONCEPTS OF PROFESSION AND
PROFESSIONALISM
Objectives
Understand the concept of profession and
professionalism

Identify criteria for professionalization

Identify opportunities for professionalization of

pharmacy “profession”

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What is difference among…
Vocation Vs
Profession VS
Occupation
Occupation" is a neutral,
generic term indicating any
activity that takes up a
significant quantity of time,
but is normally used to refer
to one that earns money,

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 Vocation" literally means "calling" ( "vocal").
It refers to work that one does because of a
feeling of deep affinity, attraction and/or
talent.

"Profession" is an activity one "professes", i.e.

consciously adopts and studies.

By convention, it generally refers to intellectual

(rather than manual) pursuits which involve
gaining a recognised qualification,
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 Profession a

The word profession literally means to “testify on

behalf of” or “stand for something.”

Profession is calling requiring specialized

knowledge and often long and intensive
academic preparation. (Merriam-Webster
dictionary)

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 A disciplined group of individuals who
adhere to high ethical standards and
uphold themselves to, and are accepted
by, the public as possessing special
knowledge and skills in a widely
recognised, organised body of learning
derived from education and training at a
high level, and who are prepared to
exercise this knowledge and these skills
in the interest of others

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Professional: A member of a profession who
displays the following 10 traits
1. Knowledge and skills of a profession.
2. Commitment to self-improvement of skills
and knowledge.
3. Service orientation.
4. Pride in the profession.
5. Covenantal relationship with the client.
6. Creativity and innovation.
7. Conscience and trustworthiness.
8. Accountability for his/her work.
9. Ethically sound decision making.
10. Leadership.
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Professionalism
Professionalism: The active demonstration of
the traits of a professional.

It also refers to the standards, behaviors and

character of an individual engaged in
responsibilities or duties related to his or her
work or profession.

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 Core features of a profession.
To be granted entry into a profession an
individual must acquire specialized
knowledge and undergo lengthy
training.

Service orientation, i.e. a professional

acts in the public’s best interests, rather
than pursuing their own self-interest.

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 Professions also determine the content
and scope of training, arbitrate over
eligibility of membership, and assess
competency to practice, i.e. they ‘self-
regulate’.

Professions have a monopoly of practice

granted and secured by the State, which
also sanctions their right to monitor and
control their activities

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Professionalization
Professional socialization
(professionalization):

The process of inculcating a

profession’s attitudes, values, and
behaviors in a
professional.

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Discussion
1. Is pharmacy a profession???

2. What are factors undermining

professionality of pharmacy???

3. Is there opportunities to improve

professional status of pharmacy? How?

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 Constraints to pharmacy’s occupational
development
Social closure
Credentials required to practice the core
function of pharmacy
—dispensing or supplying prescribed medication are
not exclusive to pharmacy

Physicians, dentists and nurses may all, in

certain limited circumstances, supply
medication to patients
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 Controlling the use of medicines
Pharmacists cannot legally prescribe potent
medications, but instead are required to supply
them in accordance with prescribers’
instructions.

Thus, decisions about who uses, which

prescribed drug, for which ailment, and how,
are beyond the controlling power of
pharmacists.

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Drug information
Major responsibilities of pharmacy

This service undermined by the fact that pre-

packaged medicines contain written
inserts giving detailed instructions for
their use

Competence with other sources of advice

and information such as doctors, the media
and the lay community
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Technology

Original pack and patient-pack dispensing

diminished compounding and formulating
skills

Computer software which identifies potential

drug interactions and inappropriately
prescribed doses….. diminished dispensing
process

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Despite all these ….Pharmacy is indeed
profession

Monopoly of practice… dispense prescribed

medication

Possess specialized knowledge

Service-oriented

Self-regulating

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 2.3 POTENTIAL OPPORTUNITIES FOR OCCUPATIONAL
DEVELOPMENT

Promotion of pharmacists as first port of call

for health issues

Pharmacists have promoted themselves as

‘first port of call’ health professionals,
available to the public without
appointments, providing advisory and
health care services.
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 Devolution of dispensing duties
The provision of health care advice and
diagnostic testing(blood cholesterol,
blood pressure, blood glucose level)

Pharmaceutical care…. emphasis on the

patient, and in particular, its outcome
orientation the problem of boundary !!!

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RELATIONSHIP WITH OTHER HCP

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Team working
There has been increasing number of examples of
the pharmacist being integrated into the
health care team
Public health; immunization, health
promotion, medication therapy management,
etc

However, good professional communication in

health care is an essential component of team
working.
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Inter-professional communication
Communication, respect, trust and mutual
recognition of each other's professional competence
is very important.

Access by both physicians and pharmacists to the

same accurate and up-to-date information base is
important to avoid providing patients with
conflicting information.

Keeping an open and continued dialogue between

physicians’ and pharmacists’ is also needed
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Key components of effective team working
Sharing a common purpose to bind and guide
Having a clear understanding of one’s own
role
Recognizing common interests

Understanding the roles and responsibilities

of others
Pooling knowledge, skills and resources
Sharing a responsibility for outcomes

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11/14/2023
THANK YOU!
For 4th Year BSC Pharmacy Student 42