Clinical Pharmacy in the Community

Every pharmacist is a clinical pharmacist! But how does one move from ‘pharmacist’ to ‘clinical pharmacist’? In my view, this transition occurs as soon as pharmacists begin to deliver pharmaceutical care with patients… so probably within the first five minutes of being a practicing pharmacist! 

Hepler and Strand defined the term pharmaceutical care as: “The responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life.” To apply this concept, a pharmacist does not have to do anything complicated. It could be something as simple as explaining the importance of avoiding alcohol when taking a course of metronidazole as the drug is dispensed. Or, it could involve a complex series of decisions to de-prescribe drugs as part of a complicated example of polypharmacy.

Both actions have the patient at the centre, and ultimately have the goal of improving the standard of care. The definite outcome in the metronidazole example is, of course, avoidance of the disulfiram reaction, and therefore avoidance of the inevitable patient discomfort, not to mention the likely termination of treatment by the patient, if they suffer this potentially nasty reaction. So, in my view, if you apply pharmaceutical care then you are a clinical pharmacist.

Pharmacists have a legal and professional obligation to deliver pharmaceutical care as a matter of course in their day-to-day practice. This is where the Royal Pharmaceutical Society support network comes in to support professional pharmacists in this endeavour.

The term pharmaceutical care is the bedrock upon which modern pharmacy practice must build. I wanted to take a moment to pay tribute to Hepler and Strand who conceived the idea and wrote about it back in 1990.The concept is as relevant today as it was then, and their paper is a must read for all pharmacists and pharmacy students, regardless of setting or career intentions.

There is no such thing as a non-clinical pharmacist.

Johnathan Laird, based in Aberdeen, is a community pharmacist independent prescriber with a special interest in asthma.


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