STATUS OF COMMUNITY PHARMACY PRACTICE
Sunil Jain*, Sunil K Batra and Satish Sardana
Hindu College of Pharmacy, Sonipat-131001 (Haryana)
Community pharmacy practice includes all services offered by a pharmacist to society through pharmacy where patients receive drugs. Community pharmacy is still in primitive stage in India & is confined to so called ‘Medical Store’. Standard of a profession largely depends on the performance of persons practicing it. The objective of this study was to assess the overall performance of community pharmacy & thereby identify shortcomings so that need to improve may be appreciated & realized. Data was collected through a pre-drafted structured & undisguised questionnaire & objective of the study was made known to respondents. Investigator personally visited randomly selected 90 community pharmacies scattered in Panipat city in Haryana, India & responses were recorded after observations & discussions with pharmacist present there.
The study concludes that majority of pharmacies (40%) are named ‘MEDICAL HALL’ while only 4% are named ‘PHARMACY’. About 66% pharmacists counsel the patients on ‘How to take the medicines’ & ‘Duration of therapy’ for medicines sought by them. Very few pharmacists (8%) consult physicians if prescribed brand is not available. It is surprising to note that none of the pharmacist was wearing apron in pharmacy. From this study we could realize ground realize of the pharmacy practice.
Keywords – Community pharmacy, Pharmacy, Pharmacy practice, Questionnaire.
Although more than 20 years have passed since the introduction of concept of Pharmaceutical care1, the pharmacists in India have not yet embraced the concept. It is generally felt that community pharmacists in India are under trained to meet the changing needs of their roles towards pharmaceutical care. World Health Organization (WHO) defines ‘Community Pharmacists’ as health care professionals most accessible to public. The WHO consultative group drafted the job responsibilities2 for community pharmacists in 1993. International Pharmaceutical Federation (FIP) also published a document on Good Pharmacy Practice Standards3.The underlying principle of the GPP document is to provide medicines, health care products and services and help people to make the best use of them.
Pharmacist who works in community should always be vigilant regarding safety of patients and consumers. He must act in the interest of public health rather than sale of prescription medicines to public. Pharmacist who is in charge of drug store sells medicines without showing any concern or care who is purchasing the medicine. A vicious circle of maximizing profit by various stakeholders has eroded of Standard of community pharmacy in country4. Several studies have been conducted on standards of retail (community) pharmacy in India5-9 in the past, but situation of community pharmacy practice has not changed much in the last two decades.
With this background in mind an attempt was made to assess the overall performance of community pharmacy & thereby identify shortcomings so that need to improve may be appreciated & realized. In our study we selected community pharmacist because image of pharmacy profession in the minds of community at large is mainly perceived from the community pharmacist. We intend to make pharmacists aware of their performance as a professional so that need to improve may be appreciated and realized.
Data was collected through a pre-drafted structured & undisguised questionnaire & objective of the study was made known to respondents. About 90 community pharmacies (Chemist shops) scattered in Panipat city in Haryana (India) were randomly selected for study. Panipat city has about 275 medical stores. Investigator personally visited selected community pharmacies and responses were recorded after observations & discussions with pharmacists present there. Out of these 90 selected pharmacies, 21 were dropped out because of their non cooperativeness due to lack of time, lack of interest or absence of any responsible person (Pharmacist). Response rate was 76.7%
Majority of the pharmacies are named as ‘Medical Hall’ (40%) while 28% pharmacies are named and functioning as ‘Medicose’. Only 4% medical stores are named ‘Pharmacy’ (Fig. 1). It seems pharmacists refrain from naming retail drug store as ‘Pharmacy’ to differentiate it from highly advertised ayurvedic and unani treatment centres like ‘Hero Pharmacy’, ‘Sablok Pharmacy’ etc.
Fig. 1: Name of Pharmacy Preferred by Pharmacists
Most prescribed category of drug by physicians is antibiotic followed by analgesics (pain killers) and antacids respectively. Among antibiotics ofloxacin and cefixime were most prescribed. (Fig. 2)
Fig. 2: Antibiotics Prescribed by Physicians
68% respondents dispensed same brand of medicine that had been prescribed while rest of the respondents substitute the brand if prescribed brand is not available. Among them only 8% respondents consult the prescriber before substituting the brand while 24% respondents dispense a substitute of brand without consulting the prescriber.
Fig. 3: Substitution of Brand by Pharmacist
Sanitary napkins and diapers were the most prominently displayed items in show window followed by bandages and baby foods respectively. (Table 1 and Fig. 3)
Table 1: Products Displayed Prominently
|Serial no.||Product displayed prominently||Drug Store (%)|
|2||Vicks & Strepsil Lozenges||14%|
|3||Horlicks , Complan etc boxes &pouches||16%|
|4||Sanitary Napkins &Diapers||47%|
Fig.4: Products Displayed Prominently
Location of Pharmacy plays a considerable role in sales of the pharmacy. It was observed that 68% pharmacies were located in the vicinity of a hospital or a big nursing home. Most of the pharmacies (except computerized shops) issue authorized bill only on demand. 32% pharmacies were found to be larger in area than that prescribed in Drugs and Cosmetics Act 1940 and Rules 1945. 24% of the pharmacies surveyed were excellent in appearance. About 36% community pharmacists contacted counsel the patient on ‘How to take medicine’ and ‘Duration of therapy’.
Almost all of the pharmacists contacted were of the view that about 40% customers visiting their shops fill full prescription while others ask for only part filling of prescription due to lack of money or high cost of medicine or anticipation of adverse effect of medicine on body .
We were surprised to observe that none of the community pharmacist on the pharmacies surveyed was wearing apron. It was also observed that State council Registration Certificate of Pharmacist was not displayed prominently on the premises of any pharmacy.
Standard of a profession largely depends on the performance of persons practicing it. Through our work we made an attempt to assess the working of community pharmacists. While it is heartening to note that all community pharmacies approached for study were manned by qualified pharmacists it is sad that only 36% community pharmacists performed the responsibility of counseling the patients. We strongly recommend that instead of engaging in unfair trade practices of offering discounts to customers and incentives to physicians, pharmacist should start counseling the patient. It will not only help improving the image and status of pharmacist in the eyes of general public but chances of medication errors, drug interactions and adverse drug reactions will be reduced. As a result pharmacist will gain professionally, personally and economically.
- Community pharmacist should be strictly instructed to wear apron while in Community pharmacy so as to look professional and patient could easily identify him as the person to be consulted for advice on medicine.
- 2. Registration certificate of community pharmacist should be prominently displayed on Pharmacy.
We thankfully acknowledge the contribution of Late Mr Ravi Ghalot who not only helped in selection of community pharmacies for study but also visited community pharmacies along with investigator for collection of relevant data. Mr Ghalot unfortunately died in a tragic accident during the period of study.
- Helper CD and Strand LM, Opportunities and Responsibilities in Pharmaceutical Care, Am J Hosp Pharm, 1990;47: 533-543
- The Role of Pharmacist in the Health Care System, WHO Consultative Group.1993; 16-19
- FIP Standards, fip.org
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