Pharmacists' Role in Healthcare Still Evolving

Charlotte A. Kenreigh, PharmD; Linda Timm Wagner, PharmD


November 03, 2006

In This Article

A Revolution in the Making

The practice of pharmacy has changed significantly in recent years. In the 1950s, pharmacists' responsibilities centered around dispensing and compounding drugs, and they rarely communicated with patients about their medications or disease processes.[1] With the introduction of "clinical pharmacy," however, the pharmacist's attention began to shift from the medication itself to the interaction between the patient and the medication. Today, the pharmacist's role in many practice settings has expanded to include not only dispensing functions, but also direct contact with patients and other providers.

This changing vision for the practice of pharmacy got an important boost in 1990, when Hepler and Strand[2] coined the term "pharmaceutical care." Over the next decade, it became a buzz word promoted by pharmacy organizations. Pharmaceutical care embodies a patient-centered, outcomes-oriented practice of pharmacy. This practice model promoted the pharmacist as a key member of the healthcare team, with responsibility for the outcomes of medication therapy.

The emergence of the pharmacist's patient-centered role was reinforced in 2000 when the American College of Clinical Pharmacy issued a white paper, "A vision of pharmacy's future roles, responsibilities, and manpower needs in the United States."[3] Two other major pharmacy organizations, the American Pharmacists Association (APhA) and the American Society of Health-System Pharmacists (ASHP), also have launched initiatives designed to support an expanded role for the pharmacist and to increase recognition of the profession.

And yet, many pharmacists complain that this transformation is not happening quickly enough, or going far enough. On discussion boards and blogs, as well as in private conversations, pharmacists note practice realities that seem to contradict the change in practice promoted by pharmacy leaders. As in many other professions, achieving true change has been a challenge, and many barriers still remain to be overcome.

The ability of pharmacists to provide true "pharmaceutical care" hinges on the redesign of the traditional pharmacy environment and services, according to the APhA, one of the largest professional pharmacy organizations.[4]The group has called for such "revolutionary changes" as private consulting areas in pharmacies and pharmacist house calls. In fact, the APhA describes its mission as "adding value" to the pharmacist license via expanded patient services.[5] Pharmacists are encouraged to provide new and innovative services such as immunization clinics, emergency contraceptives, and collaborative practice provisions for optimal medication therapy management.

"There are increasing numbers of opportunities for pharmacists to assume greater roles in helping patients make better use of their medications and achieve optimal therapeutic outcomes in both the public and private sectors," said Anne Burns, RPh, Group Director, APhA Practice Development and Research. "The effective use of automation and pharmacy technicians assists in freeing the pharmacist to have dedicated time for patient care delivery."

Similarly, ASHP has been working to improve pharmacy practice for hospital pharmacists, as outlined in its landmark initiative, "Health-system Pharmacy 2015." The program has 6 goals and 31 specific objectives to make medication use more effective, scientific, and safe.[6] The overarching goal is to raise the profile of the pharmacist from a quiet but valuable member of the healthcare team to a more visible and vital component of patient care. The specific goals were designed to reflect a realistic assessment of what could be accomplished by 2015.


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