Global Trends in Pharmacy

Introduction

In parallel with industrialization, the focus of pharmacists' practice has evolved from compounding and dispensing medications to the provision of professional services for patients.

As experts in medicines, pharmacists can review complex medicine regimens and identify causes of problems and resolve them.

Prevention in Public Health

Pharmacists play a crucial role in primary healthcare, offering services like disease risk assessment, screening, patient education, patient referrals, medication reconciliation and medication optimization for noncommunicable diseases like cardiovascular conditions, asthma, chronic obstructive pulmonary disease and diabetes mellitus.

Most community pharmacies routinely provide preventive services like blood pressure, glucose and lipid screenings.
Additionally, pharmacists in many countries, including the United States, UK and Australia, are empowered to administer vaccines, improving accessibility and reducing healthcare system strain.

Minor Illness

Minor ailments schemes in the United Kingdom allows patients eligible for free National Health Service (NHS) prescriptions to go directly to pharmacies and request medicines.

Watson et al. (2015) showed that NHS costs were significantly lower when patients were treated for minor ailments through community pharmacies. Symptom resolution and improvement in quality of life were found to be the same as in general practice (GP) or emergency room.

On 31 January 2024, the UK launched the Pharmacy First scheme, allowing patients to get treatment for seven common conditions directly from their local pharmacy, without needing a GP appointment or prescription.

These conditions include sinusitis, sore throat, earache, infected insect bite, impetigo, shingles and uncomplicated urinary tract infections in women.
Pharmacists can issue prescriptions for antibiotics or antivirals where necessary.

NOTE: Prescribing by pharmacists is an established component of practice in several countries including New Zealand, UK, Switzerland, Canada and some states in the USA. The extent of what is allowed varies between countries and states.

Medication Review

Australia has a well-established government-funded model that supports the provision of medication review in primary. There are 2 established programs:

Home medicines review (HMR)
Residential medication management review (RMMR)

Technology Advancement

Technology is rapidly transforming the way pharmacy operates, bringing about significant changes in how prescriptions are handled, patient data is managed and care is delivered remotely.

Following successful trials in 2023, UK citizens can now use the NHS App to view their prescriptions nationwide.
At Malaysia, the national Electronic Medical Records (EMR) system is targeted for a nationwide rollout by 2026 to ensure a better and seamless delivery of services to patients at public healthcare facilities.
MyUBAT mobile application was developed by Malaysia government to make it easier for patients to apply pharmacy value-added services from government healthcare facilities without the need to come to the pharmacy counter.
Telepharmacy allows patients in remote areas or with mobility limitations to consult with pharmacists remotely.

Summary

Despite advancements, challenges persist.

Restrictive laws and regulations hinder innovation and expansion of services.
Lack of remuneration (payment) structure for new services disincentivizes pharmacists from offering them.
Limited patient's knowledge on self-management can impact adherence and outcomes.

Remember, when we are expected to do more for less, the practice becomes unsustainable.

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