The use of medicines is the most common intervention
in healthcare. As a consequence this puts the pharmacist at the heart of patient care and presents both opportunities and responsibilities.
Opportunities include direct patient contact and the
chance to understand the patient in the context of their own background, guide the
choice of therapeutic selection or formulation and provide appropriate,
personalized support to facilitate patient medication adherence.
But medicine use also has a down side. It has the
potential to be fraught with problems that include complexities of selecting the most
appropriate medicine,dose selection and administration, medicine formulation
and stability, the
potential to interact with other medicines, poor patient adherence and a changing harm-benefit risk profile.
As a consequence the mantra of promoting safe, appropriate
and cost-effective prescribing that respects patient choice and promotes
adherence is a continuous challenge. This is true whether we are students or
qualified pharmacists and requires a sustained enthusiasm to question and learn, and
a commitment to
continually update our knowledge and practice.
The emerging dimension that we also consider alongside the
patient focused approach is the public health perspective. No longer is it
acceptable to ignore the\ population based impact of any health care intervention whether this is linked to the inappropriate and wasteful use of healthcare resources
or involves overuse of
a given medicine. This is well illustrated by the
restrictions we must now place on the use of antibiotics to prevent the emergence of
antibiotic-resistance to preserve their effectiveness for use in those most in
need.
Whether we practice in a patient facing setting, work in
public health or combine the two dimensions, the opportunity for pharmacy to make a
significant and valued
contribution to healthcare and society has never been greater. This is our challenge.
Roger Walker
Chief Pharmaceutical Officer, Welsh Assembly
Government, U.K.
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