Short Essay on the Future of Dispensing Pharmacy

In view of the highly Specialised and responsible nature of the job, a pharmacist throughout the world has been entrusted with the handling of drugs and most countries have enacted laws to give protection to the society. In India Pharmacy Act 1948 and the Drugs and Cosmetics Act 1940 and Rules, 1945 regulate the profession of pharmacy and dispensing of medication.

With changing times, compounding of drugs is being gradually replaced by manufactured drugs on the following grounds:

1. Advances in pharmaceutical technology of dosage forms have rendered compounded medication almost obsolete both for scientific reasons and convenience.

2. Increase in the number of in-patients and ambulant patients have forced the pharmacist to over-the-counter (OTC) dispensing.

3. Patient psychology has undergone changes with time. Previously a patient felt convinced that a “coloured” mixture or liquid preparation was the answer to his ailment but today unless he is given a costly prescription embodying an injection etc, he underrates the prescriber and the medication.

4. There is an acute shortage of qualified pharmacists all over the world and in course of time supply of manufactured drugs has evolved as the substitutes of traditional dispensing.

Increasing population and awareness of health matters have contributed to an increase in the number of prescriptions thus making the task of a pharmacist more difficult if he. sticks to compounding individual prescriptions.

5. Solid dosage forms like tablets and capsules which are difficult to prepare at the dispensing counter are preferred by the patient and the physician over liquid dosage forms for obvious reasons.

6. A pharmacist’s role in the health care team is better recognised today. It has been accepted that he is the expert on drugs. This means a departure from the conventional role of a compounder/dispenser. Today he advises the physician on dosage forms, dosage regiment, side effects, bioavailability and drug interaction.

7. A compounded dosage form can not be subjected to quality control whereas manufactured products are subjected to such a testing and therefore considered more reliable.

The paradigm shift from compounded to manufactured products will be more prominent in course of time and greater emphasis is likely to be placed on unit-dose dispensing systems, which appear to be an answer to manifold problems. The following are some advantages attributed to unit-dose dispensing system.

1. Patients receive improved pharmaceutical service 24 hours a day and are charged for only those doses which are administered to them.

2. All doses of medication required at the nursing station are prepared by the pharmacy thus allowing the nurse more time for direct patient care.

3. Allows the pharmacists to interpret or check a copy of the physician’s original order thus reducing medication errors.

4. Eliminates excessive duplication of orders and paper work at the nursing station and pharmacy.

5. Eliminates credits.

6. Transfers intravenous preparation and drug reconstitution procedures to the pharmacy.

7. Promotes more efficient utilization of professional and non-professional personnel.

8. Reduces revenue losses.

9. Conserves space in nursing units by eliminating bulky floor stock.

10. Eliminates pilferage and drug wastage.

11. Extends pharmacy coverage and control throughout the hospital from the time the physician writes the order to the time the patient receives the unit-dose.

12. Communication of medication orders and delivery systems are improved.

13. The pharmacists can get out of the wards where they can perform their intended function as drug consultants and help provide the team effort that is needed for better patient care.

The removal or withdrawal of a single dose from a drug container and its administration to a patient on the order of a physician or dentist is purely a nursing function and this has to be viewed quite distinctly from the act of dispensing which is the exclusive domain of a pharmacist.

Till the unit-dose dispensing becomes universal it may be advisable to adopt pre-packaging in hospitals. Thus pharmacist will be performing the compounding function to the least extent and dispensing function will be in the form of pour and count and handover.

In course of time a pharmacist will be required to dispense radiopharmaceuticals and the pharmacists must prepare themselves to discharge this function.

To keep pace with the modern developments and in order to facilitate the dispensing function, it will be a common practice to make use of electronic data processing machines and computers etc. Use of appropriate software and websites would eliminate chances of prescription errors, would facilitate information on drug-drug, drug-food and drug-excipient interactions; as well as irrational combinations, banned drugs and drug combinations.

However, the pestle and mortar on traditional basis may retain its importance as the symbol of both dispensing and the dispenser.