Professional values in community and public health pharmacy
Published online: 29 August 2010 Ó Springer Science+Business Media B.V. 2010
Abstract General practice (community) pharmacy as a healthcare profession is largely devoted to therapeutic treatment of individual patients whether in dispensing medically authorised prescriptions or by providing members of the public with over-the-counter advice and service for a variety of common ailments. Recently, community pharmacy has been identiﬁed as an untapped resource available to undertake important aspects of public health and in particular health promotion. In contrast to therapeutic treatment, public health primarily concerns the health of the entire population, rather than the health of individuals (Childress et al. in J Law Med Ethics 30:170–178, 2002). Thus, an important question for the profession is whether those moral and professional values that are appropriate to the therapeutic care of individual patients are relevant and adequate to support the additional public health role. Keywords Pharmacy ethics Á Pharmacy values Á Public health pharmacy
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Transformation of many key aspects of the traditional prescription dispensing service. Recognition of patient care as being central to the whole ethos of pharmacy practice. Introduction of pharmacist independent prescribers A revised and extended role for pharmacists in patientoriented medicines management and aspects of public health.
Introduction The profession of pharmacy in the United Kingdom (UK) has undergone and continues to experience fundamental changes in its practice. These changes can be summarised as:
D. Badcott (&) Centre for Applied Ethics, Cardiff University, Humanities Building, Colum Drive, Cardiff CF10 3EU, UK e-mail: email@example.com
The drivers for these changes are due in part to revisions generated from within the profession itself (Harding and Taylor 1997), but to a large extent are a response to central government initiatives. These latter include plans for both a major overhaul of the provisions of the National Health Service and in more effectively promoting public health (See reports: Nufﬁeld Committee of Inquiry into Pharmacy 1986; Wanless 2002; Securing good health for the whole population 2004; Choosing health thorough pharmacy 2005; and, Pharmacy in England. Building on strengths— delivering the future 2008). A parallel to the changes, and one that has a strong bearing on the question of professional values is that pharmacy in the UK is evolving from a profession characterised largely by technical craft skills and medicines management to one that encompasses pharmaceutical patient care. The latter has been deﬁned as ‘the responsible provision of drug therapy for the purposes of achieving deﬁnite outcomes that improve the patient’s quality of life’ (Hepler and Strand 1990). The concept of pharmaceutical care that originated in the United States stems from a need to better employ pharmaceutical expertise to reduce the large number of adverse drug responses in clinical medicine, due either to inappropriate medication or lack of patient compliance (Hepler and Strand 1990). Additionally, a more patient-centred approach helps patients to meet
¨ agreed therapeutic goals (Bjorkman et al. 2008), encourages formation of an enduring bond or therapeutic relationship between patient and pharmacist (Strand 1998; Rogers 2009), and would appear to be an asset in progressing effective public health pharmacy initiatives (Schulz and Brushwood 1991; Kenreigh and Wagner 2006; Fassett 2007). Community pharmacies enjoy a high measure of public conﬁdence in health matters. Whilst not generally having the widespread and in-depth diagnostic skills of medical practitioners,1 pharmacists possess a substantial therapeutic skills base and...