The most well-known definition for pharmaceutical care came from Doug Hepler and Linda Strand in their article ‘Opportunities and responsibilities in pharmaceutical care’ from 1990. This was a landmark paper because it marked the start of the international movement to make pharmaceutical care more visible, and get the term and the type of care implemented in hospital and community pharmacy practice. During the following years both authors worked to make the concept applicable in practice. The definition reads: ‘Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve the patients’ quality of life’.[1]

 

Another definition reads: Pharmaceutical care is the direct or indirect responsible provision of drug therapy for the purpose of achieving the elimination or reduction of a patient's symptoms; arresting or slowing of a disease process; or preventing a disease.

 

In 2013, a European organization, the Pharmaceutical Care Network Europe (PCNE), created a new definition that could satisfy experts from a multitude of countries. After a review of existing definitions, a number of options were presented to the participants and in a one-day meeting consensus on a definition was reached.

 

‘Pharmaceutical Care is the pharmacologist/pharmacist’s contribution to the care of individuals in order to optimize medicines use and improve health outcomes’.

 

The ultimate goal of pharmaceutical care (optimize medicines use and improving health outcomes) exists in all practice settings and in all cultures where medicines are used. It involves two major functions: identifying potential and manifest problems in the pharmacotherapy (DRPs), and then resolving the problems and preventing the potential problems from becoming real for the patient and his therapy outcomes and a good follow up strategy. This should preferably be done together with other health care professionals and the patient through a review of the medication (and diseases) and subsequent counselling and discussions. The roles of pharmacists have evolved from product oriented, dispensing of medications to more patient-focused services such as the provision of pharmaceutical care. Such pharmacy service is also becoming more widely practised in Malaysia but is not well documented. Therefore, this study is warranted to fill this information gap by identifying the types of pharmaceutical care issues (PCIs) encountered by primary care patients with diabetes mellitus, hypertension or hyperlipidaemia in Malaysia. Wermeille and colleagues [6] reported PCIs resolved by community pharmacists in collaboration with medical general practitioners (GPs). Other studies reported a significant reduction in HbA1c in community-based patients with diabetes provided pharmaceutical care by a pharmacist [7–12]. A systematic review conducted by Royal and colleagues [13] showed that pharmacist-initiated medication review was effective in reducing hospital admission by 36%. However, most of the studies on pharmaceutical care were conducted in countries such as Australia, the United Kingdom and the United States [6, 7, 14–20]. Studies in South East Asia are scarce and therefore, this study is warranted to fill the information gap by identifying the types of PCIs encountered by primary care patients with diabetes mellitus, hypertension or hyperlipidaemia in Malaysia. This study was part of a large controlled trial called the Cardiovascular Risk Factors Intervention Strategies (CORFIS) trial. The CORFIS trial was a community-based, multicentre trial which compared the impact of collaborative intervention by various healthcare professionals (GPs, pharmacists, dietitians and nurses) to usual standard care on patients with diabetes, hypertension or hyperlipidaemia. All the patients in the intervention group of the CORFIS trial were included in this part of the study. Patients in the control group were not included in this part of the study because under the usual healthcare practice in Malaysia, patients who seek treatment in GP clinics obtained their medications from the clinic itself and do not have to see a pharmacist. The study was approved by the Medical Research Ethics Committee of the Ministry of Health Malaysia.

 

Last Updated on: Nov 27, 2024