The Role of Pharmacist in Public health
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What is public health?

Public health can be defined as “what we in term of society do to persuade the conditions in which people can be healthy.” It is not about medicine, but it also “emphasizes” the prevention of disease and the needs of the population health as a whole.

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What are Public health services?

Public health services occur on two measures: the macro measures and micro measures i.e., planning and the implementation of planning, respectively.Macro-level public health measures target on the health of the population as a whole. These services include identification of health-related community problems with community representatives, planning community health programs and policies, administering and evaluating community health promotion programs, educating the community about public health, and researching and publishing facts about public health actions. All these activities are exercised by public health professionals of different backgrounds.Micro-level public health measures consist of the activities necessary to execute public health plans. These services are carried out on a “program-to-population or a provider-to-patient basis”. For examples; the screening of diseases, tobacco-cessation programs immunization programs, and counseling for at-risk populations.

The overall concept beneath these so many public health activities is prevention, which can be categorized into three types: primary prevention secondary prevention and tertiary prevention i.e., reduction of the occurrence of diseases, decrease the progression of the disease, and treatment of disease to return the initial state respectively.

What should be the public health activities of a Pharmacist?

In 1981, the role of the pharmacist in public health is defined by the American Public Health Association (APHA). This association outlined that the role of the pharmacist is now escalating beyond the dispensation and distribution of medicines, and health supplies. Today, the administrative, and public health functions are also included in the services of pharmacists. Now, it becomes more patient-oriented. A pharmacist can provide many services to public health that may include pharmacotherapy, provide care, and prevention measures. A pharmacist has an available resource for health and medication information apart from dispensing medicine. Due to valuable placement of pharmacists in the clinical community, the integration of public health custom into pharmaceutical care, and pharmacological training is indispensable.

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The public health services that an individual pharmacist performs will depend on the abilities, experience, training, and work methodology. APHA believes that all pharmacists can contribute to the promotion of public health by working alone or in cooperation with health care colleagues and administrators. The following are the other activities where pharmacists can play an important role to promote public health:

1. Population-based Care:

The Center for Advancement in Pharmaceutical Education (CAPE) Educational Outcomes suggested that pharmacists should involve in both patient-based and population-based care. In the past twenty years, the health-system pharmacists can support public health efforts using designing and providing disease management programs. The health-system pharmacists with their health care colleagues can contribute to population health care using tools such as medication-use evaluation, evidence-based disease management programs that are planned according to the needs of the served institutions and communities. Health-system pharmacists can involve in quality reviews by which they assure that evidence-based treatments are used for all patients to help assuage population health care.

2. Prevention of Disease and Medication Safety:

A pharmacist can be indulged in the prevention and control of disease in a many ways. They can help in the establishment of some screening programs to check out the status of immunization, and identification of some undiagnosed medical conditions. The federal government’s Healthy People 2010 initiative is also outlined the role of health-system pharmacists in medication safety and error prevention. These practices can reduce the number of hospital admissions due to reasons for drug therapy mismanagement and counterfeit medications. Medication reconciliation programs are one of the vital tools with which pharmacists can achieve these goals.

3. Health Education:

The development of programs on the safe and effective use of medication, and other public health-related topics, such as exercise, healthy nutrition and tobacco cessation, is also an important area where pharmacists play their role. The education and training programs are beneficial for public health care if they start on at an early age, such as school health programs, which help in the development of good health behaviors in children that can continue into adulthood also. Pharmacists should support these types of school health programs. Furthermore, health-system pharmacists can educate their health care colleagues about the safe and effective use of medication that further improves use of medications. The pharmacists can also educate community leaders like public office holders, legislators, school officials, regulators, and religious leaders who involve in public health customs.

4. Public Health Policy:

Health-system pharmacists can participate in the development of public health policy concerned with local boards of health as well as national programs. Drugs are the central part of health systems. Hence, the health policy, especially policy targeted for chronic disease, must be prepared with better consideration of drug therapy as well as factors affecting the disease outcomes. The role of Health-system pharmacists in emergency planning and service delivery of specialized pharmaceuticals like antidotes, vaccines, and antibiotics is critical. APHA also outlined the role of health system pharmacists as assistant in procuring, distributing and dispensing emergency supplies of pharmaceuticals, medications and immunization products and managing the drug therapy of individual victims with National Disaster Medical System assistance teams, the National Pharmacy Response Team or local units of the Medical Reserve Corps. Pharmacists, as medication-use experts, should also work in the assistance of health-system administrators to develop policies for the best management practices in the proper handling and disposal of hazardous drugs.

5. Research and Training:

A health-system pharmacist must get adequate education and training to carry out his responsibility in public health. Health-system pharmacists should be expertise in pharmacoepidemiology, research methodology, and biostatistics with their applications in decision related to public health. He should have an understanding of the design, conduct, and interpretation of clinical studies. Health-system pharmacists should participate in collaborative research and serve on data monitoring and safety committees, institutional review boards, and expert medication advisory committees. Moreover, the research fellows need exposure to research in public health policy, pharmacoeconomics, pharmacoepidemiology, and evidence-based medicine for experimental and instructive training. Health-system pharmacists should also work in collaboration with public health policymakers, governmental agencies, medical centers, and academic institutions to promote optimal pharmacotherapy.

Future Aspects

The revolutionary progress in biomedical sciences, including stem-cell biology, human genomics, biomedical engineering, immunology, and bioinformatics, open the door to provide information for the betterment of human health. New technology and practices such as population genetics and pharmacogenomics will allow reduction in failures of treatment and prevent adverse drug reactions using the proper appliance of pharmacogenetic principles. Health-system pharmacists will need to apply these new tools not to get better patient-specific pharmacotherapy but to progress public health. Health professionals, as well as the legislators, will require education and training about the safe use of new medication delivery technologies.

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Dr. Shilpi Chauhan

(Assistant Professor)