E-DRUG: Re: Trust (cont)

[Timothy Dodd <Cath_and_Tim_Dodd@compuserve.com>]

E-DRUG: Trust (cont)
--------------------

Dear E-druggers,

There has been some debate about 'trust' in association with the provision
of pharmaceutical care.

It is helpful to remind ourselves of the definition of 'pharmaceutical
care'.  This was developed almost one decade ago by Doug Hepler & Linda
Strand in a seminal paper in Am J Hosp Pharm entitled 'Opportunities and
responsibilities in pharmaceutical care' (Hepler CD, Strand LM. Am J Hosp
Pharm. 1990; 47:533-43).  A paper, incidentally, that everyone who calls
themself a pharmacist should read.  They defined Pharmaceutical Care as:

"The responsible provision of medicine therapy for the purpose of achieving
definite outcomes that improve a patient's quality of life.  These outcomes
are cure of a disease, elimination or reduction of symptoms, arresting or
slowing of a disease process, or prevention of a disease or symptoms. "

They went on to say, amongst other things, that "pharmaceutical care is
provided for the direct benefit of the patient and the pharmacist is
responsible directly to the patient for the quality of that care".

This definition has been adopted by many pharmacuetical societies across
the world.

My point is that there are some very important words in this definition. 
Words that identify the reason for medicine provision in terms of a clear
therapeutic objective, but perhaps the most important is the word
'responsible'.  In the provision of care the pharmacist is responsible and
not only that but responsible to the patient.  It the duty of the
pharmacist in the provision of that care to ensure that the patient is
capable of sharing in that process as, at least, an equal partner, so that
the patient is capable of determining the extent to which the pharmacist
has complied with their professional obligation.  That is what provision of
pharmaceutical care is all about and embody the basic retaionship of trust
that is required to ensure effective care.

I fully appreciate that there are pharmacists who do not discharge their
obligations as well as might be wished.  It the duty of the other
pharmacists in the form of professional societies who must ensure that
these behaviours are changed.  Mechansims such as peer review, education
and information, defined and published standards of practice, and
development of laws and sanctions are all available to effect such changes.

Tim Dodd
Training Advisor, Ghana National Drugs Programme
Email: Cath_and_Tim_Dodd@compuserve.com
 
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