Scope of Contemporary Pharmacy Practice: Roles, Responsibilities, and Functions of Pharmacists and Pharmacy Technicians-Executive Summary
Nicole Paolini and Michael J. Rouse
This is the executive summary of an article commissioned by the Council on Credentialing in Pharmacy (CCP), which provides an overview of current pharmacy practice, its range of services, and the role of pharmacy technicians. The complete article is available open access at www.pharmacycredentialing.org/ccp/Contemporary_Pharmacy_Practice.pdf.
Health care delivery in the United States
In the United States, pharmacists constitute the third largest group of health professionals, after physicians and nurses,1, 2 and have been rated the most trustworthy and accessible.3, 4 However, health-system resources are stretched and, overall, not efficiently utilized. The number of errors (including medication errors) increases as patients encounter multiple providers and multiple levels of care. In addition, many new therapies require intensive monitoring and are extremely individualized. Also, patients must be competent to access available pharmaceutical information. Also, patients from different backgrounds have different perceptions of their disease and medications, which affect their treatment outcomes. Medication therapy management is a partnership of the pharmacist, the patient or caregiver, and other health professionals to promote the optimal use of medications. As the pharmacist obtains accurate disease and medication histories, he or she achieves an understanding of the primary medical problem, co-morbidities, and pharmacologic effects of the patient's medication regimen.
Training and credentialing
Today, pharmacists' education revolves around three broad outcomes: patient care, systems management, and public health. Since 2000, Doctor of Pharmacy (PharmD) students are required to complete at least six years of postsecondary education, up from the five years required previously. This change allows increased clinical training, ensuring that pharmacists are appropriately prepared to collaborate with physicians, nurses, and other health care professionals. These three main outcomes align with the five core competencies identified by the Institute of Medicine: (1) delivering patient-centered care, (2) working as a part of interprofessional teams, (3) practicing evidence-based medicine, (4) focusing on quality improvement, and (5) using information technology.5
Domains of pharmacy practice
Most pharmacists work in patient care settings. The services provided by pharmacists in such settings - the focus of this paper - can be further differentiated by the scope and complexity of care provided, reflecting different societal needs for pharmacy services. The majority of pharmacists in patient care roles can be described as "generalist practitioners;" they serve a wide variety of patients with medical needs ranging from minor ailments to more complex conditions. Their typical practice settings are community and hospital pharmacies.6-9
In recent years, states have expanded the scope of practice and responsibilities of pharmacy technicians and now require technicians to have more extensive training. Pharmacy technicians work in community pharmacies, hospitals, the armed forces, home health care, long-term-care facilities, prescription mail-order services, managed health care facilities, and educational or training programs. New responsibilities include handling restricted, investigational, and chemotherapy drugs and increased involvement in third-party payment.
The evolution in pharmacy practice has presented opportunities for pharmacists to perform nontraditional services. New postlicensure training and credentials support and enhance the competence of practitioners. New roles and responsibilities for pharmacy technicians allow them to better support pharmacists in the delivery of pharmacy services. CCP presents this material to describe where pharmacy is today and what pharmacy practice will look like in the future.
Nicole Paolini, Pharm.D., CDE, is Clinical Assistant Professor, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY. Michael J. Rouse, B.Pharm. (Hons), M.P.S., is Assistant Executive Director, International and Professional Affairs, Accreditation Council for Pharmacy Education, Chicago, IL.
Address correspondence to Marissa Schlaifer, B.S.Pharm., M.S., Secretary/Treasurer, Council on Credentialing in Pharmacy, c/o Academy of Managed Care Pharmacy, 100 North Pitt Street, Suite 400, Alexandria, VA 22314.