DEVELOPING PHARMACY PRACTICE. A FOCUS ON PATIENT CARE
Wiedenmayer K, Summers RS, Mackie CA, et al.
WHO. HANDBOOK - 2006 EDITION. 11 novembre 2006


Il ruolo del farmacista negli ultimi anni si sta modificato in modo sostanziale, dall'originale attenzione alla dispensazione delle medicine verso un'attività più completa che comprende anche l'appropriatezza della cura del paziente.
In questo volume l'Organizzazione Mondiale della Sanità presenta alcune definizioni di buona pratica in farmacia in differenti contesti, descrive un approccio stepwise alla cura farmaceutica, all'interno del contesto della medicina generale. Inoltre sottolinea il valore di riferimento appropriato della farmacia nella gestione sanitaria complessiva del paziente.

INTRODUZIONE DEL VOLUME
Over the past four decades there has been a trend for pharmacy practice to move away from its original focus on medicine supply towards a more inclusive focus on patient care.
The role of the pharmacist has evolved from that of a compounder and supplier of pharmaceutical products towards that of a provider of services and information and ultimately that of a provider of patient care. Increasingly, the pharmacist's task is to ensure that a patient's drug therapy is appropriately indicated, the most effective available, the safest possible, and convenient for the patient. By taking direct responsibility for individual patient's medicine-related needs, pharmacists can make a unique contribution to the outcome of drug therapy and to their patients' quality of life. The new approach has been given the name pharmaceutical care. The most generally accepted definition of this new approach is: "Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life".
In adopting this definition in 1998, the International Pharmaceutical Federation (FIP) added one significant amendment: "achieving definite outcomes that improve or maintain a patient's quality of life".
The practice of pharmaceutical care is new, in contrast to what pharmacists have been doing for years. Because pharmacists often fail to assume responsibility for this care, they may not adequately document, monitor and review the care given. Accepting such responsibility is essential to the practice of pharmaceutical care.
In order to fulfil this obligation, the pharmacist needs to be able to assume many different functions. The concept of the seven-star pharmacist, introduced by WHO and taken up by FIP in 2000 in its policy statement on Good Pharmacy Education Practice, sees the pharmacist as a caregiver, communicator, decision-maker, teacher, life-long learner, leader and manager. For the purposes of this handbook, we have added the role of researcher.
The knowledge base of pharmacy graduates is changing. As these graduates move into practice, so pharmacy practice itself will change, to reflect the new knowledge base. However, pharmacists already in practice were mainly educated on the basis of the old paradigm of pharmaceutical product focus. If these pharmacists are to contribute effectively to the new patient-centred pharmaceutical practice, they must have the opportunity to acquire the new knowledge and skills required for their new role. To do this they must become life-long learners, one of the roles of the new pharmacist.
This handbook is designed to meet these changing needs. It is intended for use not only by pharmacists and interns who already practice in patient care settings, but also by educators and new students - the pharmacists of tomorrow - in countries throughout the world.
To reach as wide an audience as possible, the handbook will be available both in electronic form and in print. The aim throughout is to make it interactive and provide suitable "model" responses, so that it can also be used for self-assessment. It contains a wide variety of illustrative case studies in order to meet the needs of different users. It is designed to guide learners towards specific end-points, enabling them to carry out a task which requires a combination of knowledge, skills and attitudes. These end-points are reflected in the learning objectives provided at the beginning of each section. The handbook has been reviewed by all targeted groups in a wide variety of settings.
Chapter 1 Considers some definitions of good pharmacy practice in different contexts. Underpinning them all is the concept of the seven-star pharmacist.
Chapter 2 Presents a stepwise approach to pharmaceutical care, within a general practice environment. It also stresses the value of appropriate referral in overall patient care.
Chapter 3 looks at the need to assimilate and manage information and new developments, some trends in evidence-based practice, and the use of guidelines to inform medicine selection within specific contexts. The importance of patient beliefs, preferences, knowledge, rights and choices is also emphasized.
The overarching message of this handbook is that there is an important and rewarding professional role for pharmacists beyond pharmaceutical product supply and management. The pharmaceutical product should be seen not as an end in itself - as often emphasized in pharmaceutical education and practice - but rather as a means to an end. Where medicines are used for the greatest possible benefit of each individual patient and of society as a whole, this will result in improvements in health as well as cost savings. New pharmacists should have the knowledge and skills needed to take up their new role and responsibilities and to function as collaborative members of the health care team.

References
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2. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990;47:533-43.
3. The role of the pharmacist in the health care system. Preparing the future pharmacist: Curricular development. Report of a third WHO Consultative Group on the role of the pharmacist, Vancouver, Canada, 27-29 August 1997. Geneva: World Health Organization; 1997. WHO/PHARM/97/599. Available at: http://www.who.int/medicinedocs/