The Blueprint for Pharmacy: Our Professional Role All Along!

On My Second Day of Pharmacy School I was Handed a Coiled book titled “Pharmaceutical Care.” Over my 4 years as a pharmacy student, I sat through countless lectures learning every major disease state known to man, including the pathophysiology, epidemiology, etiology, diagnosis, and of course the numerous drugs used to treat each condition. Most lectures were based directly on clinical practice guidelines that were required reading and which I immersed myself in nightly.

Beyond the lectures, I often sat with a small group of students going through cases of patients with specific disease states and working through the pharmaceutical care process. This involved reviewing all relevant patient information, including diagnosis, lab values, signs and symptoms, and medications. Our mission was to generate drug-related problems, establish desired clinical outcomes/endpoints, and then determine pharmacotherapeutic alternatives. After choosing the best solution and individualizing the therapeutic regimen, we implemented and designed a monitoring plan with appropriate follow-up.

I cannot tell you how many PAW (Pharmacotherapeutic Alternative Work sheets) charts I've engraved in my brain over the years, detailing a drug's indication, mechanism of action, efficacy, time frame, adverse effects, contraindications, and drug interactions. It is second nature for me to look at a patient's diagnosis and medications, identify drug-related problems, and resolve them using evidence-based decision-making. This has been my education over the past few years and now that I've graduated, my profession as a pharmacist will begin.

After reading the “Blueprint for Pharmacy,” ¹ I'm convinced that it outlines the pharmacy profession that I am designed to be in and for which my education, stated above, has prepared me. But the fact that the pharmacy profession in Canada is in need of change in order to meet the standards of my education is shocking!

I am educated to be a medication expert, who manages drug therapy and is responsible to patients for monitoring their drug therapy outcomes. Of all health professionals, pharmacists see the patient most often, enabling appropriate follow-up and ensuring monitoring of drug therapy. We do not need this blueprint to know we are in the best position to stop inappropriate use of medications and make sure medication use is safe and effective.

Have I have spent the last 4 years learning pharmacotherapeutic alternatives for every medical condition only to give a patient the drug that the prescription tells me to? I am indeed educated to prescribe the drug that is most efficacious for that patient's diagnosis based on clinical practice guidelines, which I have spent the last 4 years studying. Pharmacists, without question, have the background knowledge and skills required to initiate and modify drug therapy.

Over the past 4 years I've been educated and become passionate about using the pharmaceutical care process. The Blueprint for Pharmacy believes “Optimizing health outcomes by identifying, resolving, and preventing actual and potential drug-related problems; initiating or modifying drug therapy; and monitoring and evaluating response to drug therapy” is vital in changing the pharmacy profession in Canada. This is exactly what that coiled book handed to me the second day of school taught and what my education has been based on for the past 4 years — implementing the pharmaceutical care process. Are we forgetting that competency #1 of the Standards of Practice for Pharmacists states “Practise pharmaceutical care”? ²

How can any pharmacist or pharmacy stakeholder for one second doubt or question the implementation of the Blueprint for Pharmacy? The education a pharmacist receives and the resultant knowledge and skills enables any pharmacist to be competent in achieving every goal within the scope of this blueprint. Instead of looking at this blueprint as “changing the pharmacy profession in Canada,” how about realizing this was our professional role all along, one that our education prepared us for but the health care community and drug industry warped. It is disheartening that my 90 colleagues and I are entering a career in which our full potential cannot be used should this blueprint not be nationally accepted. It's time for pharmacists to take increased accountability and responsibility and use the knowledge and skills acquired through their extensive education to show the nation that “patient-centred, outcomes-focused care” is and always was the vision for pharmacy.