PharmD Course in India - Prospects & Constraints

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Dear Member:

Reproduced below please find an article from Pharmabiz reflecting the state of affairs of community pharmacy in India. The initiative leading to commencement of PharmD course in India is all about improving the existing scenario vis-a-vis clinical, hospital and community pharmacy practice in India. In my earlier post I have cited an article on the decade long journey of pharmacy practice in India. Hope this sequel shall add up to the interest of our esteemed readers so that they respond and react to the observations made therein. Feedback is solicited from all learned members of the forum.

With regards

Dr. Geer M. Ishaq

Assistant Professor

Dept. of Pharmaceutical Sciences

University of Kashmir

Srinagar-190006 (J & K)

Ph: 9419970971, 9906673100

Website: http://ishaqgeer.googlepages.com

Myths about Indian community pharmacists

Wednesday, September 10, 2008 08:00 IST Subal C Basak and D SathyanarayanaSeveral misleading notions about community pharmacists are prevalent not only amongst laymen (i.e. non-pharmacists) but also amongst pharmacists, pharmacy academics and pharmacy professionals (both industrial and practicing). Many of these notions are no more than myths. The first of these myths is that India has the world's highest ratio of pharmacists to population. The second is that the quality of pharmacy education and practice is witnessing steady improvement. The third important myth is that the community pharmacist is an important member of health care system in India.The first myth is both - a statistical dexterity and misinterpretation of pharmacists registered in the state pharmacy council as "diploma pharmacists", "non-diploma pharmacists", "degree pharmacists", "postgraduate pharmacists" and

even "pharmacists with PhD degree". The results of this are indeed impressive. According to Pharmacy Council of India, there were 5,59,408 registered pharmacists in India in June 2003 and the figure is estimated to be around 7 lakh registered pharmacists in 2008, thereby achieving a ratio of 1 pharmacist per 1785 persons (about 5.6 pharmacists per 10,000 people against average of 4.3 in the industrialised countries). Pharmacists practicing in communityIn reality, the number of registered pharmacists does not reflect the number of those who are engaged in pharmacy practice in general and community pharmacy practice in particular. The number of pharmacists employed officially for community pharmacy service is much less, and does not exceed half of the total number of registered pharmacists due to migration, retirement and those work in other areas such as industry, research, academic, marketing and regulatory. An International

Pharmaceutical Federation (FIP 2006) study reports that 55% of the total registered pharmacists practice in community setting. Further, the actual number of pharmacists involved in practice is likely to be much less due to the fact that large numbers of community pharmacies do not have a pharmacist present at all. The supporting persons or drug retailers (i.e. pharmacy assistants) manage the pharmacies in absence of the registered pharmacists. Medicines are still being sold/dispensed by pharmacy assistants (illegally?) with little or no training.It is true that in the developing world, India does have the largest base in pharmacy education, and the largest absolute number of pharmacists, but this does not indicate standard of practice either in community or institution is improving and comparable to even some of the Asian countries. The minimum qualification for registration as a pharmacist is a pass in D Pharm. India is the only country with

qualification for registration as pharmacist remains 2 years of study with only 500 intern hours, much below the international requirements. The current regulations do not require pharmacists to periodically to update their knowledge and skills.Qualitative factor more importantThis qualitative factor becomes even more important, when the role and duty of Indian pharmacists is considered. This is second myth. The role of pharmacist in the developed nations has evolved from that of a supplier of medications towards that of a provider of services and information of medications and finally that of a provider of patient care. In order to achieve skills for providing patient care, the concept of seven star pharmacist introduced by WHO and FIP in 2000 to cover the following roles: caregiver, communicator, decision-maker, teacher, life-long learner, leader and manager. In India, consumers' (or patients) demands from pharmacists are straight

forward that medication is effective, safe, and affordable. Further what they expect from Indian pharmacists is to supply drugs according to rules with proper advice, is to advise patients on how and when the medicines to be taken, and is to advise what to do in case of adverse drug reactions and to provide advice on common ailments. It is undeniable fact that the community pharmacist has failed to provide all these patient oriented basic services. This is not to argue that pharmacists of India have low competence. Many, after graduation or post graduation, are working successfully as registered community pharmacists in the US. But the delivery of pharmaceutical services involves much more than individual merit. It has more to do with priorities needed for Indian scenario, clear objectives, coordination among various stakeholders and proper leadership. It is here that pharmacy practice in India is weak. Perhaps our curriculum (presently D Pharm) has

failed to change its focus from preparative and compounding pharmacy towards patient care.So far as the more important issue of provision of health care goes community pharmacist's image in India is somewhat between poor and abysmal. The community pharmacists are still struggling for their identity as health care professionals. The community pharmacists are branded as drug trader or drug seller by the public. The national health policy 2002 while declaring current levels of healthcare professionals, maintain a stoic silence about pharmacist. This shows that Government does not recognize the pharmacists as health care providers. The public (patients or consumers) view the drug sale in a community pharmacy same as the similar sale in a stationary shop. The perception of government toward pharmacists received a setback when in the year 2002, when a Government committee suggested review of the licensing conditions that there is no requirement of

pharmacists in distribution and sale of drugs. The Indian Public Health Standards formulated recently under the National Rural Health Mission does not lay much emphasis on the role of pharmacists as compared to other categories of personnel such as nurses and lab technician. The general public's perception is that anyone in our country can open a stationary shop and a medical store (i.e. pharmacy) also. Critics often argue why a pharmacist is necessary just to sell medicines from a community pharmacy. The only significant exception to this is chain pharmacies operated by well established corporate bodies, where pharmacists' presence behind the counter is well received. India faces massive challenges to provide health care for its vast and growing population. Obviously the myths are by no means unimportant. Despite many barriers, pharmacists' service is central to safe and effective medicines management in advancing health.(The authors are

Readers in Pharmacy, malai University, malainagar 608 002 TN)

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