September 23, 2011

According to the U.S. Bureau of Labor Statistics, there were approximately 217,000 licensed pharmacists in the United States in the year 2000, representing the third largest health care profession (following nurses and physicians). While pharmacists traditionally are known to dispense medications, many are becoming more involved in drug therapy decision-making and patient counseling. Some specialized pharmacists function as primary care providers. All states require pharmacists to have a license to practice pharmacy. To obtain a license, one must complete an internship under a licensed pharmacist, graduate from an accredited college of pharmacy, and pass a state licensure examination.

In 2000, 82 colleges of pharmacy were accredited to confer degrees. Pharmacy programs grant the degree of Doctor of Pharmacy (Pharm.D.), which requires at least 6 years of postsecondary study as well as passing the state licensure examination. The Pharm.D. degree has replaced the Bachelor of Science (B.S.) degree, which will cease to be awarded after 2005. Approximately 70% of first-year pharmacy students are women and 13% are of minority groups.

The job opportunities available for pharmacists are extensive, ranging from community or retail pharmacy to basic science research in a laboratory. Traditionally, pharmacists either worked in a retail store, whether it be a chain or independent pharmacy, or in a hospital; however, they may also work in industry, academia, or as a primary care provider. Still other graduating pharmacists will go on to do residencies and specialty fellowships.

The primary role of the pharmacist is to provide pharmaceutical care. Modern pharmacists are responsible for the outcomes from the use of medication and are to ensure that the treatment administered improves the quality of life for patients. Pharmacists are well trained in pharmacology and therapeutics, as well as in pharmacokinetics, pharmacodynamics, and drug-drug interactions. The provision of pharmaceutical care involves various functions. One of the vital functions a pharmacist performs is a review of patient profiles by seeking to identify an indication for each medication that a patient may be receiving. Once the indication has been ascertained, the pharmacist determines if each medication is appropriate for the indication, in which case the dose and dosing interval are evaluated. Next, the entire medication profile is assessed to identify potential drug-drug interactions that may hinder the patient from achieving the desired therapeutic effect. One takes into account any gender and ethnic issues that may result in metabolic or pharmacodynamic concerns as well as the patient-specific kidney and liver functions. This is because the liver and kidney are the primary organs that break down and remove most drugs from the body and the prescribed medications may be ineffective or toxic in the event that the liver and kidney exhibit poor function. Taken together, the above steps represent the process of pharmaceutical care.

Pharmacists have other roles as well. For example, they play a critical role in improving patient adherence to their prescribed medications. Nonadherence has long been cited as a major reason for the lack of effect of medications. Since the pharmacist is often the last person to see the patient before they take their medications, especially in the retail setting, they are in an excellent position to advise and aid adherence to prescribed medication regimens and to intervene on the patient’s behalf if problems exist. Adherence may be improved by educating patients about medications and the conditions being treated. An assessment of the patients’ needs should be made to include the proper use of aids that are appropriate for language, readability, and font size (especially for the elderly).

Within a few years, there will likely be a critical shortage of pharmacists. Employment opportunities for pharmacists are expected to grow faster than the average of all occupations through 2010. This is largely due to the increased pharmaceutical needs of a growing elderly population and greater use of medication. Other factors include scientific advances, new development in genome research and medication distribution systems, and consumer’s desire for more drug information. By 2020, it is estimated that there will be a shortfall of 157,000 pharmacists. This is in part due to the aging population and the increase in health care services for this group but also due to other health care issues including the increased prevalence of chronic diseases, the complexity and number of medications available, the increased emphasis on primary care, home health care, and long-term care, and also concerns regarding cost containment. While new pharmacy schools have opened in recent years it is unclear if they will be able to fill the projected void between supply and demand. The role of the pharmacist will continue to evolve as changes in health care demand.

SEE ALSO: Disability, Morbidity

Suggested Reading

  • Schumock, G. T., Butler, M. G., Meek, P. D., et al. (2003). Evidence of the economic benefit of clinical pharmacy services: 1996-2000. Pharmacotherapy, 23(1), 113-132.


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