Date sent: Fri, 25 Jul 1997

Can someone please help me?

I have heard that we should be talking about "pharmacy care" rather than "pharmaceutical care". Those who support this change seem to suggest that pharmacy care is something that only pharmacists can do whilst any appropriately trained person is able to practice pharmaceutical care. Does this mean that pharmacy care is confined to taking place in a pharmacy and is provided by all people within a pharmacy or only pharmacists within a pharmacy?

Our discussion on Pharmaceutical care seems to be generating lively debate.

Personally I am concerned that we retain this term to advance the professional aspirations of Pharmacy for five reasons;

1. 'Pharmaceutical care' describes what the patient receives and not what the pharmacist does. 'Clinical pharmacy' is what the pharmacist does and the settings in which the pharmacist conducts clinical pharmacy (i.e. community or hospital) do not seem to be relevant.

2. 'Pharmaceutical care' implies a system to which other professions contribute. It is a multidisciplinary quality system, which requires to be implemented through attention to effective co-operation between the various players and the transfer of information. The patient is a member and a player in that system with the right to be an active participant. The quality system only works when a feedback loop is in place, which links outcomes to the setting of expectations.

3. Pharmacists, ethically, cannot and should not be part of the delivery of medicines to patients without taking responsibility for the integrity and effectiveness of that quality system feedback loop.

4. There will probably never be enough pharmacists for pharmaceutical care activities to be conducted exclusively by pharmacists themselves. Nor is that exclusivity desirable…

5. Concepts of pharmacy or clinical pharmacy which cannot be shown to contribute to pharmaceutical care will become extinct sooner or later…

I submit for discussion that it follows from the above points that pharmaceutical care is not 'pharmacy care' nor is it 'clinical pharmacy', since it includes those concepts. I would like the focus of discussion to extend to ways of achieving pharmaceutical care in the various clinical settings. The rapid growth in communications technology allows pharmacists to develop this quality assurance concept and it allows us to target the direct patient care activities of the pharmacist selectively and more rationally.

I think that the possession of an accepted adjective describing a profession is a sign of social acceptance. Nurses have not quite got there yet, so they have to use nursing (a gerund) to describe their activities. Medical doctors however, have "medicine" to describe their trade, and medical as an adjective. Pharmacists however are still stuck with "pharmaceutical" to describe their activities when in fact we are not doing much pharmaceutics. "Pharmacal" would be the equivalent to "medical" but of course this is not a socially acceptable term. Pharmacy care sound less mouthful to me and the public would find it easier to relate. Of course, here we are actually using a noun in the function of an adjective. Enough grammar for today? Now let's go and do it!