When I was a practicing pharmacist in the 1950s through the early 1990’s it was not uncommon to discuss the proper use of medications with a patient.  As a matter of fact, pharmacists actually waited on the patient and even if not requested, discussed the proper means of administration, possible side effects and drug interactions.  There was no internet around as a source for information.  Today, with the proliferation of busy chain and big box stores, pharmacists are not as accessible and are usually found isolated standing behind computers in the back of the store.  The current setup acts as a barrier to receive information.  While it is fair to say that a patient can ask the pharmacist for advice, it is less common than in the old days and fewer independent stores, if any, are around.  Even with this set up, patients should seek the knowledge and skills offered by pharmacists.  As such they can provide effective and accurate patient education and counseling.   One reason is that pharmacists are better educated than graduates of yesteryear.  Courses are offered today that were not available years ago, pharmacokinetics is one example.  Best of all, unlike other professions, the advice from a pharmacist comes without charge.  Most important, is that pharmacists can contribute to positive outcomes by motivating patients to follow their drug regimen and monitoring plans.

 Theoretically, pharmacists should know about their patient’s cultures, especially health and illness beliefs, attitudes, and practices.  A trained pharmacist will be aware of patients view on their own roles and responsibilities for decision making and managing their own care.  The pharmacist will assess a patient’s cognitive abilities, learning style, and sensory and physical status to provide the information that meets the patient’s needs. A pharmacist needs to determine whether a patient is willing to use a medication and whether he or she intends to do so.  Today, many pharmacists have a Doctor of Pharmacy degree (Pharm. D.), meaning that they have attended an accredited university for at least six years and serve time working as an apprentice in a drug store or hospital.   There are also continuing education requirements. It is a good practice to choose your pharmacist as you would your doctor.  For example, a well read pharmacist would be aware of new reports suggesting that patients take antihypertensive medicine at bedtime rather than in the morning to improve blood pressure control.  New clinical information is now readily available to disclose the best times to take other drugs as well.

Perhaps I am old fashioned but I am saddened by the loss of independents.   In 2011 there were 23, 106 independent pharmacies, by 2017 that number dipped to 21, 909 despite an increase in actual population growth. The number of independents is expected to fall below 20,000 before 2025. Many large retailers are making attractive offers to independent owners to sell their businesses and many independent operators are older and looking for an exit, while younger pharmacists are less attracted to the risk and return of ownership. Pill Box pharmacy here in Warsaw has addressed some of that loss by setting up a satellite or telepharmacy in Albion,  a town without a drug store.  It was the first of its kind in Indiana and required a new state law to allow that to happen.  The Albion location is deemed a remote dispensing facility, set up like a normal pharmacy.  Albion was without a pharmacy since December, 2006, when CVS transferred all of the prescription files to a store in Kendallville and closed.  Pill Box will use image capture and real time video conferencing to bring retail pharmacy back to Albion.  Using telepharmacy software Pill Box will share a full time pharmacist between two locations, giving the residents of Albion access to his or her counseling and the services of a pharmacy technician.  The technician makes an original prescription available to the pharmacist here in Warsaw by placing it in view of the video communication system or by scanning the prescription into the shared electronic record keeping system.  The new technology stores all of the transaction and helps to minimize the possibility of errors. Patient counseling is mandatory when new drugs are dispensed.

Final thoughts

A pharmacist is the key to proper drug usage.  This includes the expected benefits and action and whether the medication is intended to cure a disease, eliminate or reduce symptoms, arrest or slow a disease process, or prevent the disease or symptom.  The pharmacist can describe the action taken in case of a missed dose and potential common and severe adverse effects that may occur along with actions to prevent or minimize their occurrence.  Because many people take more than one drug, a pharmacist can provide information about potential drug-drug , drug-food and drug-disease interactions.  Pharmacists can also counsel patients in the proper selection of nonprescription or over-the-counter medications.  Why not take advantage of this marvelous gift?

Max Sherman is a medical writer and pharmacist retired from the medical device industry. He has taught college courses on regulatory and compliance issues at Ivy Tech, Grace College and Butler University. Sherman has an unquenchable thirst for knowledge on all levels.  Eclectic Science, the title of his column,  touches on famed doctors and scientists, human senses, aging,  various diseases, and little-known facts about many species, including their contributions to scientific research. He can be reached by email at  [email protected].