At a first glance, the title “public health pharmacist” may sound like a contradiction. This is due to the misconception that public health involves preventing diseases, while Pharmacy involves simply providing medications to treat or manage diseases. Another argument is that public health focuses on communities and populations (right), while Pharmacy only involves individual patients (wrong).
However, public health is more than just preventing diseases, and Pharmacy is more than disease management or treatment. According to the World Health Organisation (WHO), “Public health refers to all organized measures (whether public or private) to prevent disease, promote health, and prolong life among the population as a whole.” A broad definition of a pharmacist is one who “is trained to formulate, dispense, and provide clinical information on drugs or medications to health professionals and patients.”
The theme for this year’s World Pharmacists Day, celebrated on 25 September, is Pharmacy united in action for a healthier world, and it aims to highlight how the various aspects of Pharmacy work to promote healthcare globally. Public health pharmacy is one area that remains blurry, regardless of the active and invaluable role pharmacists play in public health.
There are four levels of prevention in public health – primordial, primary, secondary, and tertiary. Primordial involves preventing risk factors for disease, illness, or the development of poor health outcomes. Primary deals with preventing diseases, injury, and occurrence of poor health outcomes. Secondary focuses on reducing the impact of diseases, illnesses, injuries, or poor health outcomes. Tertiary focuses on reducing the long-term impact of disease, illness, injury, or poor health outcomes.
The role of pharmacists spreads across the different levels of prevention, particularly secondary and tertiary prevention. Some examples of secondary prevention to reduce impact of diseases are the treatment of smoking-related illness, individual nutrition counselling, monitoring opioid use, etc.; while examples of tertiary prevention are disease management, health monitoring, medication-assisted therapy, etc. The pharmacist’s role in these prevention activities is a crucial one.
In the community, pharmacists provide accessibility that is rare among other healthcare providers. With a unique position in the community and sound medical/health knowledge, the pharmacist is suited to carry out public health activities and act as an information resource on lifestyle changes that can influence health outcomes.
Apart from these, the role of a public health pharmacist spans several aspects including:
Drug development/clinical trials: Pharmacists in public health supervise the safety of clinical trials and provide pharmacovigilance services to detect potential adverse effects
Antimicrobial stewardship and infection control: Pharmacists are referred to as antimicrobial stewards and help to safeguard antibiotics by promoting and encouraging practices that tackle antimicrobial resistance.
Promoting disease prevention and control programmes: These include health screening activities, health/medical outreach, vaccination, etc. Pharmacists can screen the population for important health problems like diabetes, hypertension, obesity, etc.
Health information and education: Pharmacists develop health education policies and programmes that address the needs of patients and other healthcare professionals within their institution. Pharmacists also participate in health-related awareness campaigns and patient education programmes on issues like nutrition and healthy behaviour.
Research and training: Engaging in public health-related research and education programmes, starting or promoting campaigns to spread new knowledge, providing training programmes.
Medication safety: Every practising pharmacist, by default, is involved in medication safety. Public health pharmacists can specialise full-time in medication safety activities to prevent medication-related harm.
Chronic/geriatric care: Pharmacists are also vital in managing chronic diseases or conditions, thanks to accessibility. As the most visited healthcare provider, the pharmacist has good opportunities to monitor chronic diseases and work with patients and their doctors in effective management. Pharmacists also play an essential role in geriatric management.
Pharmacists play a critical role in the provision of public health. Pharmacists are now gradually recognised as professionals in the public health workforce. We now have public health pharmacists, just like public health nutritionists, physicians, etc. However, their roles need to be defined and standardised, with commensurate reimbursement.G