Pharmacies are a very important component in the structure of health systems, and their qualified employees have much broader competence than only dispensing medicines recommended by doctors. Pharmacists are able to advise patients on drug regimens and can offer pharmacovigilance services. Since the outbreak of the coronavirus pandemic in 2019, pharmacists around the world have struggled because they felt a pressing need for advanced technological solutions to be quickly introduced and to support their everyday practice. During the pandemic, patients had very limited access to specialists and hospitals making every effort to handle the health crisis. At that time pharmacies became a very important platform connecting people who needed reliable information and medical advice with the entire health system. Major limitations introduced in order to ensure safety of the population left people isolated. In those circumstances, everybody mainly used tools allowing remote communication, such as computers, telephones and the Internet. This, in turn, increased the global importance of teleconsultations and telepharmacies.
Telepharmacy services which before used to be available in the United States, Spain, Italy, Scotland and Germany, consist in drug selection, review and issue of ordered products, patient counselling, monitoring and clinical support, all without the need for the pharmacist to be actually present at a pharmacy. Apart from the obvious advantages of telepharmacies, such as facilitated access to pharmaceutical care in areas where such access was limited due to economic or geographical reasons and minimised number of interactions between patients and healthcare professionals, there are also negative aspects of such services. One of the significant risks are problems with the evaluation of dispensed medicines or decreased level of safety and integrity of patients’ data.
Another aspect that has significantly affected pharmaceutical practice was the introduction of Electronic Medical Documentation (EDM). In the EDM system, a clinical pharmacist is responsible for entering notes on the amount of medicines, documenting allergies and progress in treatment, recording the reasons why therapy with a specific drug was discontinued or justification for using a specific drug in the financial context. During medicinal products stocktaking, pharmacists can now access patients’ medical records faster, which allows them to analyse medicine amounts more precisely, but also to assess the effectiveness of medicines and their adverse effects. In some countries, pharmacists working in publicly-accessible pharmacies have access to a national electronic database, so that they can supervise therapies of individual patients. Such a solution can potentially expand the role of a pharmacist and increase the safety of drug therapies. However, serious concerns are voiced, for example related to liability or patient consent. Electronic documentation systems cause other difficulties that pharmacists have to deal with, for example the need to fill in electronic forms, which is a time-consuming process. Pharmacists face the fear of criticism and are afraid that their entries will be disregarded by doctors and other specialists.
Because e-prescriptions have been implemented, there is room for e-pharmacies, where drugs are dispensed remotely. Currently, a patient who is chronically ill or unable to leave home to go to a pharmacy may order medicines directly to his or her home using a computer or phone. The same will apply to people in the regions where they do not have direct access to the medicines they need. Thus, e-pharmacies are a solution that increases access to medicines, saves time, money, ensures privacy and transparency of prices, and makes it possible to compare different products on a website. This seemingly perfect solution has many inherent risks. The biggest risks include: promoting self-medication, the risk of overdosing, misuse of the drug, drug abuse resulting in increased microbial resistance or limitations to the activity of offline pharmacists. Additionally, e-pharmacies are still unattainable for persons unable to read or use computers. This applies to a large proportion of the population in less developed countries, where access to medicines is usually the most difficult.
In order to keep up with the dynamic technological development and evolving expectations of patients, according to the WHO, the “future pharmacist” needs to have certain skills and characteristics, such as decisiveness, empathy, communication skills, management skills, teaching skills, willingness to care for patients and to learn lifelong. Pharmacists who are not proficient users of computers and the Internet will not be able to catch up with the digital technology implemented in every aspect of their work, which makes their professional activity more complicated and demanding. Faculties of pharmacy are in the process of developing new study programs, which are to be better aligned with the new digitalized reality, are aimed at developing soft skills of students and reducing training on mechanical and repetitive activities that are today taken over by machines.
References:
https://link.springer.com/article/10.1007/s11096-021-01365-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681067/
https://academic.oup.com/jamia/article/24/1/193/2631445
https://jddtonline.info/index.php/jddt/article/view/4122/3188
