Pharmaceutical Society of Ireland – The Pharmacy Regulator The Role of the Pharmacist in Self Care Telephone: Shrewsbury Rd Fax: Ballsbridge Dublin Website: Ireland

Self care WHO definition of “self care” “Self-Care is what people do for themselves to establish and maintain health, prevent and deal with illness. It is a broad concept encompassing: Hygiene (general and personal); Nutrition (type and quality of food eaten); Lifestyle (sporting activities, leisure etc); Environmental factors (living conditions, social habits. etc); Socioeconomic factors (income level, cultural beliefs etc); Self-medication.” (Definition taken from Report of the 4 th WHO Consultative Group on the Role of the Pharmacist WHO?DAP/98.13 ) (

Role of the Pharmacist Pharmacist – health professional having expertise in the science of medicines, inclusive of development, use and supply. Optimise professional performance and contribute to the optimisation of the performance of others – part of the healthcare team. Effectiveness of Pharmacy Systems - improving patient safety. Contribute to the effective operation of the practice environment – evidence based practice. Produce and distribute medicinal and health related products – ensure the best use of medicines. Provide pharmaceutical care inclusive of information and services - patient as a partner.

Regulatory Environment – Pharmacy Practice facilitating Self Care. Pharmacy Act 2007 – provides an essential governance structure within which pharmacy services are delivered. Requires that sale and supply of medicinal products must be by or under the supervision of a pharmacist from a retail pharmacy business. Introduced a professional management structure through the roles and responsibilities of the pharmacist via the roles of the superintendent pharmacist and the supervising pharmacist (Sn. 26,27,28 & 29) Registration requirement in respect of the Pharmacy with associated conditions of registration.

Regulation of Retail Pharmacy Businesses Regulations 2008 – SI 488 of 2008 – provides a framework of practice which governs the mechanism of service delivery in the interest of the health safety and convenience of the public. Key provisions in Articles 9 and 10. Enshrines the professional role of the pharmacist in legislation. Art 9 - Review and counselling of Rx medicines:- Review include therapeutic duplication, interactions, incorrect dosage/duration, allergic reactions, clinical abuse/misuse and Counselling include information about medicine, correct use, compliance, side- effects/ADRs, missed dose, safe disposal. Art 10- Counselling on non-Rx medicines – registered pharmacist satisfied that patient aware of appropriate use, is being sought for appropriate purpose, not intended for abuse/misuse Effectively completes control of supply chain of medicinal product from manufacturer to patient.

Code of Conduct for Pharmacists – a public declaration of the principles and ethical standards which govern pharmacists in the practice of their profession. Primary principle requires the practice by a pharmacist of his/her profession must be directed to maintaining and improving the health, wellbeing, care and safety of the patient. that all actions of the pharmacist be motivated towards Other principles refer to societal obligations, trust, behaviour and good name, competence and adherence to the Code. Code ensures that the patients normative need must at all times dictate the response of the pharmacist Responsibility to engage and work with other frontline professionals to advise, influence and assist Deviation from the provisions of the Code would be professional misconduct. Other Medicines Legislation – provide the mechanism of practical controls on the management of medicinal products.

Pharmacy Ireland 2020 Interim Report published to look at how the pharmacy profession can contribute to a more integrated approach to healthcare in Ireland Number of initiatives explored including Chronic Disease Management in Pharmacy, Medicines Management, Medicines Use Review, Minor Ailments Scheme, Re- categorisation of Medicines and Health Screening all of which would fall within the definition of self-care.

MAS – Scotland started in – 70,000 consultations a month in Scottish pharmacies (March 2008 Bill Scott) – “Patients like it and pharmacists like it and it has really started to make a difference in the pharmaceutical care of patients who are exempt from NHS prescription charges. What I am most pleased about that is that it is improving access to consultations, advice and medicines for common illnesses and allowing community pharmacists to prescribe where appropriate” (Head of Corporate Affairs Community Pharmacy Scotland PI 2020 pg 35) Improved medication and self-care. A controlled intervention study. Study carried out by the Danish College of Pharmacy Practice in 2003 to evaluate if systematic counselling on self medication and self-care in the pharmacy leads to improved treatment outcomes and more rational use of resources for society and patients.

Role of the Pharmacist in Self-care Pharmacy Act 2007 requires that the supply of medicines be from a pharmacy under personal supervision of a pharmacist Pivotal role of the pharmacist to ensure and facilitate appropriate medicines utilisation. Legislative requirements under SI 488 of 2008 that when supply occurs that information and advice be provided. Robust regulatory framework provides for opportunity to develop pharmacy services. PI2020 looking at evolving roles in respect of ensuring health, MUR, medicines management, screening Evidence supportive that the development and promotion of self care is of value for the patient, and value for public health.

Pharmacists have a significant role in self-care as medication experts committed to patient care. The evolving evidence supports this Pharmacists are obliged to take increased accountability and responsibility for the safe and effective use of medicines. The pharmacist has a role in promoting wellness and disease prevention and empowering patients in collaboration with other health professionals.