Feature
Hospital Pharmacy in Bangladesh
Mithilesh Kumar Jha
TODAY the practicing pharmacist spends most of his time filling orders, checking adverse drug interactions and answering questions in every sphere of the modern world, where the life expectancy at birth has been drastically uplifted due to the unexpected revolution in the Biochemical Technology. Pharmacy is the art and science of preparing and dispensing medications and drugs and related information to the public. A pharmacist is a specialist in medications, a custodian of medical information, a companion of the physician, a counselor to the patient, and above all, a guardian of public health. Thus pharmacists have a very important role in the national health care system. They are rendering valuable services to the people by making quality medicines. Hospital pharmacy is the most advanced branch of pharmacy.
The separation of Pharmacy from medicine took place in charitable institutions operated under governmental or ecclesiastic authority. Because the division occurred in hospitals, the hospital pharmacist was the first recognized practitioner of the profession of pharmacy. The development of hospital pharmacy in different countries was vitally affected by educational standards and the caliber of its practitioners. Jonathan Roberts became the first hospital pharmacist at the Pennsylvania Hospital (Philadelphia) in 1752. Hospital pharmacy goes back, in the United States, to before the Revolution. By 1942 hospital pharmacists had become so significant a part of the health-care community that they formed the “American society of Hospital pharmacists”. As the twentieth century progressed, the practice of Clinical pharmacy developed.
In Clinical pharmacy the pharmacist is responsible in a hospital situation for cooperating with the physician in monitoring the prescribed medications. Clinical or patient-oriented pharmacy service has gained tremendous acceptance in hospital pharmacy. The hospital environment offers the hospital pharmacist a multitude of opportunities to develop meaningful clinical roles in the safe and rational use of medications in hospitalized as well as ambulatory patients.
Within the system of health care, hospital pharmacists are experts in the therapeutic use of medications. They routinely provide medication therapy, evaluations and recommendations to patients and other health care professionals. Hospital pharmacists are the primary source of scientifically valid information and advice regarding the safe, appropriate and cost-effective use of medications. In some countries, Hospital pharmacists are given prescriptive authority. In UK a pharmacy graduate is in a position to perform the responsibility of response to questions: “what drugs are; what they do and how they do, and what is the most appropriate treatment of a disease or disorder”.
The history of hospital pharmacy is about 250 years old but in Bangladesh the seed of hospital pharmacy practice is yet to be germinated. In Bangladesh a pharmacist has no image as a caregiver. In hospitals pharmacists are still serving as compounders rather than counselors. There is no active role played from the government for promoting the practice of hospital pharmacy. But we can see the reflection of hospital pharmacy practice in some expensive private modern hospitals of Bangladesh, which are inaccessible for the majority of the people of Bangladesh.
The hospital pharmacists can play pivotal role in South Asian counties like Bangladesh where the Doctorpatient ratio is very poor. India and Pakistan have already adopted the concept of hospital pharmacy practice both in private and public hospitals. Hospital pharmacists are employed in every government hospital, even at the district level in Nepal. Several fatal diseases are being prevented by their active role. But there are still several countries in South Asia where the concept is yet to be realized.
Pharmacy education in Bangladesh and majority of South Asian countries doesn't meet the requirements of patient care and pharmacy practice. The challenge of health care system can be faced only by changing the approach to a pharmacists' education. Every pharmaceutical institution should focus on the applied and effective knowledge of pharmacy rather than the traditional one.
(The writer is a Nepalese student of Department of Pharmacy, Bangladesh University).
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