The pharmacy profession has undergone substantial change over the last two to three decades. Whilst medicine supply still remains a central function, pharmacist’s roles and responsibilities have become more clinic and patient focused. In the community (primary care), pharmacists have become important providers of healthcare as Western healthcare policy advocates patient self-care. This has resulted in pharmacists taking on greater responsibility in managing minor illness and the delivery of public health interventions. These roles require pharmacists to more fully use their clinical skills, and often involve diagnosis and therapeutic management. Community pharmacists are now, more than ever before, in a position to identify, record and report medication safety incidents. However, current research suggests that diagnostic ability of community pharmacists is questionable and they infrequently report to local or national schemes. The aim of this paper is to highlight current practice and suggest ways in which community pharmacy can more fully contribute to patient safety.
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Commonwealth of Australia. Building a 21st century primary health care system: Australia’s first national primary health care strategy. Canberra: Department of Health and Ageing; 2010 [online]. http://www.health.gov.au/internet/yourhealth/publishing.nsf/Content/report-primaryhealth. Accessed 23 Jan 2014.
Commonwealth of Australia. A national health and hospitals network for Australia’s future: delivering the reforms. Canberra: Commonwealth of Australia; 2010 [online]. http://www.health.gov.au/internet/yourhealth/publishing.nsf/Content/DeliveringTheReforms. Accessed 23 Jan 2014.
Black N. Can England’s NHS survive? N Engl J Med. 2013;369(1):1–3.
Keyhani S, Falk R, Howell EA, Bishop T, Korenstein D. Overuse and systems of care: a systematic review. Med Care. 2013;51(6):503–8.
Marchildon G. Canada: health system review. Health Syst Transit. 2013;15(1):1–179.
The NZ health strategy, health targets, better sooner more convenient [online]. http://www.health.govt.nz/system/files/documents/publications/better-sooner-more-convenient-health-care_0.pdf. Accessed 23 Jan 2014.
NHS and social care workforce: meeting our needs now and in the future? [online]. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/perspectives-nhs-social-care-workforce-jul13.pdf. Accessed 23 Jan 2014.
Health Workforce New Zealand [online]. http://healthworkforce.govt.nz/annual-plans. Accessed 23 Jan 2014.
Paudyal V, Hansford D, Cunningham S, Stewart D. Pharmacy assisted patient self care of minor ailments: a chronological review of UK health policy documents and key events 1997–2010. Health Policy. 2011;101(3):253–9.
Pharmacy Guild of Australia [online]. http://www.guild.org.au/docs/default-source/public-documents/news-and-events/2013-federal-election/vital-facts-on-community-pharmacy-june2013_441678_2.pdf. Accessed 26 May 2014.
Planning a research study? Think community pharmacy RPS [online]. http://www.rpharms.com/news-story-downloads/think-pharmacy—promotional-leaflet.pdf. Accessed 23 Jan 2014.
Jesson JK, Langley CA, Wilson KA, Hatfield K. Science or practice? UK undergraduate experiences and attitudes to the MPharm degree. Pharm World Sci. 2006;28:278–83.
NHS choices: pharmacy services [online]. http://www.nhs.uk/NHSEngland/AboutNHSservices/pharmacists/Pages/pharmacistsandchemists.aspx. Accessed 23 Jan 2014.
Department of Health. Pharmacy in England: building on strengths: delivering the future. London: Crown Copyright; 2008 [online]. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Consultations/Closedconsultations/DH_087324. Accessed 23 Jan 2014.
Canadian Pharmacists Association Task Force on a Blueprint for Pharmacy. Blueprint for pharmacy: designing the future together. Ottawa: CPhA; 2008 [online]. http://www.pharmacists.ca/index.cfm/pharmacy-in-canada/blueprint-for-pharmacy/. Accessed 23 Jan 2014.
Pharmaceutical Society of New Zealand. Focus on the future: a ten-year vision for pharmacists in New Zealand 2004–2014. Wellington: Pharmaceutical Society of New Zealand; 2004 [online]. http://psnz.org.nz/public/home/documents/10_yea_plan.pdf. Accessed 23 Jan 2014.
Healthy lives, healthy people: our strategy for public health in England. Department of Health (2010) [online]. https://www.gov.uk/government/publications/healthy-lives-healthy-people-our-strategy-for-public-health-in-england. Accessed 23 Jan 2014.
Guide for public health: partnering with pharmacists in the prevention and control of chronic diseases. National Center for Chronic Disease Prevention and Health Promotion [online]. http://www.cdc.gov/dhdsp/programs/nhdsp_program/docs/pharmacist_guide.pdf. Accessed 23 Jan 2014.
Claim and Confirmation for Home Medicines Review Service [online]. http://www.medicareaustralia.gov.au/provider/pbs/fifth-agreement/files/4915-1303en.pdf. Accessed 23 Jan 2014.
van Grootheest K, Olsson S, Couper M, Jong-van den Berg L. Pharmacists’ role in reporting adverse drug reactions in an international perspective. Pharmacoepidemiol Drug Saf. 2004;13:457–64.
Emmerton L, Marriott J, Bessell T, Nissen L, Dean L. Pharmacists and prescribing rights: review of international developments. J Pharm Pharm Sci. 2005;8(2):217–25.
Pharmacy Council of New Zealand. Pharmacist prescribers [online]. http://www.pharmacycouncil.org.nz/cms_display.php?st=1&sn=232. Accessed 23 Jan 2014.
California’s pharmacist provider status bill passes state Senate [online]. http://www.pharmacist.com/CEOBlog/california%E2%80%99s-pharmacist-provider-status-bill-passes-state-senate. Accessed 23 May 2014.
World self-medication industry. SWITCH. Prescription to non-prescription medicines switch. WSMI 2009 [online]. http://www.wsmi.org/pdf/wsmi_switchbrochure.pdf. Accessed 23 Jan 2014.
Wertheimer AI, Santella TM. Medication errors associated with over-the-counter drugs; prevalence and reduction strategies. J Pharm Finance Econ Policy. 2007;15:109–44.
European Medicines Agency: Alli [online]. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000854/human_med_000641.jsp. Accessed 26 May 2014.
Lansam GD, Kropff MA. Community pharmacists’ assessments and recommendations for treatment in four scenarios. Ann Pharmacother. 1998;32:409–16.
Horsley E, Rutter P, Brown D. Evaluation of community pharmacists’ recommendations to standardized patient scenarios. Ann Pharmacother. 2004;38:1080–5.
Hanna L, Hughes CM. ‘First, do no harm’: factors that influence pharmacists making decisions about over-the-counter medication: a qualitative study in Northern Ireland. Drug Saf. 2010;33(3):245–55.
Iqbal N, Rutter P. Community pharmacists reasoning when making a diagnosis: a think-aloud study think aloud. IJPP. 2013;21(Suppl 2):17–8.
Rutter P, Patel J. Decision making by community pharmacists when making an over-the-counter diagnosis in response to a dermatological presentation. Self Care. 2013;4:125–33.
Consumers’ Association. Pharmacists: how reliable are they? Which Way to Health?. 1991;(12):191–4.
Consumers’ Association. Vital checks are still not being made. Which Way to Health?. 1994;(12):196.
Consumers’ Association. Counter advice. Which Way to Health?. 1999;(3):22–5.
Which? Pharmacies get test of own medicine [online]. http://www.which.co.uk/news/2008/09/pharmacies-get-test-of-own-medicine-157330/. Accessed 23 Jan 2014.
Future pharmacists standards for the initial education and training of pharmacists [online]. http://www.pharmacyregulation.org/sites/default/files/GPhC_Future_Pharmacists.pdf.
Accreditation Council for Pharmacy Education. Accreditation standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree [online]. https://www.acpe-accredit.org/pdf/FinalS2007Guidelines2.0.pdf. Accessed 23 Jan 2014.
Pharmine: pharmacy education in Europe [online]. http://enzu.pharmine.org/media/filebook/files/PHARMINE%20Final%20Report%20Public%20Part.pdf. Accessed 23 Jan 2014.
CPPE consultation skills; meeting the new practice standards for pharmacy [online]. http://www.cppe.ac.uk/learning/Details.asp?TemplateID=Consult-W-03&Format=W&ID=26&EventID=. Accessed 23 Jan 2014.
Brown D, Portlock J, Rutter P. Services to support the healthy living pharmacy: a literature review. Int J Clin Pharm. 2012;34(3):399–409.
Hadi MA. Impact of pharmacist recruitment on ADR reporting: Malaysian experience. South Med Rev. 2011;4:102.
Kimura T, Matsushita Y, Kao Yang YH, Choi NK, Park BJ. Pharmacovigilance systems and databases in Korea, Japan, and Taiwan. Pharmacoepidemiol Drug Saf. 2011;20:1237–45.
Granas AG, Buajordet M, Stenberg-Nilsen H, Harg P, Horn AM. Pharmacists’ attitudes towards the reporting of suspected adverse drug reactions in Norway. Pharmacoepidemiol Drug Saf. 2007;16:429–34.
Gavaza P, Brown CM, Lawson KA, Rascati KL, Steinhardt M, Wilson JP. Pharmacist reporting of serious adverse drug events to the Food and Drug Administration. J Am Pharm Assoc. 2012;52(5):e109–12.
Su C, Ji H, Su Y. Hospital pharmacists’ knowledge and opinions regarding adverse drug reaction reporting in Northern China. Pharmacoepidemiol Drug Saf. 2010;19:217–22.
Tobaiqy M, Stewart D, Helms PJ, Bond C, Lee AJ, Bateman N, McCaig D, McLay J. A pilot study to evaluate a community pharmacy-based monitoring system to identify ADRs associated with paediatric use. Eur J Clin Pharmacol. 2010;66(6):627–32.
Ashcroft DM, Morecroft C, Parker D, Noyce PR. Likelihood of reporting adverse events in community pharmacy: an experimental study. Qual Saf Health Care. 2006;15:48–52.
NRLS quarterly data workbook up to September 2012 [online]. http://www.nrls.npsa.nhs.uk/resources/type/data-reports/?entryid45=135212. Accessed 23 Jan 2014.
Pharmaceutical Services Negotiating Committee. New medicines service [online]. http://psnc.org.uk/services-commissioning/advanced-services/nms/#directions. Accessed 23 Jan 2014.
Claim and confirmation for home medicines review service [online]. http://www.medicareaustralia.gov.au/provider/pbs/fifth-agreement/files/4915-1303en.pdf. Accessed 23 Jan 2014.
Jadeja M, McCreedy C. Positive effect of new medicine service on community yellow card reporting. Pharm J. 2012;289:159.
Smith MP, Webley SD. Pharmacovigilance teaching in UK undergraduate pharmacy programmes. Pharmacoepidemiol Drug Saf. 2013;22:223–8.
Sardas SS, Akici AA, Dagistanli SD. The knowledge and attitude of the undergraduate students in the faculty of pharmacy towards pharmacovigilance. Drug Saf. 2010;33(10):930–1.
Elkalmi RM, Hassali MA, Ibrahim MI, Widodo RT, Efan QM, Hadi MA. Pharmacy students’ knowledge and perceptions about pharmacovigilance in Malaysian public universities. Am J Pharm Ed. 2011;7595:Article 96.
American Board of Internal Medicine. Project professionalism; 1995 [online]. http://www.abim.org/pdf/publications/professionalism.pdf. Accessed 23 May 2014.
General Pharmaceutical Council. Approval of courses [online]. http://www.pharmacyregulation.org/education/approval-courses. Accessed 23 Jan 2014.
Stewart D, MacLure K, Paudyal V, Hughes C, Courtney M, McLay J. Non-medical prescribers and pharmacovigilance: participation, competence and future needs. Int J Clin Pharm. 2013;35:268–74.
Kroger E, Moisan J, Gregoire JP. Billing for cognitive services: understanding Quebec pharmacists’ behaviour. Ann Pharmacother. 2000;34:309–16.
Chan P, Grindrod KA, Bougher D, Pasutto FM, Wilgosh C, Eberhart G, Tsuyuki R. A systematic review of remuneration systems for clinical pharmacy services. Can Pharm J. 2009;141(2):102–12.
Rosenthal M, Austin Z, Tsuyuki RT. Are pharmacists the ultimate barrier to pharmacy practice change? Can Pharm J. 2010;143(1):37–42.
Austin Z, Gregory PAM, Martin JC. Negotiation of interprofessional culture shock: the experiences of pharmacists who become physicians. J Interprof Care. 2007;21:83–93.
Blake KB, Madhavan SS. Perceived barriers to provision of medication therapy management services (MTMS) and the likelihood of a pharmacist to work in a pharmacy that provides MTMS. Ann Pharmacother. 2010;44:424–31.
National Services Scotland. Practitioner services [online]. http://www.psd.scot.nhs.uk/pharmacists/patient-registration.html. Accessed 23 May 2014.
Gray B. Ontario pharmaceutical opinion program. Can Pharm J. 2013;146(6):329–34.
Richardson E, Pollock AM. Community pharmacy: moving from dispensing to diagnosis and treatment. Br Med J. 2010;340:1066–8.
Gonzalez-Gonzalez C, Lopez-Gonzalez E, Herdeiro MT, Figueiras A. Strategies to improve adverse drug reaction reporting: a critical and systematic review. Drug Saf. 2013;36(5):317–28.
The manuscript does not contain clinical studies or patient data.
Funding and conflicts of interest
We state that we have full control of all primary data and that we agree to allow the journal to review the data if requested.
David Brown is an honorary research fellow of the UK Drug Safety Research Unit, Southampton. This is an associate organisation of the University of Portsmouth.
No sources of funding were used to assist in the preparation of this article. Paul Rutter, David Brown, Justine Howard and Christine Randall have no conflicts of interest that are directly relevant to the content of this article.
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Rutter, P., Brown, D., Howard, J. et al. Pharmacists in Pharmacovigilance: Can Increased Diagnostic Opportunity in Community Settings Translate to Better Vigilance?. Drug Saf 37, 465–469 (2014). https://doi.org/10.1007/s40264-014-0191-6