Pharmacists' professional responsibilities: How do these differ between Singapore and other countries

20161109160000, Hannah Lim
Professional responsibilities: How it does it differ between Singapore and other countries
Pharmacy is a dynamic and growing profession. A century ago, pharmacists were chemists who were only experts in the art and science of compounding medicines. Today, pharmacy has evolved to be a profession of health promoters, disease prevention specialist, health and chronic diseases management and medication health information experts1. As pharmacists continue to strive for excellence in the profession, it is interesting to see how pharmacy practices differs between Singapore and some other countries.

1) United Arab Emirates (UAE)

The UAE constitutes of seven Emirates: Abu Dhabi (the capital), Dubai, Sharjah, Ajman, Umm Al-Qaiwain, Ras Al-Khaimah and Fujairah. It is a rich country - blessed with petroleum, oil and gas - and has a diverse and expanding population. However, the country faces a shortage of pharmacists (pharmacist density per 1000 population was a mere 0.4) and the authorities fill the gap with foreign expatriates mainly from India, Pakistan and the Philippines2. As opposed to Singapore, there are no independent professional bodies such as the Singapore Pharmacy Council (SPC) and the Pharmacy Society of Singapore (PSS) to regulate pharmacy practice. Perhaps due to this absence, prescription medications such as antibiotics, insulin, inhalers, can sometimes be sold without prescriptions even though the law prohibits this practice.

UAE specifies that local pharmacies must be owned by UAE citizens. However, very few UAE citizens are pharmacists and therefore most pharmacies are not owned by pharmacists. Most prescriptions are filled and dispensed by pharmacy technicians while pharmacists do other administrative job such as inventory management. Patient counselling is often limited to the indication and the dose/frequency of the medications. Only occasionally do patients get to hear more on adverse effects and drug interactions of the medications they are taking.

2) Australia

In Australia, only authorized healthcare professionals are allowed to supply medications to the public. These professionals include doctors, nurses, midwives, psychologists and pharmacists. Although patients have a myriad of choices for their prescription to be filled, the general public would choose to go to a pharmacy3.

As opposed to community pharmacy practice in Singapore where pharmacists seldom are involved in health screening and risk assessment, community pharmacists in Australia participate actively in the former activity. They also do clinical interventions and follow-ups with their regular patients for common chronic conditions such as heart failure and drug addiction issues. Community pharmacists can also provide over the counter immunisation and vaccination services, which is otherwise done in either a private practitioner’s clinic or the nation’s travel and health clinic.

3) Sweden

There are about 800 community pharmacies and 80 hospital pharmacies in Sweden, all of which has been organised and ran by one single, government-owned chain, known as Apotekek AB. Staff who work at these pharmacies can have different roles – pharmacists, prescriptionist (licensed pharmacist), pharmacy technicians and more. Similar to Singapore, physicians in Sweden have sole prescribing authority and this liability makes them the central decision maker in patients’ use of medications.

While a patient may visit multiple doctors due to different conditions, they usually fill their prescription at one pharmacy. Community pharmacists in Sweden therefore have the luxury to follow through on cases and have evolved from information recipient to information gatherer and partners in medication use. This is in contrary to the current practice in Singapore where patients still prefer to fill their prescription at the clinics of their physicians. MIMS

Read more:
Pharmacist-led clinics in Singapore
A snapshot of the Malaysian pharmaceutical industry
Superwoman: Being a pharmacist and a mother at the same time in Singapore
Are pharmacists’ roles as primary health professionals underutilised in Singapore?

Sources:
1. The NUS Pharmily welcomes you. Available at: http://www.pharmacy.nus.edu.sg/about/welcome.html. Last accessed 1 October 2016.
2. Pharmacy in the United Arab Emirates. Majd Dameh. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3471164/. Last accessed 1 October 2016.
3. Pharmacy Practice in Australia. Rebekah J Moles. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605468/. Last accessed 1 October 2016.
4. Pharmaceutical care in community pharmacies: practice and research in Sweden. Annuals of Pharmacotherapy. 2006 Jun; 40(6):1162-9. Epub 2006 May 30. Westerlund LT1, Björk HT. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16735653. Last accessed on 1 October 2016.
5. Counselling in Swedish Community Pharmacies. Understanding the process of a pharmaceutical care service. Anna Montgomery. Available at: http://www.pharmaceutical-care.org/archivos/830/a_montgomery.pdf. Last accessed on 1 October 2016.