Current status of pharmacist influences on prescribing of medicines

Chemists, druggists, and apothecaries historically were trades-people who performed similar tasks. Eventually, apothecaries split from the chemists and druggists to become general practitioners, while the other two groups combined to become pharmacists.1 Looking back at the development of pharmacy as a profession, we can see whence we came and where we are going may well be the same place. However, the question of what constitutes prescribing must first be answered in order to evaluate how pharmacists in a variety of practice situations can influence prescribing to improve patient outcomes. If pharmacists become prescribers, they will be subjected to the same influences as any other prescriber. The processes of prescribing can be expanded from the basic process given by the World Health Organization (WHO).2 The influence of pharmacists on prescribing practices can be seen daily in any conceivable practice situation. No health professional is infallible, and the benefits of a variety of clinical pharmacist interventions have been documented.3,–9 Some interventions or influences that may seem simple and mundane in advanced health systems such as those in Europe, the United States, or Australia (e.g., medication counseling4,5 or taking an admission drug history)3,4 may produce a major improvement in a developing nation. Indeed, pharmacists should focus on the diseases where they can have the greatest impact in their local environment. For example, this could involve human immunodeficiency virus (HIV) and tuberculosis in developing countries, while developed countries may focus on diabetes, hypertension, and hyperlipidemia.