Current status of human resources and training in hospital pharmacy

Clinical hospital pharmacy services and clinical pharmacist staffing have been associated with reduced adverse drug reactions and mortality rates in patients.1,2 At the core of this lies the understanding that pharmacists are requisite to making the goal of access to and rational use of essential medicines a reality.3 Hospital pharmacists comprise up to 25% of the work force, and hospitals are often the second-largest sector employing pharmacists.4 There are marked inequalities in the distribution of the pharmacy work force worldwide, with pharmacy personnel being particularly scarce in sub-Saharan Africa. The ratio of the pharmacy work force (pharmacists and pharmacy technicians) to population varies widely between regions, from 0.8 per 10,000 population in the African region to 5.4 per 10,000 population in the Americas.3 Less is known about the prevalence of pharmacy technicians, assistants, and related midlevel cadres, and there is greater variation in their training and regulation.4,5 Unless planned for, changing demographics in the pharmacy work force, such as increases in the female work force, increasing part-time employment, and the retirement of the baby-boomer generation, will exacerbate work-force shortages in health systems that are struggling to cope with increasing demands.4,6