DRUGS IN USE FOURTH EDITION
When I first conceived this book, back in the late 1980s, cutting-edge pharmaceutical practice was taking place primarily in hospitals, and ‘clinical pharmacist’ was a somewhat elitist term applied to the smallish number of hospital pharmacists who contributed to the direct care of patients on hospital wards but rarely got involved in actually writing the prescription or independently adjusting drug dosage. Twenty years on, most practising pharmacists can justly be described as ‘clinical’ pharmacists. Pharmacists are independent prescribers in a wide range of clinical areas and working under patient group directions to supply and administer medicines without a prescription.In hospitals, consultant pharmacists have their own case load of patients and provide the highest levels of pharmaceutical care as well as contributing to research and development in their chosen specialty, whereas in the community, pharmacists with a special interest are being commissioned to provide high-level services that contribute to the overall care of patients in their specialty area. In hospitals most pharmacists spend a large part of their day working on the wards providing direct patient care, such as taking drug histories, advising on and monitoring therapy, and supporting discharge. In the community pharmacists are being commissioned to contribute to the management of patients with long-term as well as acute conditions, provide medicines use reviews to support adherence, and are seen as a key source of advice and support for preventative health measures, providing immunisations, helping patients to stop smoking and lose weight, and carrying out NHS health checks. The career opportunities for pharmacists in primary care have also expanded. Pharmacists can now be found working in GP surgeries, helping GPs to optimise their prescribing, and running medication review or specialist clinics, and pharmacists in NHS commissioning organisations are bringing their knowledge and skills to the commissioning and monitoring of NHS services involving medicines, as well as to the area of public health.
