THE ROADMAP TOWARD PHARMACEUTICAL CARE (COPY AND PASTE)
Autor: Manuel Machuca
Learning from mistakes is essential for both personal and professional growth. It involves, first and foremost, recognizing and analyzing them to understand their causes and consequences, and then applying the lessons learned to avoid repeating negative patterns in the future. Ultimately, it is about transforming mistakes into opportunities for improvement and development, rather than viewing them as failures.
That the roadmap toward Pharmaceutical Care in Spain has failed is obvious. After roughly thirty years of implementation, the outcomes of a patient-centered practice originally designed to reduce medication-related morbidity and mortality speak for themselves. It is time for those who believe that a profession is a duty to societyand that its purpose is to apply specialized knowledge to alleviate societal problems (not just personal ones)to define a roadmap. This roadmap, incidentally, is little more than a copy and paste of what has proven successful elsewhere. In my opinion, it must include the following key components, which could even be pursued simultaneously if the necessary resources are available:
- Training undergraduate students.
- Training practicing pharmacists.
- Research at multiple levels.
TRAINING UNDERGRADUATE STUDENTS
Pharmacy students must be trained throughout their undergraduate education to work with real patients, under faculty supervision, to conduct clinical interviews, identify drug therapy problems, develop individualized care plans, and collaborate effectively within multidisciplinary teams.
We must transform the model pharmacieswhich have recently become popular in universitiesinto university clinics, where students and faculty from different disciplines work and learn together for the benefit of the community. There is precedent in university clinics of dentistry, podiatry, physiotherapy, and nursing, not to mention the traditional sixth-year medical rotations in teaching hospitals. But we need to take additional steps toward true multidisciplinary collaboration.
This care practice canand shouldbe researched, not only from clinical perspectives but also from economic, ethical, educational, legal, and communication viewpoints. This roadmap should also contribute to the redesign of a healthcare system still anchored in the era of acute illnesses. Undergraduate theses and larger-scale projects lie ahead.
TRAINING PRACTICING PHARMACISTS
Practicing pharmacists are the ultimate agents of this transformation. If they have not succeeded so far, it is not because of a lack of ability to learn and apply patient-centered practices, but because of the highly adverse professional environment in which they operate. I refer mainly to community pharmacists, because those in hospitals or primary caredespite working within more favorable compensation modelshave yet to embrace this shift, still clinging to an outdated version of clinical pharmacy focused on adverse drug reactions, adherence, and so-called rational use of medicines.
This transformation can be supported through publicly funded knowledge-transfer activities, which should not only promote the implementation of pharmaceutical care but also facilitate robust research into its outcomes across different fields and specialties. Let it be clear: this applies to all care settings. Whats essential is the belief that this roadmap is worth pursuing. Professional associations and scientific societies can play a key role hereor choose not to.
RESEARCH
Research permeates every aspect of this process. Without it, and without the adoption of its findings by all stakeholders, sustainable change will not occur. Robust research projects must be developed and supported by health authorities. If we replicate the results seen in places that have rejected self-deception and abandoned practices that amount to playing solitaire with marked cards, the benefits for public health will be extraordinary.
These projects must allow pharmaceutical care to be studied in real-world settings like primary care centers, working with real patients just as is done in medicine and nursing. Doctoral dissertations, masters theses, and competitive research grants will complete a strategy that addresses a major public health challenge and redefines the pharmacy profession at every levelfrom education to professional practice.
Only those resistant to change would label this roadmap as idealistic or unrealistic. In reality, its a copy and paste of what has workedand continues to workin other countries.
This roadmap relieves community pharmacists of the sole responsibility for driving change. On the contrary, it calls for a joint venture among faculty from diverse disciplines, practicing professionals, and any willing stakeholders. Ultimately, it should give rise to a new model of professional practiceone that responds to current population needs related to medication and includes a fair compensation structure based on responsibility assumed, quality delivered, and benefits generated.
This is not a short journeyfar from it. In the United States, the transformation took over thirty years. If we learn from their missteps, we may move faster, but this will not happen overnight. Patience will be required to avoid skipping steps, and firmness will be essential to resist the temptation of shortcuts that are known dead ends. He who travels too fast misses the essence of the journey, wrote American author Louis LAmour.
And to make it clear that change is possible when commitment exists, at Universidad Loyola Andalucía we have already begun to take the first steps. We invite any young researcher who wants to help lead this transformation to join the project. So, if youve made it to the end of this piece and want to take part, heres the link to get started: