Strategies for Expanding Access and Improving the Quality of Pharmaceutical Services

Introduction

Perception and satisfaction of patients with healthcare services are increasingly being considered important parameters to assess the quality and competence of care providers and the outcomes and impacts of their services in patients’ health and in society. The World Health Organization (WHO) defines quality of care as the coverage to which the care provision achieves the most favorable outcomes when balancing risks and benefits in a given financial setting, and because of the worldwide rise in medication use in recent years, this subject has gained more attention among Pharmacists and pharmacy practice research (Schulz et al., 2001; Kheir et al., 2004; Patwardhan et al., 2014; Sakharkar et al., 2015; Shemeikka et al., 2015).

Pharmacy profession has improved to include the provision of services beyond the traditional role of medication dispensing. Pharmacists are highly accessible healthcare professionals considering also the availability, geographic distribution and location of pharmaceutical enterprises like drugstores and compounding pharmacies. Historically, the main role of pharmacy is to dispense medications and provide patients enough instructions regarding their correct use. The Pharmacist is usually the first professional addressed by a patient with minor or complex health issues, commonly due to the scarcity of physicians, or even due to financial barriers to private clinical services when public healthcare services cannot address patients’ needs. Conversely, in spite of this context, differently from other health professionals, providing patient care is not an imperative activity for Pharmacists, as several technical fields of the profession (comprising both privative and non-privative activities) do not necessarily involve direct contact with patients (Hepler, 1996; Schulz et al., 2001; Kheir et al., 2004; Wiley et al., 2014; Penm et al., 2015).

The World Health Organization has pointed that more than half of the world population cannot access the medication they demand. Prices are often too high for people or health systems to afford, and therefore, spends on medicines are a major part of the total healthcare budget. Governments must control the cost of drugs through specific policies and make sure that essential medicines are not overpriced. Also, policies for pharmaceutical services must be included, given that the Pharmacists are the most appropriate professionals to provide the correct and safe use of medications, and to analyze, consider and include pharmacoeconomic and pharmacoepidemiological factors in the organization of drug dispensing (Malone et al., 2001; Murray et al., 2009; Penm et al., 2015).

In some countries, in addition to counseling patients on appropriate drug administration, dosage, side effects, storage and interactions, Pharmacists are allowed to prescribe over-the-counter and other types of medications in several countries, such as phytotherapics and homeopathic products, what can help patients to take decisions on self-treatment with medications. This helps to explain in parts why patients often seek advice in pharmacies, and frequently do not consider a physician consultation, which are also, sometimes, not accessible for patients, generally due to the scarcity of professionals. Nevertheless, there are several challenges for providing these services for patients with limitations such as low education, difficulties on reaching the Pharmacist, the need for individualized monitoring (due to the complexity of therapy), and reports of low quality services are growing worldwide. These facts have been requiring Pharmacists to rethink the way in which pharmacy practice is performed (Lewin, 2013; Sakthong et al., 2013; Sakharkar et al., 2015; Fisher et al., 2015; Malewski et al., 2015).