Is There Such a Thing as a Clinical Community Pharmacist?

IvyIvy HuangHuang

What is a “clinical” service in

a community pharmacy? Hearing the words clinical and community side by side sounds instinctively contradicting and unnatural. It’s true that since the beginning of pharmacy, the pharmacist’s primary role is in the dispensary, where their priorities have been to provide the right drug to the right patient.1 However, with the new emergence of PharmD’s into community practice, they are ready challenge the definition of what being a pharmacist means and refining the boundaries of practice.

If you search for the definition of “clinical” online, the Oxford Dictionary of English defines it as the “treatment and prevention of disease” (2). By this definition, certainly all pharmacists are clinical whether they practice in a community or hospital setting. Nevertheless, having an official definition of “clinical” establishes pharmacists as an integral part of the health care team rather than auxiliary players. Indeed, dispensing remains as a core service for pharmacists however, stepping outside of that box illuminates endless possibilities.

In British Columbia,

definition for the word there

is “clinical” no nor

“clinical services” by

body. Through the any regulating

BC

PharmaCare program, pharmacists are eligible to claim a clinical service fee for having performed services such as prescription renewal, thus implying that these services are “clinical”(3). But how about services that lie outside the claimable fee, are they not considered clinical? It seems that this ambiguity extends to the community pharmacies themselves. I completed an environmental scan of websites of all community pharmacies in BC and my finding was that no pharmacy website had defined the meaning of “clinical” or “clinical services” despite offering some sort of “clinical” or cognitive service. This finding was interesting for many reasons.

Firstly, despite receiving financial compensation from the BC government for performing such “clinical” services, there is very little advertisement of these services by the pharmacy pharmacist on any internet platform. or

This goes hand in hand with the low uptake of clinical services by BC pharmacists as shown in the 2021 end of year BC Pharmacare Newsletter. To highlight this issue further, a 2015 study on BC pharmacists found that only 0.17% of eligible prescription adaptation were performed(4). The numbers in 2021 are shockingly similar(5). Secondly, this shows that despite the current movement of the profession towards more clinical work, there are many frameworks not yet in place for this shift in pharmacy work culture. For example, the lack of formal definition of “clinical” on any website or documentation alongside limited scope of practice for pharmacists in BC may be a barrier for pharmacists who want to practice clinically.

One of the dangers of not having a definition of the term “clinical” lies in the ambiguity of the clinical-community pharmacist role. Shifting the perspective of a community pharmacist to be seen as a clinical pharmacist can be empowering in interactions with both patients and other health care providers.

In the era of increasing

PharmD graduates entering the profession, pharmacists are more capable than over to engage in more aspects of patient care, outside of the dispensary.

One recent example of this can be seen in how pharmacists stepped up during the COVID-19 pandemic to administer vaccines in pharmacies as well as immunization clinics (6). These actions demonstrate the capabilities of pharmacists’ ability to provide clinical roles in a community pharmacy.

There is no denying the

current movement in community pharmacy that is pushing the profession forward, however, without a standardized definition, the path forward is unclear. As the landscape of community pharmacy changes, it becomes increasingly important for terms such as “clinical” and “clinical service” to be defined as they will shape the future of the profession. 1. Gier J. Clinical Pharmacy in Primary Care and Community Pharmacy. Pharmacotherapy [Internet]. 2000 [cited 14 February 2022];20(10 Part 2):278S281S. Available from: https://accpjournals.onlinelibrary.wiley.c om/doi/epdf/10.1592/phco.20.16.278S.350 05?saml _ referrer

2. Clinical [Internet]. Oxford English Dictionary. 1889 [cited 14 February 2022]. Available from: https://www.oed.com/view/Entry/34381? redirectedFrom=clinical& 3. 8.5 Special Services Fees - Province of British Columbia [Internet]. Www2.gov.bc.ca. 2022 [cited 14 February 2022]. Available from: https://www2.gov.bc.ca/gov/content/hea lth/practitioner-professionalresources/pharmacare/pharmacarepublications/pharmacare-policymanual-2012/pharmacyfees-subsidiesproviderpayment/special-services-fees

4. Law M, Cheng L, Kratzer J, Morgan S, Marra C, Lynd L et al. Impact of allowing pharmacists to independently renew prescriptions: A population-based study. Journal of the American Pharmacists Association [Internet]. 2015 [cited 14 February 2022];55(4):398-404. Available from: https://pubmed.ncbi.nlm.nih.gov/261153 80/

5. BC PharmaCare Newsletter [Internet]. B.C. Ministry of Health; 2021 [cited 14 February 2022]. Available from: https://www2.gov.bc.ca/assets/gov/healt h/health-drugcoverage/pharmacare/newsletters/news 21-012.pdf

6. Poon A. Pharmacists essential to

COVID-19 vaccine roll-out |

BC Pharmacy Association [Internet]. Bcpharmacy.ca. 2021 [cited 14 February 2022]. Available from: https://www.bcpharmacy.ca/tablet/sprin g-21/pharmacists-essential-covid-19vaccine-roll-out

"There is no denying the current movement in community pharmacy that is pushing the profession forward, however, without a standardized definition, the path forward is unclear.

As the landscape of community pharmacy changes, it becomes increasingly important for terms such as

“ clinical” and “ clinical service ” to be defined as they will shape the future of the profession. "