1.1 The pharmaceutical industry started to manufacture drugs on


1.1 The history of pharmaceutical care:

Earlier the pharmacist had been compounding, and dispensing. but during the middle of the 20th century their practice changed. The pharmaceutical industry started to manufacture drugs on a large scale, and the need for compounding medicines in the pharmacy decreased. In 1951 the prescription only legal status was introduced in the US, limiting the amount of drugs that could be bought over the counter (OTC). There were similar developments in the UK through the Medicines Act 1968, confirming a trend to address patient safety by increasing controls over medicines distribution. The American Pharmaceutical Association (APhA) Code of Ethics from 1922 prohibited the pharmacist from discussing the therapeutic effect and the composition of a prescription with the patient until 1969, when the Code of Ethics was changed (Jones and Rospond, 2003 (.Although   the profession of pharmacy has been integral to the delivery of drug therapy to patients since its inception, yet pharmacists commonly have been dissociated from the use, evaluation, and monitoring of drug therapy. The widely cited reports of the Institute of Medicine (IOM) articulated an increased awareness of a lack of continuity of care and associated challenges for the provision of health care in the United States (Institute of Medicine, 2001). Society has experienced an increase in adverse drug reactions and drug costs, which has prompted a call for an enhanced role for pharmacists in ensuring effective drug use and patient safety (Institute of Medicine, 2006).

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Pharmacy’s focus began to expand again during the 1980s. A professional movement that proponents called clinical pharmacy gained momentum, urging pharmacists to take on a vital role in the American health care system by providing medication information to ensure that patients are properly and safely use their medications (Institute of Medicine, 2001). The movement had gathered considerable  steam by the time federal legislation once again intervened, this time in the form of the 2003 Medicare Prescription Drug Improvement and Modernization Act. The law opened up tremendous opportunities for drug therapy and information services by mandating that those patients covered by the act should receive counseling when they purchase medications. Pharmacists are stepping up to fulfill the mandate, answering questions and offering advice to patients about both prescription and over-the-counter (OTC) medications, and be educated and advised about life style changes conducive to better health.  The practice of pharmacy the started coming to full circle (Institute of Medicine, 2006).

Pharmacists are assuming increasingly critical roles in modern health care , providing direct patient care and advocacy. What does that mean for patients? It means pharmacists are there to help improve their health. No doubt, pharmacists are the most accessible health care professionals in every community. They provide education, medication management and professionally responsible service to patients. Patient-centered care is our tradition and our history, as well as our future (Kari, 2008). (This statement is wrong).

Based on this new change in pharmacy practice . According  to  the new  pharmacists’  accepted responsibilities which are  stipulated by the pharmaceutical care new mode of pharmacy practice, the role of the pharmacists is no longer limited to dispensing the proper medication and the mere provision of medication information. He/she is responsible for actualizing the targeted therapeutic outcomes of the patient’s treatment, while  securing  patients’  safety and education.

 Abduelkarem RA . Extending  the role of pharmacists patients care :  Are pharmacists in developing nations ready to change ?Pharmacology & Pharmacy, 2014;5: 865-875.


1.2Definition of pharmaceutical care ( PC): 

The term   pharmaceutical care (PC) was born and first introduced in 1980, but the definition and the concepts which are most widely  used  today  were  formulated  and  presented  by  Hepler  and  Strand  at  the  “Pharmacy in the 21st Century Conference” in 1989 (Institute of Medicine ,2001).This definition was later  published  in  the seminal  article  opportunities and responsibilities  in pharmaceutical  care. With  that  article,  the  concept  of  pharmaceutical  care was  understood  worldwide,  but  its  implementation  is  far  from universal and so remains not as highly developed in reality. Hepler and Strand defined  pharmaceutical care as  “the  responsible provision  of drug  therapy  for  the  purpose  of  achieving  definite outcomes that improve a patient’s quality of life”. ( Hepler and Strand,1989).

This definition focuses to a greater degree on the responsibility and commitment of the practicing pharmacist. These outcomes are, cure of a disease; elimination or reduction of a patient’s symptomatology; arresting or slowing of a disease process; or preventing a disease or symptomatology    (Hepler, 2004).

In 1998 World Health Organization (WHO) defined pharmaceutical care as : a system that continually observes the short-term results of the therapy in progress and helps to make corrections to improve management outcomes. The term requires multidisciplinary approach by almost all the members of the healthcare professionals (HCPs) team, which  normally consist of the   patient, pharmacist, physician and nursing staff.  ( Gada, 2008).

Pharmaceutical care is a practice philosophy for pharmacy. It is the way of pharmacists to educate the individual patients about their medication, and, if needed, life style changes, as well. The concept deals with the way a patient should receive and use medication and should receive