A pharmacy (also called "drugstore" in
American English
American English, sometimes called United States English or U.S. English, is the set of varieties of the English language native to the United States. English is the most widely spoken language in the United States and in most circumstances ...
or "community pharmacy" or "chemist" in
Commonwealth English
The use of the English language in current and former member countries of the Commonwealth of Nations was largely inherited from British colonisation, with some exceptions. English serves as the medium of inter-Commonwealth relations.
Many ...
, or rarely,
apothecary
''Apothecary'' () is a mostly archaic term for a medical professional who formulates and dispenses '' materia medica'' (medicine) to physicians, surgeons, and patients. The modern chemist (British English) or pharmacist (British and North Amer ...
) is a
retail
Retail is the sale of goods and services to consumers, in contrast to wholesaling, which is sale to business or institutional customers. A retailer purchases goods in large quantities from manufacturers, directly or through a wholesaler, and th ...
shop which provides
pharmaceutical drugs, among other products. At the pharmacy, a
pharmacist
A pharmacist, also known as a chemist (Commonwealth English) or a druggist (North American and, archaically, Commonwealth English), is a healthcare professional who prepares, controls and distributes medicines and provides advice and instructi ...
oversees the fulfillment of
medical prescriptions
A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historica ...
and is available to counsel patients about
prescription and
over-the-counter drugs or about health problems and wellness issues. A typical pharmacy would be in the
commercial area
Commercial areas in a city are areas, districts, or neighborhoods primarily composed of commercial buildings, such as a strip mall, office parks, downtown, central business district, financial district, " Main Street", or shopping centers. C ...
of a community.
Community pharmacies (drugstores)
In most countries, a retail outlet for
prescription drug
A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The rea ...
s is subject to legislation; with requirements for storage conditions, staff qualifications, equipment, record keeping (especially of
controlled drug
The prohibition of drugs through sumptuary legislation or religious law is a common means of attempting to prevent the recreational use of certain intoxicating substances.
While some drugs are illegal to possess, many governments regulate the ...
s) and other matters, all specified in legislation. It was once the case that pharmacists stayed within the premises compounding/dispensing medications, but there has been an increasing trend towards the use of trained
pharmacy technicians, with the pharmacist spending more time communicating with patients. Pharmacy technicians are now more dependent upon automation to assist them in their new role dealing with patients' prescriptions and patient safety issues.
Pharmacies are typically required to have a
qualified pharmacist on-duty at all times when they are open. It is also often a requirement for the owner of a pharmacy to be a registered pharmacist, but that is not the case in all jurisdictions: where permitted, many
retailer
Retail is the sale of goods and services to consumers, in contrast to wholesaling, which is sale to business or institutional customers. A retailer purchases goods in large quantities from manufacturers, directly or through a wholesaler, an ...
s (including
supermarket
A supermarket is a self-service shop offering a wide variety of food, beverages and household products, organized into sections. This kind of store is larger and has a wider selection than earlier grocery stores, but is smaller and more lim ...
s and
mass merchandisers) now include a pharmacy as a department of their store.
Likewise, many pharmacies are now rather grocery store-like in their design. In addition to medicines and prescriptions, many now sell a diverse arrangement of additional items such as
cosmetics
Cosmetics are constituted mixtures of chemical compounds derived from either natural sources, or synthetically created ones. Cosmetics have various purposes. Those designed for personal care and skin care can be used to cleanse or protec ...
,
shampoo
Shampoo () is a hair care product, typically in the form of a viscous liquid, that is used for cleaning hair. Less commonly, shampoo is available in solid bar format. Shampoo is used by applying it to wet hair, massaging the product into th ...
,
office supplies
Office supplies are consumables and equipment regularly used in offices by businesses and other organizations, by individuals engaged in written communications, recordkeeping or bookkeeping, janitorial and cleaning, and for storage of supplies ...
,
confections,
snack foods
A snack is a small portion of food generally eaten between meals. Snacks come in a variety of forms including packaged snack foods and other processed foods, as well as items made from fresh ingredients at home.
Traditionally, snacks are p ...
,
durable medical equipment
Durable medical equipment is any medical equipment used in the home to aid in a better quality of living. It is a benefit included in many insurance policies and in some cases covered by Medicare benefits. The item is defined by Title XIX for Med ...
,
greeting cards
A greeting card is a piece of card stock, usually with an illustration or photo, made of high quality paper featuring an expression of friendship or other sentiment. Although greeting cards are usually given on special occasions such as birthday ...
, and provide
photo processing services.
Community pharmacies offer a unique added value by building direct relationships with their customers. They are able to provide more personalized, dedicated care to local members of their community and even offer enhanced services such as Medication Therapy Management (MTM), Medication Synchronization, and compounding. With the aid of
pharmacy management systems and different integrated technologies, these smaller pharmacies are able to keep up with their large-scale competition.
Ethical standards
Community pharmacists’ understanding of ethics,
confidentiality
Confidentiality involves a set of rules or a promise usually executed through confidentiality agreements that limits the access or places restrictions on certain types of information.
Legal confidentiality
By law, lawyers are often required ...
, patient
autonomy,
trustworthiness
Trust is the willingness of one party (the trustor) to become vulnerable to another party (the trustee) on the presumption that the trustee will act in ways that benefit the trustor. In addition, the trustor does not have control over the acti ...
and
reliability
Reliability, reliable, or unreliable may refer to:
Science, technology, and mathematics Computing
* Data reliability (disambiguation), a property of some disk arrays in computer storage
* High availability
* Reliability (computer networking), ...
are essential in community practice and must influence their decision making should an ethical dilemma arise. In some countries, community pharmacists may be asked to compromise on their values and ethical issues may arise not only because of patient's or physician's request but may also because of their employers' intrusion. Individual factors such as age, gender, work experience, and educational level and
organizational
An organization or organisation (Commonwealth English; see spelling differences), is an entity—such as a company, an institution, or an association—comprising one or more people and having a particular purpose.
The word is derived fr ...
factors such as the number of pharmacists in a pharmacy and location of pharmacy may affect the ethical perspectives of community pharmacists.
Characteristics of a good pharmacy
The
American Association of Colleges of Pharmacy recommends that consumers choose a pharmacy at which they can have a consulting relationship with the pharmacist.
Anyone using drugs benefits when they have easier access to a pharmacist. Being timely includes both processing the request quickly and having drug stock available to fill the prescription.
Some consumers need drugs delivered to their home, perhaps by mail, and may select a pharmacy that offers that service.
Different pharmacies may charge different prices for the same drugs, so shopping for lower prices may identify a pharmacy offering better value.
In addition to fulfilling prescriptions, a pharmacy might offer
preventive healthcare
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
services like vaccinations.
Up-to-date technology at a pharmacy can assist a patient with prescription reminders and alerts about potential negative drug interactions, thereby reducing
medical errors.
Duties of pharmacy staff
The
International Pharmaceutical Federation has declared their vision of a community-based pharmacist:
* An expert in
pharmaceutical care,
pharmacotherapy
Pharmacotherapy is therapy using pharmaceutical drugs, as distinguished from therapy using surgery (surgical therapy), radiation (radiation therapy), movement ( physical therapy), or other modes. Among physicians, sometimes the term ''medical th ...
and
health promotion
Health promotion is, as stated in the 1986 World Health Organization (WHO) Ottawa Charter for Health Promotion, the "process of enabling people to increase control over, and to improve their health."
Scope
The WHO's 1986 Ottawa Charter for Hea ...
* A professional communicator with
patient
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health ...
s, other
healthcare providers and decision makers
* Deliver high quality products, services and
communication
Communication (from la, communicare, meaning "to share" or "to be in relation with") is usually defined as the transmission of information. The term may also refer to the message communicated through such transmissions or the field of inqu ...
* Document their work and communicate the outcome to professional colleagues.
Responsibilities
Community-based pharmacists' responsibilities include: checking and dispensing of
prescription drugs
A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The rea ...
, providing advice on
drug
A drug is any chemical substance that causes a change in an organism's physiology or psychology when consumed. Drugs are typically distinguished from food and substances that provide nutritional support. Consumption of drugs can be via inhal ...
selection and usage to doctors and other health professionals and counseling patients in health promotion,
disease prevention
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental hea ...
and the proper use of medicines.
In most countries regulations govern how dispensaries may operate, with specific requirements for storage conditions, equipment and record keeping.
United Kingdom
It is becoming more common for pharmacists to take on extended roles that provide more clinical care directly to patients as part of a primary care team. There are around 11,400 community pharmacies in England. Many are open for extended hours in the evenings and weekends and they are accessible without appointment.
In the English
NHS there were 438 million visits nationally to community pharmacies for health related reasons in 2015. More than 1 billion prescription items were dispensed in 2012. More than £14 billion is spent on prescribed drugs annually. Under the 2005 NHS Community Pharmacy contract all community pharmacists in England and Wales provide:
*Dispensing Service
*Repeat Dispensing Service: This allows the patient to collect regular repeat prescription medicines for an agreed period of time, without having to go back to their GP
*Disposal of Unwanted Medicines.
*Promotion of Healthy Lifestyles.
*Signposting to other Services.
*Support for Self-Care: advice on treating minor illnesses and long term conditions.
Widely available Advanced Services:
*Medicines Use Review & Prescription Intervention.
*New Medicine Service. For patients who have been given their first prescription for a medicine to treat Asthma and COPD, Type 2 diabetes, Hypertension or Anticoagulant Therapy.
*Appliance Use Review Service.
*Flu Vaccination.
Enhanced Services which are not available unless locally commissioned:
*Minimising Adverse Effects and Admissions Related to Medicines.
*Discharge and Transfer Planning.
*Managing Dental Pain.
The introduction of the digital hospital-to-pharmacy referral service, which was to launch in July 2020, as part of the new community pharmacy contract, was postponed to 15 February 2021 because of the
COVID-19 pandemic in England
The COVID-19 pandemic was first confirmed to have spread to England with two cases among Chinese nationals staying in a hotel in York on 31 January 2020. The two main public bodies responsible for health in England are NHS England and Public ...
. It will enable hospitals to digitally notify community pharmacies when patients are discharged and may need advice on taking new medicines, and about changes to their prescriptions.
In 2022 the average pharmacy carried out around 19 consultations per day, averaging 5.6 minutes each - about 65 million consultations across 10,800 pharmacies in the year.
Support staff
To help pharmacists be able to take on extended roles, it is common for them to work as part of a team that can include pharmacy technicians, dispensing assistants and counter assistants.
Ownership
In parts of mainland Europe, the pharmacist is required to own the pharmacy of which she or he is the licensee. Under this arrangement, a pharmacist can be the operator of only a single outlet. In the UK, 60% of all community pharmacies are owned by companies that own multiple pharmacies.
In the United States, more than 25% of independent owners have ownership in two or more pharmacies.
Most of New Zealand's community pharmacies are owner-operated. In Australia, pharmacists recognise the need to integrate professional pharmacy services into the health system to meet the changing health care needs of the population.
Society and culture
A survey conducted by PrescribeWellness found that almost half of Americans older than 40 years-old value pharmacies that offer
preventative care services, and would be willing to transfer their
prescriptions to pharmacies that offer those services.
Patients also value pharmacies where they can receive medical advice concerning their prescription medications, how those medications may
interact with each other, and receive
over-the-counter drug
Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to consumers possessing a valid presc ...
recommendations for the management of common ailments.
In a survey of over 1,000 U.S. adults older than 40 years-old conducted by Propeller Insights, 67% of patients responded that they would prefer that their pharmacist discuss new prescriptions with them, rather than their
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
, because they viewed their pharmacist as "better at explaining
side effects
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
and has more time to spend with them."
Internet pharmacies
Since about the year 2000, a growing number of
Internet
The Internet (or internet) is the global system of interconnected computer networks that uses the Internet protocol suite (TCP/IP) to communicate between networks and devices. It is a ''internetworking, network of networks'' that consists ...
pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by
brick-and-mortar
Brick and mortar (also bricks and mortar or B&M) refers to a physical presence of an organization or business in a building or other structure. The term ''brick-and-mortar business'' is often used to refer to a company that possesses or leases ...
community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as online pharmacies) are also recommended to some patients by their physicians if they are home-bound.
While most Internet pharmacies sell
prescription drug
A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The rea ...
s and require a valid prescription, some Internet pharmacies sell prescription drugs without requiring a prescription. Some customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor, or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of medication. There also have been reports of such pharmacies dispensing substandard products.
Of particular concern with Internet pharmacies is the ease with which people, youth in particular, can obtain
controlled substances (e.g.,
Vicodin
Hydrocodone/paracetamol (also known as hydrocodone/acetaminophen) is the combination of the pain medications hydrocodone and paracetamol (acetaminophen). It is used to treat moderate to severe pain. It is taken by mouth. Recreational use is ...
, generically known as
hydrocodone
Hydrocodone, also known as dihydrocodeinone, is an opioid used to treat pain and as a cough suppressant. It is taken by mouth. Typically it is dispensed as the combination acetaminophen/hydrocodone or ibuprofen/hydrocodone for pain severe en ...
) via the Internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are instances where a practitioner issues a prescription, brokered by an Internet server, for a controlled substance to a "patient" s/he has never met. In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship. The Food and Drug Administration (FDA) is also heavily involved in monitoring internet pharmacies and has issued warnings against several companies who have violated the U.S. Federal Food, Drug, and Cosmetic Act that protects individuals against rogue online pharmacies.
Canada is home to dozens of licensed Internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers (who must otherwise pay one of the world's highest drug prices).
[London Free Press Regional News Archive]
Canada Internet Pharmacy Merged In $3.8 Million Deal
In recent years, many consumers in the US (and in other countries with high drug costs), have turned to licensed Internet pharmacies in India, Israel, and the UK, which often have even lower prices than in Canada.
In the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., federal district, five ma ...
, there has been a push to legalize the importation of medications from
Canada
Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tota ...
and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates
Food and Drug Administration
The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
(FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities.
Gallery
File:Raeapteek sign.jpg, Sign of the Town Hall Pharmacy in Tallinn
Tallinn () is the most populous and capital city of Estonia. Situated on a bay in north Estonia, on the shore of the Gulf of Finland of the Baltic Sea, Tallinn has a population of 437,811 (as of 2022) and administratively lies in the Harju '' ...
, operating continuously from at least 1422, showing the Bowl of Hygieia
The Bowl of Hygieia is one of the symbols of pharmacology, and along with the Rod of Asclepius it is one of the most ancient and important symbols related to medicine in western countries. Hygieia was the Greek goddess of health, hygiene, cleanl ...
File:Farmacia conventuale Museo scienza e tecnologia Milano.jpg, Convent pharmacy exhibited at the Museo nazionale della scienza e della tecnologia Leonardo da Vinci of Milan.
File:Szczecin al Jana Pawla II 42 zabytek.jpg, Contemporary pharmacy in an older building
File:NatMuseum.Ravenna.jpg, 19th-century Italian pharmacy
File:Ancienne Pharmacie avec symboles sur la mur.JPG, Classic symbols at the wall of a former German pharmacy
File:Drug store interior - DPLA - d624c216c03f4f63f172cf014313fb61.jpg, interior of an unidentified drugstore in Toledo, Ohio, United States, 1900s. A large cigar counter and a long bar with seating is featured. The photo was taken by Charles F. Mensing around 1900.
File:PostcardSimsburyCTAELathropsDrugStoreCirca1905.jpg, Typical American drug store with a soda fountain, about 1905
File:Drug store restoration, Wellington, TX IMG 6178.JPG, Drug store restoration ca. 1920 at Collingsworth County
Collingsworth County is a county in the U.S. state of Texas. As of the 2020 census, its population was 2,652. Its county seat is Wellington. The county was created in 1876 and later organized in 1890. It is named for James Collinsworth, a signer ...
Museum and Art Center
File:Selvvalg.jpg, Modern pharmacy in Norway
Norway, officially the Kingdom of Norway, is a Nordic country in Northern Europe, the mainland territory of which comprises the western and northernmost portion of the Scandinavian Peninsula. The remote Arctic island of Jan Mayen and t ...
File:Walgreens store.jpg, A chain store
A chain store or retail chain is a retail outlet in which several locations share a brand, central management and standardized business practices. They have come to dominate the retail and dining markets and many service categories, in many ...
pharmacy in the United States
File:Drug Mart Pharmacy in South Plainfield NJ.jpg, alt=Outside an independent drugstore in South Plainfield, New Jersey, Outside an independent pharmacy in South Plainfield
South Plainfield is a borough in Middlesex County, New Jersey, United States. It is located in the heart of the Raritan Valley region. As of the 2010 United States Census, the borough's population was 23,385,[New Jersey
New Jersey is a U.S. state, state in the Mid-Atlantic States, Mid-Atlantic and Northeastern United States, Northeastern regions of the United States. It is bordered on the north and east by the state of New York (state), New York; on the ea ...]
File:Apteekki - panoramio.jpg, A pharmacy at night in Nokia
Nokia Corporation (natively Nokia Oyj, referred to as Nokia) is a Finnish multinational telecommunications, information technology, and consumer electronics corporation, established in 1865. Nokia's main headquarters are in Espoo, Finlan ...
, Finland
Finland ( fi, Suomi ; sv, Finland ), officially the Republic of Finland (; ), is a Nordic country in Northern Europe. It shares land borders with Sweden to the northwest, Norway to the north, and Russia to the east, with the Gulf of Bo ...
File:Vitusapotek 2012.JPG, A pharmacy in Norway
Norway, officially the Kingdom of Norway, is a Nordic country in Northern Europe, the mainland territory of which comprises the western and northernmost portion of the Scandinavian Peninsula. The remote Arctic island of Jan Mayen and t ...
that is part of a shopping mall
File:Ethio 12.jpg, Interior of a pharmacy in Ethiopia
Ethiopia, , om, Itiyoophiyaa, so, Itoobiya, ti, ኢትዮጵያ, Ítiyop'iya, aa, Itiyoppiya officially the Federal Democratic Republic of Ethiopia, is a landlocked country in the Horn of Africa. It shares borders with Eritrea to the Er ...
File:President Richard Nixon Making a Surprise Visit to the Keystone Drug Store in Houston, Texas - DPLA - 3897797abd765a94c74089c94dc0f2e9.jpg, Richard Nixon
Richard Milhous Nixon (January 9, 1913April 22, 1994) was the 37th president of the United States, serving from 1969 to 1974. A member of the Republican Party, he previously served as a representative and senator from California and was t ...
at a drug store lunch counter in Houston, Texas, on March 20, 1974
File:NanningTianchiShanPharmacy.jpg, alt=, A pharmacy in Nanning
Nanning (; ; za, Namzningz) is the capital and largest city by population of the Guangxi Zhuang Autonomous Region in Southern China. It is known as the "Green City" because of its abundance of lush subtropical foliage. Located in the South o ...
, Guangxi, China
See also
*
References
External links
International Pharmaceutical Federation (FIP)
{{Authority control
Pharmacy
Retailers by type of merchandise sold