Over the past 4-5 decennary there has been drastic alteration in the function of druggist with the promotion of medicine field. Previously druggists were considered to be individual who merely used compound and fix medical specialties. But as the clip advanced, druggists were considered as professionals who non merely used to compounds and sell medical specialties but besides advice people sing the patient ‘s wellness. Pharmacists are considered to be most accessible health care professionals who provide wellness and medical installations with legal and ethical permission of selling the prescription or nonprescription ( OTC ) drugs ( WHO,1990 ) . Due to increase in demands for health care the druggist have now get downing taking patient centred attack. The function of druggist has shifted from medical specialties marketer to that of healthcare professional that provides advice to the patients sing their heath ( Basak and Sathyanarayan,2009 ) . This new attack in the field of pharmaceutics is called as pharmaceutical attention ( Shaqua and Zairi, 2001 ) . The most recognized definition of pharmaceutical attention can be given as: “ Pharmaceutical attention is the responsible proviso of drug therapy for the intent of accomplishing definite results that improve a patient ‘s quality of life ” ( Hepler and Strand, 1990 ) .
The World ‘s Health Organisation and International Pharmaceutical Federation ( FIP ) gave a construct of “ seven-star druggist ” which includes following maps of a druggist: Caretaker, Decision shaper, Communicator, Manager, Life-long scholar, Teacher and Leader. The druggists are of import nexus between the prescriber and patients. They should supply highest quality information to the patients sing the wellness and medical specialties. The druggists should maintain their accomplishments accurate and should be a uninterrupted scholar. They should besides be a really good instructor and should help the fellow druggists every bit good as public sing latest invention in health care. Along with this a druggist should besides be a really good leader with a vision and ability to take ( WHO, 2000 ) . Pharmacists provide professional services to the society in the signifier of pharmaceutical attention with focal point on populations and/or single patients. Pharmaceutical public wellness is defined as “ The application of pharmaceutical cognition, accomplishments and resources to the scientific discipline and art of forestalling disease, protracting life, advancing, protecting and bettering wellness for all through the organized attempts of the society ” ( Walker R, 2000 ) . Pharmaceutical public wellness includes services to population such as national medical specialties policy, local guidelines and intervention protocols, medical specialty usage reappraisal and rating and indispensable medical specialties lists.
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Statement of job
Many surveies have been conducted in different states on the public perceptual experience towards the druggist. Harmonizing to survey conducted by Brodie DC ( 1981 ) in England, it was concluded that by the virtuousness of cognition, apprehension, opinion, processs and accomplishments, druggists provide quality medical specialties and suited advice to patients for appropriate usage of their medical specialties. Another survey was conducted in Nigeria about public perceptual experience towards community druggists, the consequence of the survey were positive sentiments from people about druggists ( Oparah and Fwagwu, 2001 ) . A survey was conducted by Sharma et.al ( 2009 ) , in India for the appraisal of function of druggist in community services which highlighted many of import consequences about people ‘s perceptual experience towards community druggist. Some people interviewed did non even know the difference between a GP and a druggist. Many were incognizant of the health care services like wellness guidance, general advice about drug use, a druggist can supply to patients.
In India, largely druggists are non found in explicating the authorities ‘s wellness and pharmaceutical policies. The ground behind this is due to the deficiency of lucidity of their functions and the possible beyond the supply of pharmaceutical merchandises. Policy shapers in India largely see pharmaceuticss from commercial endeavor point of position and druggists as concern people. Policy shapers do non work the potency of druggists in commercial, hospital or authorities scenes for bettering the wellness and pharmaceutical scenes, so that druggists can cut down the unneeded work burden for physicians and nurses ( WHO, 2007 ) . In order to run into the societal demands and public wellness aims, the druggists should be trained and educated decently.
Why pharmaceutics services are of import portion of health care?
The chief function of Pharmacists is to distribute the drugs which are prescribed by the doctors. However there are many groundss which prove that even the traditional manner of prescribing and dispensing is non safe and effectual. Even in most of the developed states, 4-10 % of all hospital in-patients experience an inauspicious reaction due to medicate related mistakes and multiple drug therapy. For example- In USA the estimated cost of medical specialty related mistakes is US $ 130 billion and it is 4th-6th taking cause of decease in the state. In the UK, it was estimated to be around ?466 million in the twelvemonth 2004 ( WHO, 2006 ) . Therefore in order to understate the drug related mistakes pharmacist should concentrate on pharmaceutics services more actively.
In order to advance the function of druggist in health care in India, a new enterprise was started by WHO India by carry oning a “ National Conference on Challenges and Opportunities of Pharmacists in Health Care ” in New Delhi on 30th October 2007. The chief aims of this conference were ;
To better surplus to medical specialties and rational usage of drugs.
To forestall and command the usage of Anti Retro Viral in HIV/AIDS
Revise National Tuberculosis Control Programme
High blood pressure and diabetes testing
Prevention of toxic condition.
Pharmacovigilance and Adverse Drug reactions ( ADR ) monitoring.
Family planning and RCH
Problems of geriatric patients
Trauma direction in accident instances
This conference was conducted to beef up the professional image of druggist. Evidence are found worldwide which suggests that the engagement of druggists in wellness publicity, bar of diseases, supplying information on medical specialties and disease direction improves the efficiency of health care system. It is clear that the pharmaceutics has an of import function to play in the reform of wellness sector. In order to accomplish this alteration the function of druggist demands to be redefined and reoriented. Pharmacists have possible to better the patient ‘s quality of life by bettering the curative results and must set themselves at the head of health care system.
Healthcare and medicate scene in India.
In India, health care bringing and medical specialty supply to the patients are provided by three types of establishment. First, state-run wellness Centres for ambulatory patients and state-run infirmaries in subdivision towns and territories for hospitalised patients. A medical officer is in-charge of such health care and medical specialties installations. The position is same for the primary wellness Centres and sub-centres like that of state-run infirmaries. In general, the primary attention wellness Centres are chiefly located in the rural health care systems and the services are chiefly used by the lower income group people ( Lakshmi et.al, 2002 ) . Second set-up includes a in private owned multi-speciality infirmary which chiefly provides attention to more flush category of people. Patients have to pay for the services they receive. Finally, several in private owned independent clinics provide wellness attention, reding ( largely done by physicians ) and even medicines to ambulatory patients which are all paid services. India spends about 5.1 % of GDP in footings of private outgo on wellness of which drugs and pharmaceuticals account for about 15 % of entire healthcare outgo. ( Chandrasekhar and Ghosh, 2006 ) . The private wellness sector is dominant in India with about 50 % of people seeking institutional attention and around 60-70 % seeking ambulatory attention from private installations ( Basak et.al, 2009 ) .
Current scenario of Pharmacists in India
The pattern of community every bit good as infirmary pharmaceutics in a underdeveloped state like India is different from that of other developed states like U.K and U.S.A. The community pharmaceutics shops are called as medical shops, drug shops or chemist stores ( Adepu and Nagavi, 2003 ) . The perceptual experience of people for community druggists are like that of tradesmans in India. Consumers and patients come to the medical shops for purchase of medical specialties the same manner as they visit a food market shop to purchase nutrient points. The general population in India considers pharmacist as a drug bargainer and non as a healthcare professional. Pharmacists are considered as compounders who normally assist physicians. The general perceptual experience of most of people sing the pharmaceutics shops are like every bit easy as opening a stationary store ( Basak and Sathyanarayan, 2009 ) .
Harmonizing to the WHO informations ( 2007 ) , in India, there are about 500,000 druggists i.e. 5.6 per 10,000 individuals or 1 druggist per 1,785 individuals ; most of them are diploma holders. About 75 % of them are engaged in community, infirmary and authorities pharmaceutics pattern. Although the ratio of druggist to population is sensible in comparing to universe norm ( 1 druggist per 2,941 individuals ) but the existent figure of practising druggist in India is really low due to migration of druggist to other developed states. The existent figure of druggists per individual was found to be 1:3684 in Uttar Pradesh while about 1:4082 in Karnataka province of India. It was besides found that the ratio of druggist was comparatively high in the urban countries while highly low in the rural and distant countries. In a survey conducted in Mysore it was found that approximately 35 % of pharmaceuticss were run by people who hired the licence of a registered druggist on his behalf. Such people operate the pharmaceutics services from commercial point of position instead than healthcare services ( Basak et.al, 2009 ) . The minimal instruction for being a registered druggist in India is a Diploma grade of 2 old ages which is really low criterion compared to other developed states.
The intent of the research is an explanatory survey to research the challenges of pharmaceutics profession in a underdeveloped state like India and to promote possible functions a druggist can play in advancing health care services. This survey will concentrate on the current state of affairs of community and infirmary druggists in India and what is people ‘s perceptual experience about druggist in footings of supplying health care services. The survey will besides see the necessary stairss required to reform the pharmaceutics instruction in India and discourse the changing schemes for upliftment of pharmaceutics profession in corporate infirmaries like Apollo, India. Decisions of the survey will be made on the footing of findings from the questionnaire and interviews and recommendations will be provided based on these findings.
The traditional function of the druggists in the community every bit good as infirmary pharmaceutics scenes is distributing of medical specialties. However in current scenario many unethical patterns are conducted by the druggists in India including storage of medical specialties under improper conditions, running pharmaceuticss without the physical presence of registered druggist, merchandising of medical specialties without proper prescription and hard currency memo. Furthermore most of people in India consider druggists as a tradesman and non as a healthcare professional. It is besides seen that most of the druggists are found working in urban countries and hesitate to work in rural or distant countries. Therefore this survey will concentrate on the possible functions a druggist can play in advancing health care services and traveling to patient care attack instead than money doing tendency.
The chief aims of this research are:
To advance the function of druggist in supplying health care services in India.
To look into the current instruction degree of pharmaceutics in India.
To promote the engagement of druggists in supplying wellness reding to the patients.
To analyze the current perceptual experience of people towards druggists in Gujarat.
To foreground on altering tendencies towards pharmaceutics services in corporate health care administrations like Apollo and Sterling infirmaries.
The research will get down by carry oning a systemic reappraisal of old research literatures on the undermentioned subject to guarantee that the proposed research is traveling in right way with right methods. Literature reappraisal on the subject helps to back up the research aims and gives an chance to plan and transport out a significant piece of fact-finding work in a topic specific subject ( Hart C. , 1998 ) .
The first portion of the research survey will be based upon a sample questionnaire-based study which will be carried out in four pharmaceuticss ( 2-Community pharmaceuticss and 2- infirmary pharmaceuticss ) . A sample Questionnaire is developed based on the consumer study carried out in the Pharmacy Practice Research beginning ( PPRRC ) , Manchester, in 1994. The intent of the study based questionnaire will be to measure the function of druggist in supplying health care services and besides to happen out the perceptual experience of people towards the druggist. The consumers or patients will be asked to make full the study dwelling of 10 inquiries, after they receive the services from the pharmaceutics.
A sample Questionnaire prepared by writer for measuring the function of druggist in advancing health care services can be found in Appendix-1 of this research proposal.
As the writer is traveling to make a primary research in his ain state, where English is non the first linguistic communication, the study Questionnaire will besides be prepared in local linguistic communication so that people may non hold trouble in understanding the inquiries.
Although the questionnaire based study might be the appropriate method for research but writer is besides cognizant of the advantages and disadvantages of utilizing this method of research. As it is a questionnaire based study it eliminates recall prejudices, unlike other surveies and there are no verbal or visuals hints to act upon the respondent ( Sharma et.al, 2009 ) .
Table 1. Advantages and Disadvantages of Questionnaire-based studies
Supply a simple and straightforward attack to the survey of attitudes, values, motivations and beliefs.
Easy to compare and analyze
Responses are gathered in a standardised manner so they are more aims than interviews.
Potential information can be collected from a big part of group.
Cost effectual compared to confront to confront interviews.
Questionnaires occur after the event, so participant may bury of import issues.
Datas are affected by the features of the respondents for illustration ( memory, cognition, motive, experience ) .
Respondents may non handle the questionnaire earnestly and can impact the overall consequences.
Patients may non reply the inquiries accurately in order to conceal their individuality or disease.
Source- Adapted from ( Robson, 2002 ; Milen J, 1999 )
This questionnaire will seek to reply the undermentioned inquiries:
What is people ‘s perceptual experience towards druggist?
How is druggist ‘s attitude towards health care services?
How frequently do druggists supply advice sing wellness?
This type questionnaire was besides used efficaciously by Sharma et.al ( 2009 ) , in their survey to measure the function of druggist in health care services.
The 2nd portion of the survey will affect two semi structured face-to-face interviews of senior director and helper director of pharmaceutics section from Apollo infirmary, Ahmedabad, from where Author is traveling to make his primary research. Permissions have been granted by the directors sing the interviews. The intent of the qualitative interviews will be,
a ) To happen out the alteration in tendencies of pharmaceutics services with the engagement of corporate infirmaries like Apollo in Gujarat.
B ) Interviews will assist the writer to concentrate on the new schemes in corporate infirmaries to better the pharmaceutics services along with patient attention.
The interview will incorporate maximal 10 inquiries sing the function of druggists in advancing health care and what can be done to better the services. The information that emerges from qualitative is largely descriptive and are reported in words instead than Numberss ( Fraenkel and Wallen, 1990 ) .
In the first portion of survey the sample size will depend on the figure of people sing pharmaceutics and willing to make full questionnaire. Four pharmaceuticss will be chosen for this survey out of which 2 will be hospital pharmaceuticss. The age bound for take parting in the study will be kept between 12 to 75 old ages. The information will be coded and analysed utilizing computing machine programming called Statistical Package for Social Science ( SPSS ) and consequences will be based upon per centum of people replying the inquiry.
Two troughs will be interviewed in the 2nd portion of survey. Directors will be from Apollo infirmary, Ahmedabad, working as senior director and helper director in the pharmaceutics section of infirmary.
Method of research
The method used by the writer for research will be a assorted method incorporating both qualitative and quantitative survey. Harmonizing to Cornwell ( 2003 ) , this method allows the research worker to widen the treatment about a research job and concentrate on aims. The consecutive explanatory scheme will be used by writer in order to come on research.
Initially, a literature reappraisal will be carried out utilizing the keywords ‘Role of druggists in health care ‘ , ‘Indian community druggists ‘ , ‘Role of community and infirmary druggists in health care ‘ , ‘Pharmacy instruction in India ‘ , ‘Pharmacy ordinance in India ‘ , ‘Corporate hospital civilization in India ‘ , ‘Pharmaceutical attention services ‘ , ‘public perceptual experience on druggists ‘ , ‘Pharmacy pattern in Gujarat ‘ , ‘healthcare services in Gujarat ‘ , ‘Pharmacy concatenation civilization in India ‘ , ‘strategies by Indian authorities to advance pharmaceutics services in rural parts ‘ , ‘doctors behaviour for druggists ‘ , ‘registered druggists in India ‘ and ‘pharmacy council of India ‘ . This reappraisal will be carried out on databases like Google Scholar, Medline, Scirus, Pubmed, Index Copernicus, IndMed and DOAJ, till the terminal of April 2010.
A direct hunt will besides be made in diaries like “ Indian Journal of Pharmaceutical Sciences ” and “ Indian Journal of Hospital Pharmacy ” . In add-on to these, other beginnings like books and articles from library will besides be used by writer for research.
The research survey shall come on with the primary research utilizing a Questionnaire based study. Consumers or patients sing pharmaceutics will be asked to make full a questionnaire incorporating 10 multiple pick inquiries. They will be asked to make so while go outing from the pharmaceutics. The information of patients will be kept confidential and they will non be forced to make full the questionnaire. The study will take topographic point by the permission of druggists working under several pharmaceuticss. Before carry oning the study the questionnaire will be referred to senior druggist for blessing. The writer has decided to make this study from 4 pharmaceuticss out of which two shall be hospital pharmaceuticss in Apollo infirmaries. The ground for taking the infirmary pharmaceutics is to compare the services provided by hospital pharmaceutics with that of community pharmaceuticss in Ahmedabad, Gujarat. The computations for consequences of the questionnaire will be coded and analysed with the aid of computing machine scheduling. The consequences will depend on figure of people replying the Questionnaire and the per centum value will be determined based on the peculiar replies given.
The other portion of the research will be qualitative that shall get down by carry oning semi-structured interviews with two directors of pharmaceutics section in Apollo infirmaries, Ahmedabad. One will be a senior director in charge and another will be an adjunct director. Direct inquiries will be asked to the directors by writer sing the current set up of pharmaceutics services in their infirmary and what new schemes are they following to heighten the function of druggists in health care. The information provided by the directors will be noted down by the writer for farther analysis of affair. Permissions for carry oning the interviews have been granted by the directors. Therefore the attack for the research survey will be a ‘mixed research method ‘ holding both Quantitative and Qualitative attack. Through research findings from literature reappraisals, questionnaire and interviews, recommendations and decisions shall be made to turn to the research aims.
The information analysis of the questionnaire-survey will be carried out by coding with the aid of Statistical Package for Social Science ( SPSS ) computing machine programme.
Expected Outcomes from research
Outcome steps of this research include perceptual experience of people towards druggists, a Questionnaire based study will be used to mensurate this. The research will besides research the altering tendencies in corporate infirmaries like Apollo towards pharmaceutics services, by the aid of semi-structured interviews of Senior and adjunct directors of Apollo infirmary. Decisions of the survey will be made based on the literature reviews, study based questionnaire and semi structured interviews.
This research will be a assorted method survey which involves both Quantitative and qualitative signifiers of research survey. While making the Questionnaire-based study i.e. quantitative survey, research worker will see the ethical concerns like individuality of patients or consumers and willingness to experience the questionnaire. The individuality of patients will be kept confidential and they will non be forced to inquire for make fulling the questionnaire. The research worker will besides take due consideration to keep privateness of patients. The research aims will be explained clearly to all participants prior make fulling the questionnaire. The writer will besides take ethical blessing from the several pharmaceuticss from where the questionnaires based study will take topographic point. Ethical blessing has besides been granted from the university coach for the proposed research.
The writer has besides got ethical blessing for carry oning interviews of Senior Pharmacy director and Assistant Manager, Apollo infirmary, Ahmedabad through electronic mail.
The primary research will be conducted with the aid of questionnaire-based study therefore the consequences may change depending upon emotions of people at the clip of make fulling the questionnaire.
The survey is limited to a peculiar figure of pharmaceuticss and besides the sample size of respondents is limited.
The clip for the survey i.e. about 3 months is limited.
Time tabular array and cost of research
The research will be led by writer and necessary advice will be taken from the thesis supervisor as required. The writer will make his primary research from his place state India. During this clip the writer will be invariably in touch in with the supervisor through electronic mail and phone. The cost of this research will be funded by writer himself.
Table 2: Estimated costs of research programme
Outgo ( Cost in ? )
Documents required for making research
Interlibrary diary petitions
Printing of Journal articles
Printing of questionnaires
To India for making primary research
Cost of study printing and binding
?860 ( Approximately )
The timetable for carry oning the research with the estimated day of the months for executing undertakings has been presented in Appendix-2
Justification of Proposal
The proposed research is justified for a figure of grounds. First, there are limited surveies published in India which cover function of druggists in health care. This is comparatively a new subject for research in healthcare field. This fact can be supported by a bibliometric survey conducted by Basak and Sathyanarayan, ( 2010 ) to analyse and enter the published grounds sing community pharmaceutics pattern in India during the past decennary ( 1998-2008 ) . This survey concluded that merely little figure of research or reappraisal articles were available in India based on community and infirmary pharmaceutics services in India. Thus it was seen that less accent has been given on pharmaceutics research related to medicate use and function of druggist in health care services. Hence this research will research the jobs predominating in India about the pharmaceutics profession and how druggists can be made cognizant about many other possible functions they can play along with distributing medical specialties.
Second, the interviews to be taken will assist the writer to happen new schemes implemented in corporate infirmaries like Apollo for the sweetening of pharmaceutics services by concentrating more on patient attention services.