The pharmacy profession faces a growing number of challenges and complex issues, says Tiene Bauters PharmD PhD, Pharmacy; Pediatric Hematology, Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium.
Healthcare digitalisation, technology and robotisation are on the rise, all the while influencing and impacting the care for patients. This affects many aspects of hospital pharmacy, from distribution systems, medical devices, production unit services to communication platforms with patients.
For example:
- The introduction of a large number of mobile phone medication adherence apps to optimise patient compliance, by ending alerts to take medications, tracking doses, and supporting medication instructions1Remote treatment advice and telepharmacy, providing pharmaceutical care through telecommunication to patients in remote areas where no or difficult access or contact with a pharmacist is guaranteed
- The application of 3D printing creates widespread opportunities including designing drugs with specific shapes and colours, implants, and surgical moulages, and its application in orthopaedics, maxillo-facial and cardiac surgery is established and quality continually improves2,3
- Robotic automation for compounding hazardous drugs enhances healthcare workers’ safety as the robotic systems handle the drugs during the compounding system. In tandem with closed system transfer devices, it offers the highest level of protection. Other advantages are the faster rate compared with manual compounding and the reduced possibility of human error by preventing medication errors. Robots may be used increasingly in future for large scale production provided they are financially accessible. Robotic automation is not only applied for hazardous drugs but also for sterile intravenous compounding, which is considered one of the highest risk areas of pharmacy practice. A set of recommendations dedicated to automated intravenous compounding in (hospital) pharmacies has been developed and should contribute to a better understanding of the role of robotic compounding in hospital and health-system pharmacy4
- The market for automated systems for packaging, labelling, medication dispensing, coding and tracing of batch numbers and expiry dates, automatic reordering of drugs and consumables, and storage and retrieval is growing and is expected to continue to do so. Hence, prescribing, compounding and administration will become increasingly interconnected, thereby allowing increased productivity, and improved quality of care and patient safety.
Clinical pharmacy services integrating advanced clinical rules such algorithms into computerised physician order entry (CPOE) systems just as the integration of advanced systems combining information from several sources (laboratory, diagnoses, etc) with the CPOE might be a challenge for many hospital pharmacists.
Managing drug shortages is, and will remain, a significant and complex concern for practitioners in hospitals. Developing and implementing appropriate strategies to overcome these shortages and provide seamless, safe and therapeutically equivalent drug therapy, preferably at a comparable cost will be an important role and task of the pharmacist.
Students and new practitioners are the future of pharmacy practice. They must be armed with the most current and up-to-date evidence-based information available. Expanding numbers of therapeutic options drives the need for continuous training, not only for students but also for peers already active in the field, and should continue to be provided in different ways.
Finally, as patients’ needs become more complex, multidisciplinary collaborations will be key to enhanced patient safety and quality of patient-centred healthcare.
Considering these challenges, it’s clear that it is now time to work on the main steps to bridge the present with all the possibilities for the future.
References
- Park JYE et al. Mobile phone apps targeting medication adherence: Quality assessment and content analysis of user reviews. JMIR Mhealth Uhealth 2019;7(1):e11919.
- Yaniv AW et al. Robotic i.v. medication compounding: Recommendations from international community of APOTECAchemo users. Am J Health Syst Pharm 2017;74:e40–46.
- Prasad LK, Smyth H. 3D Printing technologies for drug delivery: a review. Drug Dev Ind Pharm 2016;42(7):1019–31.
- Tack P. 3D-printing techniques in a medical setting: a systematic literature review. Biomed Eng Online 2016;15(1):115.
