CLINICAL PHARMACY IN INDIA: RECENT ADVANCES AND PERSPECTIVE

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Medication Therapy Management (MTM) involves partnership of the pharmacist, the patient or their caregiver, and other health professionals that promote the safe and effective use of medications and helps patients achieve the targeted outcomes from medication therapy. Therefore, it also deals with the formal education about the rational drug use. Through this it is desired to educate and train the people regarding health care practices. In Disease State Management (DSM) process of organizing care for a specific high-cost and/or high volume diagnosis, with the intention of improving outcomes and, when possible, lowering overall costs is involved. DSM is a multi-step process which involves evidence-based clinical policies, an explicit implementation strategy and a data-driven feedback mechanism to objectively measure those aspects of care the program is designed to impact (e.g., clinical outcomes, patient satisfaction, cost, etc.). This may involve Electronic Data Processing (EDP) that can be referred to the use of automated methods to process commercial data. Typically, this uses relatively simple, repetitive activities to process large volumes of similar information. For example: stock updates applied to an inventory, banking transactions applied to account and customer master files, booking and ticketing transactions to an airline's reservation system, billing for utility services.

Clinical pharmacists practicing in the hospitals and the community pharmacies may obtain medication histories, counsel patients, review treatment regimens, monitor drug therapy, give drug information, report ADRs, conduct drug-use evaluations, and provide poison control services. Many of the advances in clinical pharmacy in India were initiated in hospitals only. However, clinical pharmacy practice is not well established in the community setting in India, because most pharmacists practicing have minimum qualifications, principally only a two-year Diploma (D.Pharm) program. Students are now beginning to realize the excitingly bright opportunities available in patient counseling and disease management. In the pharmaceutical industry, clinical trial coordination, medical information, and medical writing are the arenas where clinical pharmacists are suited to work. More clinical trials are being conducted within the pharmaceutical industry and clinical research organizations. Medical writing and education in the area of marketing allow pharmacists to apply their background in drug information and literature evaluation. Training clinical pharmacists requires well-qualified faculty.

In India, Clinical pharmacy services were initiated in 1992, when 2 Indian hospital pharmacists, B. Suresh and B.G. Nagavi, of Ooty and Mysore, respectively, sought out clinical pharmacist Frank May in Australia. That same year, May visited their schools of pharmacy in India. Clinical pharmacy education programs have been launched in India but much work will be required to expand and improve these programs to bring the benefits of clinical pharmacy practice to the huge swath of the Indian society. During 1997, the hospitals in Mysore and Ooty were the sites of clinical pharmacy practice programs developed in collaboration with a senior clinical pharmacist from RGH. The target approaches for the programs were developing competencies through academic curricula and establishing practice centers in hospitals. Curricular changes were targeted in undergraduate curriculum development, and a new branch in postgraduate courses was introduced. Two model centers for the practice of clinical pharmacy were developed: the government sector model and the private sector model. There are several Institutes for the study of Clinical Pharmacy in India like- Shri Sarvajanik Pharmacy College in Gujarat, R.C. Patel College of Pharmacy in Maharashtra, Bharath Institute of Technology in Andhra Pradesh, School of Pharmacy And Technology Management, NMIMS University in Maharashtra, Shri Guru Ram Rai Academy of Pharmaceutical Sciences in Uttrakhand and University Department of Pharmaceutical Sciences in Orissa. Along with these several institutes are also established in New Delhi- Delhi Institute of Pharmaceutical Sciences & Research (DIPSAR), Jamia Hamdard (Hamdard University), ICRI and CREMA. Several institutes are providing industrial training and placement as well. The introduction of clinical pharmacy practices is now spreading to other parts of India. It is seen that because of the success of the clinical pharmacy activities in Mysore and Ooty, activities have begun to occur in other Indian cities as well, including Bangalore, Belgaum, Chennai, Cochin, Coimbatore, Manipal, and Trichur.

Future scope
Future scope of Clinical pharmacy seems to be bright in India. Since many companies, including MNCs, are investing in Clinical Trials/Research, Pharmacovigilance and Drug Information. However, in order to understand the need for implementation and career growth in the field of clinical pharmacy in India, one must also understand the current state of pharmacy education and practice here. For the most part, these focal areas still exist according to the traditional Indian model. Therefore, it’s clear, in order to achieve excellence in our Clinical Pharmacy education we need to reframe our content and duration of the degree courses and arrange adequate training for our upcoming generations of clinical pharmacists rather than implementation of traditional knowledge of pharmacy, and also, a good investment by related companies or business giants.

CONCLUSION
Clinical pharmacy will emphasize to raise the standard of health care delivery to human life. It will promote the rationale use of medicine including allopathy and traditional medicine. In order to achieve specificity to vulnerable disease as well to assess the pathological condition accurately and this will drastically reduce the financial burden. Clinical pharmacist will focus to ensure to achieve the well-being health of human by pharmacotherapy with minimal adverse effects.

REFERENCES
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