Community Pharmacy and Management

Chapter Topic Community Pharmacy Practice – Definition, history and development of community pharmacy - International and Indian scenarios Professional responsibilities of community pharmacists Introduction to the concept of Good Pharmacy Practice and SOPs.

Prescription and prescription handling • Definition, parts of prescriptions, legality of prescriptions, prescription handling, labelling of dispensed medications (Main label, ancillary label, pictograms), brief instructions on medication usage • Dispensing process, Good Dispensing Practices, dispensing errors and strategies to minimize them Communication skills • Definition, types of communication skills • Interactions with professionals and patients • Verbal communication skills (one-to-one, over the telephone) • Written communication skills • Body language • Patient interview techniques Patient counselling • Definition and benefits of patient counselling • Stages of patient counselling - Introduction, counselling content, counselling process, and closing the counselling session • Barriers to effective counseling - Types and strategies to overcome the barriers • Patient counselling points for chronic diseases/disorders - Hypertension, Diabetes, Asthma, Tuberculosis, Chronic obstructive pulmonary disease, and AIDS • Patient Package Inserts - Definition, importance and benefits, Scenarios of PPI use in India and other countries • Patient Information leaflets - Definition and uses Medication Adherence Definition, factors influencing non- adherence, strategies to overcome non-adherence Health Screening Services in Community Pharmacy Introduction, scope, and importance of various health screening services - for routine monitoring of patients, early detection, and referral of undiagnosed cases Over The Counter (OTC) Medications • Definition, need and role of Pharmacists in OTC medication dispensing • OTC medications in India, counseling for OTC products • Self-medication and role of pharmacists in promoting the safe practices during self-medication • Responding to symptoms, minor ailments, and advice for self-care in conditions such as - Pain management, Cough, Cold, Diarrhea, Constipation, Vomiting, Fever, Sore throat, Skin disorders, Oral health (mouth ulcers, dental pain, gum swelling) Community Pharmacy Management • Legal requirements to set up a community pharmacy • Site selection requirements • Pharmacy designs and interiors • Vendor selection and ordering • Procurement, inventory control methods, and inventory management • Financial planning and management • Accountancy in community pharmacy – Day book, Cash book • Introduction to pharmacy operation softwares – usefulness and availability • Customer Relation Management (CRM) • Audits in Pharmacies • SOP of Pharmacy Management • Introduction to Digital Health, mHealth and Online pharmacies COMMUNITY PHARMACY AND MANAGEMENT – PRACTICAL Course Code: ER20-22P 75 Hours (3 Hours/week) Scope: The course is designed to train the students and improve professional skills to provide various pharmaceutical care services in community pharmacy.

Course Objectives: This course will train the students in the following

1. Professional handling and filling prescriptions

2. Patient counselling on diseases and minor ailments

3. Patient counselling on prescription and / or non-prescription medicines

4. Preparation of counselling materials such as patient information leaflets

5. Performing basic health screening tests Course Outcomes: Upon successful completion of this course, the students will be able to

1. Handle and fill prescriptions in a professional manner

2. Counsel patients on various diseases and minor ailments

3. Counsel patients on prescription and or non-prescription medicines

4. Design and prepare patient information leaflets

5. Perform basic health screening tests Practicals Note: The following practicals shall be carried out in the model community pharmacy with appropriate simulated scenarios and materials. Students shall be trained through role plays wherever necessary. The activities of the students shall be assessed / evaluated using a structured objective assessment form.

1. Handling of prescriptions with professional standards, reviewing prescriptions, checking for legal compliance and completeness (minimum 5)

2. Identification of drug-drug interactions in the prescription and follow-up actions (minimum 2)

3. Preparation of dispensing labels and auxiliary labels for the prescribed medications (minimum 5)

4. Providing the following health screening services for monitoring patients / detecting new patients (one experiment for each activity) Blood Pressure Recording, Capillary Blood Glucose Monitoring, Lung function assessment using Peak Flow Meter and incentive spirometer, recording capillary oxygen level using Pulse Oximeter, BMI measurement

5. Providing counselling to simulated patients for the following chronic diseases / disorders including education on the use of devices such as insulin pen, inhalers, spacers, nebulizers, etc. where appropriate (one experiment for each disease) Type Diabetes Mellitus, Primary Hypertension, Asthma, Hyperlipidaemia, Rheumatoid Arthritis

6. Providing counselling to simulated patients for the following minor ailments (any three) Headache, GI disturbances (Nausea, Vomiting, Dyspepsia, diarrhoea, constipation), Worm infestations, Pyrexia, Upper Respiratory Tract infections, Skin infections, Oral and dental disorders.

7 Appropriate handling of dummy dosage forms with correct administration techniques - oral liquids with measuring cup/cap/dropper, Eye Drops, Inhalers, Nasal drops, Insulin pen, nebulizers, different types of tablets, patches, enemas, suppositories 8 Use of Community Pharmacy Software and digital health tools Assignments The students shall be asked to submit written assignments on the following topics (One assignment per student per sessional period. i.e., a minimum of THREE assignments per student)

1. SOPs for various activities in Community Pharmacy (as discussed in Theory and Practical)

2. List out the various abbreviations, short forms used in prescriptions and their interpretation

3. Patient Information Leaflet for a given chronic disease / disorder

4. Patient Information Leaflet for prescription / non-prescription medicines

5. Preparation of window / shelf display materials for the model community pharmacy

6. Overview of Software available for retail pharmacy management including billing, inventory, etc.

7. Dosage / Medication Reminder Aids

8. Overview on the operations and marketing strategies of various online pharmacies

9. Overview on the common fixed dose combinations

10. Overview on the medications requiring special storage conditions

11. Role of Community Pharmacists in preventing Antimicrobial Resistance

12. Jan Aushadhi and other Generic Medicine initiatives in India

13. Global Overview of Online Pharmacies

14. Community Pharmacy Practice Standards: Global Vs. Indian Scenario

15. Overview of pharmacy associations in India Field Visit The students shall be taken in groups to visit community pharmacies and medicine distributors to understand and witness the professional activities of the community pharmacists, and supply chain logistics. Individual reports from each student on their learning experience from the field visit shall be submitted.