Theme: Labour & Employment

While helping clients, pharmacists have certain duties:

• A pharmacist is not bound to attend every person who asks for their service. However, a pharmacist should always be ready to respond to the sick and injured.^{(( Regulation 8.1(a), Pharmacy Practice Regulations, 201))}
• Pharmacists should always maintain the confidentiality of their patients. For instance, a pharmacist should not reveal any issues or defects of patients observed during medical attendance. However, if the laws of the State require a pharmacist to give such information, they can do so. Pharmacists can also give such information if they think it will protect a healthy third party from a communicable disease like malaria, COVID-19 etc.^{(( Regulation 8.1(a), Pharmacy Practice Regulations, 2015))}
• While giving a prognosis, a pharmacist should not exaggerate or minimize the seriousness of the patient’s condition. In addition, pharmacists should ensure that the patient, patient’s family and close friends have knowledge of the patient’s condition so as to serve the best interests of the patient and patient’s family.¹
• Pharmacists should respond to any request for their assistance in an emergency. They should not deliberately commit an act of negligence that may deprive the patient from necessary medical care.^{(( Regulation 8.4, Pharmacy Practice Regulations, 2015))}

Patient Counseling by Pharmacists

Upon receiving a prescription drug order, and after reviewing the patient’s record, a registered pharmacist should personally initiate discussion of matters that will optimize the drug therapy or care of the patient. The pharmacist can conduct the discussion in person, or by telephone etc.

The discussion should include appropriate elements of patient counseling.^{(( Regulation 9.3(a), Pharmacy Practice Regulations, 2015))} Such elements may include the following :

• Name and description of the drugs^{(( Regulation 9.3(a)(i), Pharmacy Practice Regulations, 2015))}
• The dosage form, dose, route of administration, and duration of drug therapy^{(( Regulation 9.3(a)(ii), Pharmacy Practice Regulations, 2015))}
• Special directions and precautions for the drug^{(( Regulation 9.3(a)(iv), Pharmacy Practice Regulations, 2015))}
• Common side effects, adverse effects etc. that may be encountered, including their avoidance, and the action required if they occur^{(( Regulation 9.3(a)(v), Pharmacy Practice Regulations, 2015))}
• Techniques for self monitoring drug therapy^{(( Regulation 9.3(a)(vi), Pharmacy Practice Regulations, 2015))}
• Proper storage of the drugs^{(( Regulation 9.3(a)(vii), Pharmacy Practice Regulations, 2015))}

The patient or their agent can always refuse such counseling.

Role of pharmacies during counseling

The pharmacist has to maintain a record of drugs administered to the patient.^{(( Regulation 9.3(b), Pharmacy Practice Regulations, 2015))}Further, pharmacies providing patient counseling have to keep in mind that:

• Only registered pharmacists can be involved in counseling.^{(( Regulation 9.3(d)(i), Pharmacy Practice Regulations, 2015))}
• Facilities should be provided for confidential conversation, and patient confidentiality must be maintained.^{(( Regulation 9.3(d)(ii), Pharmacy Practice Regulations, 2015))}
• Proper documentation is necessary.^{(( Regulation 9.3(d)(iv), Pharmacy Practice Regulations, 2015))}
• Counseling should be for the patient’s benefit. In every consultation, the benefit to the patient is of foremost importance. All registered pharmacists engaged in the case should be frank with the patient and his attendants.^{(( Regulation 9.3(d)(vi), Pharmacy Practice Regulations, 2015))}
• During counseling, punctuality should be maintained.^{(( Regulation 9.3(d)(vii), Pharmacy Practice Regulations, 2015))}

However, please remember that the law does not give pharmacists the power to open pharma clinics to diagnose the disease and prescribe medicines.^{(( Clarification on Pharmacy Practice Regulations, 2015 notified by Pharmacy Council of India in Gazette of India No.17 dated 16.1.2015))}

If these duties are not fulfilled and you face issues as a pharmaceutical client/patient, then you can file a complaint against the pharmacist.

1. Regulation 8.3, Pharmacy Practice Regulations, 2015 [↩]

Some of the ethical practices for pharmacists include:

Handling of Drugs/Medicines by Pharmacists

Pharmacists should take all possible care to dispense a prescription correctly by weighing and measuring all ingredients in correct proportions, with the help of scale and measures (visual estimations must be avoided). Further, a pharmacist should always use drugs and medicinal preparations of standard quality, and should never adulterate the preparations. A pharmacist should be very careful in dealing with drugs and medicinal preparations known to be poisonous, or used for addiction  or any other abusive purposes.^{(( Chapter II, Code of Pharmaceutical Ethics))}

Hawking of Drugs/Medicines

Hawking of drugs and medicines is discouraged. Therefore, pharmacists cannot engage in door-to-door solicitation of the products. To prevent self-medication using drugs, pharmacists are discouraged from distributing therapeutic substances without expert supervision.^{(( Chapter III, Code of Pharmaceutical Ethics))}

Fair Trade Practice

Cut-throat competition, aiming to capture the business of another pharmaceutical establishment is discouraged among pharmacists. Cut-throat competition includes:

• Offering any sort of prizes, gifts or any kind of allurement to customers
• Knowingly charging lower prices for medical commodities, compared to the reasonable prices charged by a fellow pharmacist.

In case any order or prescription intended to be served by a particular dispensary is brought by mistake to another dispensary, the latter should refuse to accept it and should direct the customer to the right place. Imitation or making a copy of labels, trademarks and other signs and symbols of other pharmaceutical establishments are also not allowed under the law. ^{(( Chapter III, Code of Pharmaceutical Ethics))}

Advertising and Displays

In connection to selling medicines to the public, a pharmacist should not use displays that are undignified, or which contain the following:³

• Any wording design or illustration that reflects pharmacists or an individual in a bad light.
• A disparaging or derogatory reference to other suppliers, products, remedies or treatments. Even if the comments are direct or implied, it is not allowed.
• Misleading or exaggerated statements or claims.
• The word “Cure” in reference to an ailment or symptoms of ill-health.
• A guarantee of therapeutic effect
• An attempt to increase fear through advertisements.
• An offer to refund money paid by a customer
• A prize, competition or similar scheme.
• Any reference to a medical practitioner or a hospital, or the use of the terms “Doctor” or “Dr.” or “Nurse” in connection with the name of a preparation not already established.
• A reference to sexual weakness, premature ageing or loss of virility.
• Indecent references to complaints of sexual nature.

If a pharmacy knows, or  could reasonably know that a preparation is advertised by such means, such preparations should not be displayed in the pharmacy.