The Australian practice pharmacist

Background: Evolution in Australian community pharmacy and general practice environments has seen the emergence of a new opportunity for pharmacist practice, distinct from the conventional community and hospital settings, in which the pharmacist is integrated into the general practice setting to provide professional services. Aim: To characterise pharmacists practising in the Australian general practice setting. Method: An electronic questionnaire. Results: Twenty-six practice pharmacists completed the questionnaire. Practice pharmacists were more likely to be female, aged between 30 and 49 years, have postgraduate qualifications and also work in other pharmacy sectors. The general practice settings more frequently had multiple general practitioners and also housed multiple allied health professionals. The most commonly conducted services provided by the practice pharmacists were Home Medicine Reviews, responding to clinical enquiries from general practitioners and responding to enquiries from other health professionals. Most practice pharmacists worked as independent contractors for services provided. The practice pharmacists provided some services in the absence of remuneration. The majority of practice pharmacists agreed or strongly agreed that a set of competencies should be developed and a credentialing process required with experience of the pharmacist being regarded highly. Conclusion: The results of this study have described the variety of professional roles, remuneration and characteristics in a small sample of pharmacists practising in a general practice setting in Australia. For this model of pharmacist practice to expand an appropriate method of remuneration is required.

Feasibility and acceptability of wrist actigraph in assessing sleep quality and sleep quantity: A home-based pilot study in healthy volunteers

Purpose This study aimed to determine the feasibility and acceptability of actigraphy to monitor sleep quality and quantity in healthy self-rated good sleeper adults at home-based settings. Method Sixteen healthy volunteers (age > 18) were invited to participate. Each participant was provided with a wrist actigraph device to be worn for 24-hour/day for seven consecutive days to monitor their sleep-wake patterns. Actigraphy data were downloaded using-proprietary software to generate an individual-sleep report. Participants also completed a set of self-reported Health Related Quality of Life (HRQOL) using WHO (five) Well Being Index (WBI) questionnaires. Results Actigraphy was well accepted by all participants. Only 43.8% of the participants achieved normal total sleep time (TST) and 62.5% had a mean sleep efficiency value below the normal range. Despite a reduced quality of sleep among the participants, the self-reported HRQOL scores produced by the WHO-5 WBI showed a “fair” to “good” among the participants. Conclusions To maintain healthy well-being, it is vital to have efficient and quality sleep. Insufficient and poor sleep may contribute to various health problems and hazardous outcomes. People often believe they have normal and efficient sleep, not realising they may be developing poor sleep habits. This study found that actigraphy can be easily utilized to monitor sleep-wake patterns at home-based settings. We proposed that actigraphy could be adapted for use in the primary care settings (e.g. community pharmacy) to improve the sleep health management in the community.

Good for the environment good for health

“First do no harm”. This phrase, attributed to the 19th century surgeon, Thomas Inman, 1 reflects an equivalent phrase found in Epidemics, Book I of the Hippocratic School, “Practise two things in your dealings with disease: either help or do not harm the patient”. Pharmacists have played, and continue to play, an important role in reducing patient harm from medication misadventures. Now, they have a new role to play. The delivery of pharmaceutical care contributes to climate change (e.g. through the embedded carbon in the manufacture and distribution of medicines, disposal of waste, and energy and water use),2 which in turn has a negative impact on health. 3,4 This paradox argues a moral and ethical obligation by pharmacists, to deliver pharmaceutical care more sustainably – do no harm. Sustainability “…. is concerned, on one hand, with resources and how we can preserve them, and, on the other hand, with waste products and how we can best reduce or dispose of them.” 5(p.37) It is about preserving and nurturing Earth’s resources and systems for this generation and future generations to enjoy. Pharmacists play an important role in preventative health strategies such as smoking cessation, promotion of healthier lifestyles and vaccination/immunisation programmes and have the potential to also play a significant role in delivering pharmaceutical care more sustainably. Sustainable pharmaceutical care may be considered a virtuous cycle - what is good for the environment is also good for our health. 5 The good news for community pharmacy owners and managers is that implementing sustainability initiatives in the pharmacy can also have significant financial co-benefits.

Pharmacist review prevents evolving metformin-associated lactic acidosis

What is known There is controversy surrounding the risk of metformin and the development of lactic acidosis. There have been no reports of a pharmacist preventing a patient developing metformin-associated lactic acidosis. Objectives Our objective was to report on a pharmacist potentially preventing an evolving case of metformin-associated lactic acidosis (MALA). Case description A patient who had been having episodes of nausea and vomiting for a year was referred for a home medicines review (HMR) by his general practitioner. The pharmacist who conducted the HMR suspected that the patient's symptoms could have been due to metformin. It was recommended to measure the serum lactate level and suspend metformin. Our patient was found to have a high lactate level and was referred to the emergency department by his general practitioner. Recovery was prompt with symptomatic support and cessation of metformin. What is new This appears to be the first case reported in the literature of a pharmacist recognizing an evolving case of MALA. Conclusion Although the incidence of MALA is rare, health professionals should be aware of the initial symptoms of lactic acidosis, especially in elderly patients with risk factors, to prevent a fatal lactic acidosis event.

Australia’s first Pharmacist Immunisation Pilot – who did pharmacists jab with a needle again? QPIP2

Introduction. The successful rollout of the Queensland Pharmacist Immunisation Pilot (QPIP1) led to expansion of the pilot into Phase 2 (QPIP2), which saw pharmacists being permitted to vaccinate adults for not only influenza, but also measles and pertussis in community pharmacies. The extremely positive results from QPIP1 paved the way for expanding the scope of pharmacists across Australia. Aims. The aim was to continue to investigate the benefits of trained pharmacists administering vaccinations in a community pharmacy setting. Methods. Participant demographics and previous influenza vaccination experiences were recorded using GuildCare software. Participants also completed a ‘post-vaccination satisfaction survey’ after receiving their vaccination. Results. To date, 22,467 influenza vaccines, 1441 pertussis and 22 measles vaccinations have been administered by pharmacists. Females accounted for 57% of the participants, with the majority of the participants aged between 46-65 years of age (51.2%). It was interesting to note that 18.9% of the participants were eligible to receive a free vaccination from the National Immunisation Program, but still opted to be vaccinated by a pharmacist in a community pharmacy setting. Participants reported a positive experience with the pharmacist vaccination service; reporting they were happy to receive vaccinations from a pharmacy in the future, and being happy to recommend the service to others. Discussion. The overwhelmingly positive uptake of this pharmacist vaccination service is demonstrated by a 100% increase in the number of influenza vaccines administered as part of QPIP1, and the ongoing positive feedback from patients. These findings will continue to pave the way for expanding the scope of practice for pharmacists across the country.

Australia’s first Pharmacists Immunisation Pilot – about the service

Background: The first phase of the Queensland Pharmacist Immunisation Pilot (QPIP) ran between April and August 2014, to pilot pharmacists administering influenza vaccinations for the flu season for the first time in Australia. Aim: An aim was to investigate factors facilitating implementation of a pharmacist vaccination service in the community pharmacy setting. Method: The QPIP pharmacies were divided into two arms; the South East Queensland arm consisting of 51 Terry White Chemists (TWCs), and 29 pharmacies in the North Queensland (NQ) arm. The TWCs featured pharmacies which previously provided a vaccination service and that were experienced with using an online booking system, providing an opportunity to capture booking data. Results: The TWCs delivered 9902 (90%) of the influenza vaccinations in QPIP. Of these, 48.5% of the vaccines were delivered via appointments made using the online booking system, while 13.3% were in-store bookings. Over one-third (38.2%) of the vaccinations delivered in were “walk-ins” where the vaccination was delivered ‘on the spot’ as spontaneous or opportunistic vaccinations. The absence of a booking system meant all vaccinations delivered in the NQ arm were “walk-ins”. The online-booking data showed 10:00 am and Tuesday being the most popular time and day for vaccinations. Patients preferred having their vaccinations in private consultation rooms, over areas which used a screen to partition off a private area. Discussion: The presence of an online booking system appeared to increase the efficiency and penetration of the of vaccine service delivery. Also, as the level of privacy afforded to patients increased, the number of patients vaccinated also increased. Conclusions: As pharmacist-delivered vaccination services start to progressively roll out across Australia; these findings pave the way for more efficient and effective implementation of the service.

Beyond vaccination: The benefits of having a pharmacist behind the syringe

Background: The Queensland Pharmacist Immunisation Pilot which ran in 2014 was Australia’s first to allow pharmacists to administer vaccinations. Aim: An aim of the pilot was to investigate the benefits of trained pharmacists administering vaccinations in a community pharmacy setting. Methods: Participant demographics and previous influenza vaccination experiences were recorded using GuildCare software. Participants also completed a ‘post-vaccination satisfaction survey’ following their influenza vaccination. Results: A total of 10889 participant records and 8737 satisfaction surveys were analysed. Overall, 1.9% of participants lived with a chronic illness, and 22.5% took concomitant medications. As part of the consultation before receiving the influenza vaccination, participants acknowledged the opportunity to discuss other aspects of their health with the pharmacist, including concerns about their general health, allergies, and other medications they were taking. It was worth noting that 17.5% of people would not have received an influenza vaccination if the pharmacist vaccination service was unavailable. Additionally, approximately 10% of all participants were eligible to receive a free vaccination from the National Immunisation Program, but still opted to receive their vaccine from a pharmacist. Conclusion: The findings from this pilot demonstrate the benefit of a pharmacist vaccination program in increasing vaccination rates, and have helped pave the way for expanding the scope of practice for pharmacists.

Pharmacist vaccination – an Australian first, but what was the impact?

Introduction/background/issues The Queensland Pharmacist Immunisation Pilot is Australia’s first to allow pharmacists vaccination. The pilot ran between April 1st 2014 and August 31st 2014, with pharmacists administering influenza vaccination during the flu season. The aim of this work was to investigate the benefits of trained registered pharmacists administering vaccinations in a community pharmacy setting. Methods Participant demographics and previous influenza vaccination experiences were recorded using GuildCare software. Participants also completed a ‘post-vaccination satisfaction survey’ following their influenza vaccination. Results/discussions A total of 10,889 participant records were analysed. Females accounted for 63% of participants, with the majority of participants aged between 45-64 years (53%). Overall, 49% of participants had been vaccinated before, the majority at a GP clinic (60%). Most participants reported receiving their previous influenza vaccination from a nurse (61%). Interestingly, 1% thought a pharmacist had administered their previous vaccination, while 7% were unsure which health professional had administered it. It was also of note that approximately 10% of all participants were eligible to receive a free vaccination from the National Immunisation Program, but still opted to receive their vaccine in a pharmacy. Over 8,000 participants took part in the post-vaccination survey, 93% were happy to receive their vaccination from a pharmacy in the future while 94% would recommend this service to other people. The remaining 7% and 6% respectively had omitted to fill in those questions. Conclusions/implications These findings have helped pave the way for expanding the scope of practice for pharmacists with the aim to increase vaccination rates across Australia. Key message • Scope of practice and ability for health providers like pharmacists to provide services such as vaccination in primary care. • New service delivery to improve access to service, and increase immunisation rates.

The health professional behind the syringe: Benefits of a pharmacist vaccination program

Background: The Queensland Pharmacist Immunisation Pilot (QPIP) which ran in 2014 was Australia’s first to allow pharmacists to administer vaccinations. An aim of QPIP was to investigate the benefits of trained pharmacists administering vaccinations in a community pharmacy setting. Methods: Participant demographics and previous influenza vaccination experiences were recorded using GuildCare software. Participants also completed a ‘post-vaccination satisfaction survey’ following their influenza vaccination. Results: A total of 10,889 participant records and 8,737 satisfaction surveys were analysed. Overall, 1.9% of the participants reported living with a chronic illness, and 22.5% were taking concomitant medications. As part of the consultation before receiving the vaccine, participants acknowledged the opportunity to discuss other aspects of their health with the pharmacist, including concerns about their general health, allergies, and other medications they were taking. It was worth noting that 17.5% of people would not have received an influenza vaccination if the QPIP service was unavailable. Additionally, approximately 10% of all participants were eligible to receive a free vaccination from the National Immunisation Program, but still opted to receive their vaccine from a pharmacist. Conclusion: The findings from this pilot demonstrate the benefit of a pharmacist vaccination program in increasing vaccination rates, and have helped pave the way for expanding the scope of practice for pharmacists.

Queensland pharmacist immunisation pilot phase 1 pharmacist vaccination - Influenza final report

The results of the pilot demonstrated that a pharmacist delivered vaccinations services is feasible in community pharmacy and is safe and effective. The accessibility of the pharmacist across the influenza season provided the opportunity for more people to be vaccinated, particularly those who had never received an influenza vaccine before. Patient satisfaction was extremely high with nearly all patients happy to recommend the service and to return again next year. Factors critical to the success of the service were: 1. Appropriate facilities 2. Competent pharmacists 3. Practice and decision support tools 4. In-­‐store implementation support We demonstrated in the pilot that vaccination recipients preferred a private consultation area. As the level of privacy afforded to the patients increased (private room vs. booth), so did the numbers of patients vaccinated. We would therefore recommend that the minimum standard of a private consultation room or closed-­‐in booth, with adequate space for multiple chairs and a work / consultation table be considered for provision of any vaccination services. The booth or consultation room should be used exclusively for delivering patient services and should not contain other general office equipment, nor be used as storage for stock. The pilot also demonstrated that a pharmacist-­‐specific training program produced competent and confident vaccinators and that this program can be used to retrofit the profession with these skills. As vaccination is within the scope of pharmacist practice as defined by the Pharmacy Board of Australia, there is potential for the universities to train their undergraduates with this skill and provide a pharmacist vaccination workforce in the near future. It is therefore essential to explore appropriate changes to the legislation to facilitate pharmacists’ practice in this area. Given the level of pharmacology and medicines knowledge of pharmacists, combined with their new competency of providing vaccinations through administering injections, it is reasonable to explore additional vaccines that pharmacists could administer in the community setting. At the time of writing, QPIP has already expanded into Phase 2, to explore pharmacists vaccinating for whooping cough and measles. Looking at the international experience of pharmacist delivered vaccination, we would recommend considering expansion to other vaccinations in the future including travel vaccinations, HPV and selected vaccinations to those under the age of 18 years. Overall the results of the QPIP implementation have demonstrated that an appropriately trained pharmacist can deliver safely and effectively influenza vaccinations to adult patients in the community. The QPIP showed the value that the accessibility of pharmacists brings to public health outcomes through improved access to vaccinations and the ability to increase immunisation rates in the general population. Over time with the expansion of pharmacist vaccination services this will help to achieve more effective herd immunity for some of the many diseases which currently have suboptimal immunisation rates.

Design challenges for electronic medication administration record systems in residential aged care facilities: A formative evaluation

Introduction Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. Methods A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. Results The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues.We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Discussion Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

Medication errors in residential aged care facilities: A distributed cognition analysis of the information exchange process

Background Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. Methods The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May–September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. Results The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Conclusions Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding the dynamics of the cognitive process can inform the design of interventions to manage errors and improve residents’ safety.

Koneellisen annosjakelupalvelun aloittaminen - lääkehoidon tarkistus ja sen vaikutus potilaan lääkehoitoon

Farmaseuttisilla palveluilla tarkoitetaan apteekkien palveluita, joissa hyödynnetään apteekin farmaseuttisen henkilökunnan tietoja ja taitoja. Farmaseuttiset palvelut voidaan jakaa farmaseuttisiin perus- ja erityispalveluihin. Farmaseuttiset peruspalvelut kattavat apteekkien lakisääteiset tehtävät, kun taas farmaseuttisilla erityispalveluilla pyritään ottamaan aktiivisempi rooli asiakkaan terveyden edistämisessä. Koneellinen annosjakelupalvelu on farmaseuttinen erityispalvelu. Koneellisessa annosjakelupalvelussa lääkkeet jaetaan kerta-annospusseihin annostusajankohdan mukaan. Kun uusi asiakas aloittaa koneellinen annosjakelupalvelun, tarkistetaan asiakkaan lääkitys yhteensopimattomien ja turhien lääkkeiden osalta. Palvelun aloitushetkellä huomioidaan myös lääkevalmisteiden sopivuus koneelliseen annosjakeluun sekä tarkistetaan valmisteiden annosteluajankohdat. Koneellisessa annosjakelupalvelussa asiakkaan lääkehoidosta muodostetaan lääkityskortti, josta kokonaislääkehoito on helppo tarkistaa. Erikoistyön tavoitteena oli selvittää millainen lääkehoidon arviointi tai tarkistus koneellisen annosjakelupalvelun aloittamisen yhteydessä tehdään ja miten palvelun aloittavien asiakkaiden kokonaislääkehoitotieto saadaan selvitettyä. Lisäksi selvitettiin millaisia muutoksia lääkehoitoihin tehdään palvelun aloittamisen yhteydessä, mitkä ovat muutosten syyt sekä millainen on asiakkaan kokonaislääkehoito. Kyselylomake lähetettiin kaikkiin apteekkeihin, jotka tilasivat koneellista annosjakelua sopimusvalmistuksena Espoonlahden apteekilta syyskuussa 2010. Tutkimus suoritettiin semistrukturoidulla kirjallisella kyselyllä, joka sisälsi sekä avoimia kysymyksiä että monivalintakysymyksiä. Kyselyyn saatiin 147 vastausta ja vastausprosentiksi muodostui 45. Vastauksia kyselyyn saatiin koko Mannersuomen alueelta ja kaikkien kokoluokkien apteekeilta. Koneellisen annosjakelupalvelun aloittavat henkilöt ovat pääasiassa iäkkäitä, jotka ovat kotihoidon piirissä, asuvat hoitokodissa tai palveluasumisen yksikössä. Asiakkaiden lääkitystietojen keräämisessä hyödynnetään lääkityskorttia, mutta lääkityskortin tietoja päivitetään myös muista lähteistä. Asiakkaiden lääkityksille tehdään useimmiten lääkehoidon tarkistus moniammatillisena yhteistyönä. Lääkehoidolle tehdyt muutokset johtuvat pääasiassa lääkevaihdosta, annosjakelukoneen lääkevalikoimasta tai puolittamisen välttämisestä. Lääkehoidoissa on vain vähän yhteisvaikutuksia, jotka johtavat lääkevalmisteen käytön lopettamiseen. Lääkehoidon tarkistuksella ei ollut suurta vaikutusta asiakkaiden käyttämien lääkevalmisteiden määrään. Palvelun aloittamisen jälkeen asiakkaalla on käytössään keskimäärin 11 lääkevalmistetta, joista seitsemää jaellaan koneellisesti. Lääkeaineryhmistä eniten käytettyjä ovat hermostoon vaikuttavat sekä sydän- ja verisuonisairauksien lääkkeet, joita kumpaakin on käytössä keskimäärin kolme jokaisella uudella koneellisen annosjakelupalvelun asiakkaalla sekä palvelun aloittamista ennen että sen jälkeen.

Programa de Gestão em Farmácia Pública módulo Saúde Mental: ferramenta gerencial para a assistência farmacêutica em um Centro de Atenção Psicossocial Álcool e Drogas

Este trabalho tem por objetivo geral apresentar uma ferramenta computacional auxiliar na gestão dos serviços farmacêuticos bem como alguns resultados alcançados com a sua aplicação na sistematização do atendimento aos usuários do Centro de Atenção Psicossocial álcool e drogas (CAPS ad) do município de Vitória-ES, conhecido como Centro de Prevenção e Tratamento de Toxicômanos (CPTT). O Programa de Gestão em Farmácia Pública (PGFP) Módulo Saúde Mental possui um formato de banco de dados relacional, desenvolvido sob a plataforma Access e possui interface com o gerador de planilhas e gráficos do tipo Excel , aplicáveis a outras farmácias de unidades do tipo CAPS ad. Desde 2004 vem sendo utilizado e aperfeiçoado com uma proposta de informatizar a administração da farmácia, possibilitando a instrumentalização do farmacêutico via emissão de relatórios para a gestão técnica, operacional e estratégica, além de propiciar a avaliação do serviço baseando-se em indicadores sócio demográficos, de morbidade e específicos da Assistência Farmacêutica voltados para o campo da toxicodependência. Para ilustrar o uso do PGFP são apresentados dados pertencentes a 489 prontuários de usuários cadastrados na farmácia no período de janeiro de 2007 a dezembro de 2008, além de 50 prescrições médicas sistematicamente selecionadas para cada ano, coletadas a partir do sistema. Com isso, foi possível elaborar o perfil demográfico, sóciosanitário dos usuários além de aspectos relacionados a Assistência Farmacêutica local. Foi utilizado o programa computacional SPSS 11.5 for Windows para a análise estatística exploratória descritiva (distribuição de freqüências) e inferencial (teste qui-quadrado) dos dados contidos nos prontuários. Dentre algumas dessas análises, observou-se a prevalência do Crack (44%) como substância psicoativa. Revelou que a maioria dos usuários cadastrados são homens (82,4%), com faixa etária prevalente entre 25 e 34 anos (31,7%) e com grau de escolaridade equivalente ao 1 Grau Incompleto (41,3%). Com relação aos aspectos relacionados a Assistência Farmacêutica pode-se observar um No. médio de medicamentos prescritos por receita entre 1,6 1,7 itens/receita; um percentual mínimo de 96% das receitas atendidas na farmácia; e o Clonazepam como o medicamento mais prescrito no período. São citadas algumas limitações do PGFP e dos dados apresentados. Conclui-se o presente estudo fazendo-se alusão a relevância do Programa de Gestão em Farmácia Pública (PGFP), em relação não somente ao seu potencial de uso na gestão estratégica e operacional da Assistência Farmacêutica em Saúde Mental (álcool e drogas), mas fundamentalmente, como importante ferramenta de informação que propicia a elucidação do perfil da drogadição, despertando a percepção para os aspectos ligados à saúde pública e as implicações sócio-econômicas sobre a população em estudo.

Tem farmacêutico na farmácia: as percepções dos farmacêuticos sobre seu trabalho nas farmácias comunitárias do Estado do Rio de Janeiro

A farmácia comunitária ocupa um importante espaço no cenário da saúde pública brasileira, como local de dispensação de medicamentos e de contínua promoção do consumo de medicamentos para a população. Nesses estabelecimentos, o usuário busca através do consumo de produtos, prescritos ou não, o restabelecimento da sua saúde. O farmacêutico é o profissional de saúde com formação específica sobre medicamentos e que, pelo imperativo da legislação sanitária, é colocado como responsável técnico, nesse lócus. Qual sua motivação para ingressar nessa carreira? Como é a sua práxis e qual a realidade percebida por ele nesse cotidiano? Este trabalho teve como objetivo identificar a concepção que os farmacêuticos responsáveis técnicos, atuantes em farmácias comunitárias do estado do Rio de Janeiro, têm sobre a sua prática profissional e como essa visão pode estar relacionada à implementação de práticas focadas no paciente, tais como a Atenção Farmacêutica. Foram realizadas 15 entrevistas semi-estruturadas com farmacêuticos responsáveis técnicos de farmácias do estado do Rio de Janeiro, representando a seguinte tipologia: farmácias de rede estadual, de rede local e familiar. A categorização do discurso dos farmacêuticos mostrou, pelo menos, quatro convergências: a deficiência no processo de formação acadêmica, a prática farmacêutica migrando para o paciente, as contínuas dificuldades da população quanto ao uso de medicamentos e o conhecimento superficial do conceito de Atenção Farmacêutica. Pensa-se que a realidade encontrada possa não ser muito diferente da de grande número de farmácias comunitárias do próprio estado do Rio de Janeiro, sendo necessário fazer reflexões sobre esse tema, para nos conduzir a um momento de discussão sobre quais elementos poderão vir a garantir, que a práxis farmacêutica se insira com complementaridade nos serviços de saúde.