The rules of good pharmacy practice introduced in Russia require mandatory consultation of the buyer during the dispensing (sale) of pharmaceutical products.
The regulatory definition of the term “pharmaceutical consulting” is included in the conceptual apparatus of the Rules of Good Pharmacy Practice for Medicinal Products for Medical Use, approved by Order of the Ministry of Health No. 647n dated August 31, 2016.
Pharmaceutical consulting - access to information on the procedure for applying or using pharmaceutical products, including dispensing rules, methods of administration, dosage regimens, therapeutic effects, contraindications, interactions of drugs when taken simultaneously with each other and (or) with food, rules for their storage in at home
Subclause "c" of clause 8 of Order No. 647n specifies the concept of pharmaceutical consulting, imposing duties on the head of a pharmacy organization to provide the consumer with information "on the procedure for applying or using pharmaceutical products, including dispensing rules, methods of administration, dosage regimens, therapeutic effects, contraindications, interactions of drugs when taken simultaneously with each other and (or) with food, rules for their storage at home" .
Order of the Ministry of Health No. 403n dated July 11, 2017 “On approval of rules for the dispensing of drugs” specifies the requirements for consultation when dispensing drugs. According to paragraph 16 of the order, the pharmaceutical specialist must inform the buyer of the drug “about the regimen and doses of its administration, storage rules at home, and interactions with other medications.” This short list should currently guide pharmaceutical specialists.
The Order reiterates the counseling requirements. Pharmaceutical consulting is now an integral part of functional job descriptions pharmaceutical worker, because the professional standard requires that all pharmacists have, incl. access to information and rules on the use of the drug.
The necessary information must be provided to the consumer, but if he does not want to listen, it is necessary warn about the need to read the instructions, about the dosage regimen, about storing the medicine at home in accordance with the manufacturer’s recommendations indicated on the packaging.
Order No. 647n also includes pharmaceutical consulting in the knowledge updating program for newly hired pharmacists and pharmacists (clause “c”, clause 14) and classifies it as one of the main production functions of pharmaceutical workers (clause “b”, clause 15). When drawing up job descriptions for pharmaceutical workers, this provision must be included in the “Responsibilities” section.
To provide pharmaceutical consulting services, a special area may be allocated in the pharmacy, including the installation of seating (clause 53). In addition, when selling medicines, a pharmacy employee is prohibited from hiding from the buyer information about the availability of other drugs with similar INNs, as well as about the price ratio for these drugs (clause 54).
Pharmacy consultation area with seating
The pharmacy assortment includes not only medicines and medical products, but also other products that can be dispensed by specialists without pharmaceutical education. The legislation does not prohibit hiring consultants who do not have the qualifications of a pharmacist or pharmacist to implement them; the decision on the appropriateness of such a personnel decision remains at the discretion of pharmacy management.
Products that are not medicines and medical devices, in terms of profitability, usually play a secondary role. Their implementation does not require special training; the outlook and professional knowledge of the first capitalists certainly allow them to successfully cope with this function.
In the absence of pharmacy organizations in populated areas In rural areas, pharmaceutical consultation is carried out by medical personnel of outpatient clinics, feldsher-midwife stations, centers (departments) of general medical (family) practice, subject to appropriate training.
The duration of the consultation and the amount of information provided depend on the specific needs of the buyer, his educational and cultural level. Particular attention should be paid to the storage conditions of the dispensed drug at home, regardless of the presence or absence of appropriate warnings and inscriptions on the packaging or in the instructions for use. The consultation is carried out taking into account the dosage form, packaging features, air temperature at different times of the year, protection from exposure to sunlight, humidity, etc.
Requirements for pharmaceutical consulting
- Professionalism.
- Safety.
- Efficiency.
- Personal approach, accessibility for the patient.
- Adequacy.
- Rationality.
- The need to mention consultation with a doctor.
- Use of the current regulatory framework.
- Offer to purchase a drug.
Key aspects of pharmaceutical consulting
- Determine the need special conditions drug release.
- Indicate the need for prescription drugs.
- Determine the visitor’s problem and ask clarifying questions.
- Indicate the need for a mandatory visit to a specialist.
- Clarify the special characteristics of the patient (age, pregnancy, chronic diseases, medications, etc.).
- Name the pharmacotherapeutic group and effect of the drug.
- Suggest drugs as an alternative and justify your proposals.
- Inform about the rules of admission, the course of therapy.
- Inform about food and drug interactions.
- Inform about storage rules at home.
- Inform about side effects.
The regulation on licensing of pharmaceutical activities, approved by Decree of the Government of the Russian Federation No. 1081, includes in the licensing requirements for pharmacy organizations compliance with the rules of good pharmacy practice (clause "d", clause 5).
Clause 6 of this provision classifies failure to comply with this requirement as gross violations qualified in accordance with Part 4 of Art. 14.1 of the Code of Administrative Offenses of the Russian Federation and entailing:
- For persons carrying out entrepreneurial activities without forming a legal entity - a fine in the amount of 4 to 8 thousand rubles. or administrative suspension of activities for up to 90 days
- For officials - a fine of 5 to 10 thousand rubles.
- For legal entities - a fine of 100 to 200 thousand rubles. or administrative suspension of activities for up to 90 days.
Pharmaceutical consulting is carried out within the educational level of the pharmaceutical specialist and in no case should replace the recommendations of the attending physician. Violation of this principle may result in unintentional harm to the health of the visitor, which entails civil or criminal liability. The consequences depend on the degree of harm caused to health (mild, moderate or severe, determined by a forensic medical examination), as well as on the circumstances of the offense.
Doctor - pharmacist.
Pharmacology (“farmakon” - medicine and “logos” - study) is a science that studies the effects of drugs on the human and animal body.
The first systematic information about pharmacology was found in ancient Egyptian papyri, records of Hippocrates and other philosophers. In the 16th century, the concept of drug dosage was streamlined. Modern pharmacology requires the pharmacist to know not only the general properties of the drug, but also the mechanisms of its action, pharmacokinetics (the science of the routes of administration, distribution and excretion of the drug from the body) and pharmacodynamics (the science of the types and mechanisms of action of the drug, its pharmacological effect).
A pharmacist is a specialist who studies medications, the effects of drugs on the body, and also searches for new medicinal substances (which are used to diagnose, treat and prevent diseases).
The dominant activities of a pharmacist are:
"Development of new and improvement of existing drugs;
" Preparation of medications (tablets, mixtures, powders, ointments, balms, etc.);
"Medicine storage;
"Dispensing medications in pharmacies to people and explaining to them the rules for taking them;
"Informing medical institutions and the population about the effects of certain medications available on the market;
"Control over the quality and shelf life of medicines;
"Receiving prescriptions from the public in pharmacies and preparing medications according to them.
A pharmacist should be distinguished by such abilities and personal qualities as:
- well-developed long-term memory (the ability to store necessary information in memory for a long time);
- excellent figurative memory (the ability to remember and reproduce taste, color, smell and other parameters of substances);
- developed tactile and motor memory;
- sleight of hand;
- a penchant for analysis and mathematical abilities;
- attentiveness, composure, accuracy, tact, high self-control.
In his work, the pharmacist strictly follows the rules for dispensing medications and carefully monitors the storage conditions of the medications.
Any weapon (including against disease) requires proper handling. All participants in the treatment process must “skillfully” handle medications - the doctor, the pharmacist and, of course, the patient himself. The pharmacist here acts as a mediator, physician assistant and patient consultant. The patient must strictly follow the instructions for using the medication, not stop treatment without the doctor’s knowledge, and not start treatment with any other drug. Violation of the dosage and rules of administration can have a detrimental effect on your health.
Only cooperation in this “union” of the doctor, pharmacist and patient is the main condition for the safe and effective use of drugs with the greatest benefit for each individual patient.
On this moment People from: Moscow, Rostov-on-Don, Chita, Arkhangelsk, St. Petersburg, Yakutsk, Irkutsk, Penza, Ekaterinburg, Naberezhnye Chelny, Ryazan, Kaliningrad, Izhevsk, Tula, Kemerovo, Novosibirsk, Krasnoyarsk, Volgograd, Blagoveshchensk, Stavropol, Tambov, Yuzhno -Sakhalinsk, Kaluga, Kazan, Ufa, Ivanovo, Chelyabinsk, Voronezh, Krasnodar, Samara, Nizhny Saratov, Novgorod, Petropavlovsk-Kamchatsky, Orenburg, Barnaul, Vladimir, Tyumen, Tomsk, Perm, Vladivostok, Belgorod, Cheboksary, Mineralnye Vody, Magadan , Maykop, Lipetsk, Nalchik, Ulan-Ude, Tolyatti, Surgut, Khabarovsk, Tver, Petrozavodsk, Salekhard, Astrakhan, Kurgan, Orel, Omsk, Yaroslavl, Gorno-Altaisk, Murmansk... as well as other large and small cities Russian Federation.
A modern pharmacy is not limited to selling medicines. There is fierce competition in the pharmaceutical business, and the winner is the company that was able to organize the service on high level, provide to buyers Additional services, win consumer loyalty through discount programs and free consultations specialists. The easiest and most financially accessible way to develop additional services in a pharmacy is to organize consumer consultations by telephone.
It all starts with the most ordinary telephone set - it has been used in business processes for almost a hundred years, since the first commercial test took place in 1927. phone conversation between London and New York via transatlantic cable. Decades have passed, technology has improved, and today the pharmacy has several options for organizing consultations by telephone.
To begin, decide on phone number. It’s good if it consists of a minimum number of numbers in a convenient combination. A beautiful phone number is easy to remember by ear; it is a kind of indicator of the solidity of the organization. Placed on a business card, on a sign, on an advertising leaflet, on a packaging bag, on a discount card, the number catches the eye and, after seeing it several times, the buyer will definitely remember it. You can get a prestigious number by concluding an agreement with a local telephone exchange or commercial telecom operator.
Telephone at the chief's workplace
If there are no constant queues at the pharmacy, for consultations it is enough to equip telephone pharmacist's workplace. Why is this necessary? Of course, to win customer loyalty! It often happens that when a person who is far from medicine comes home with a purchase, he forgets how to take the medicine correctly. And not everyone can independently understand the annotation for the drug - after all, the information provided there is intended primarily for specialists. The easiest way to solve the problem is to call the pharmacy and clarify the dosage regimen and combination of several medications.
Many buyers, when purchasing medications prescribed by a doctor, visit several pharmacies and compare prices. Knowing the phone number of the pharmacy, you can check the availability of the required medicine and its price without wasting time visiting several pharmacies. Quite often they ask about the pharmacy's opening hours over the phone. The main thing is to remember: this service is important to customers, and everything you do to organize it is not in vain!
The time of a pharmacy employee is limited, and his main responsibility is still to serve the visitors who come to the pharmacy. Over the phone, the head manager will not be able to give detailed consultations - there simply won’t be enough time, visitors in line will start to get nervous, rush the pharmacy employee, make fair comments and demand attention. In fact, this is a consultation “on the run” - answering 1-2 questions and politely saying goodbye to the caller.
Main topics of brief consultations
- Pharmacy opening hours.
- Availability of medicine.
- Prices of medicines.
- The drug is available with a prescription or is over the counter.
- When, to whom and under what conditions discounts are provided.
It’s not just the chief of staff who can answer calls briefly. Any employee, even the cleaning lady, can tell you about the pharmacy’s work schedule, and a marketer, a pharmacy manager, or a student intern can provide information about the availability of a medicine and its price.
Dedicated specialist for telephone consultation
If the employee at the first desk cannot cope with the flow of calls without compromising his main work, you should think about expanding the pharmacy staff and inviting a specialist to communicate with clients by phone. This can be not only a pharmacist or pharmacist by training, but also a doctor - practice shows that consultations with a specialist doctor are the most popular among pharmacy clients.
A doctor can advise pharmacy visitors at certain hours both by phone and in person - such consultations have a great impact on sales, increasing the average purchase price several times. A typical example is consultations with a phlebologist in a pharmacy: he can not only examine a patient suffering from varicose veins, but also recommend corrective pillows for night rest, select compression stockings, and prescribe additional medications to be taken in combination with the main therapy.
Often pharmacies, in order to save on wages, involve students of medical educational institutions - universities and colleges, as well as student interns during their internship, to work on the telephone. The key skills of a telephone employee are: sociability, friendliness, competent speech, clear diction, the ability to build a conversation, the ability to listen to the customer, understand him and attract him to make purchases at this particular pharmacy. Naturally, the main requirement is knowledge in the field of pharmacology.
To fully work, a consultant “on the phone” will need a room - a separate office or a dedicated area in the sales area, as well as a computer with access to information about the pharmacy’s inventory and prices for goods in stock.
Main topics of detailed consultations
- Selecting an over-the-counter drug.
- Clarification of the drug dosage regimen.
- Clarification and discussion of undesirable effects of administration.
- Issues of replacing drugs with synonyms and analogues.
- A combination of several drugs in the treatment of the underlying and concomitant diseases.
- Complaints about low-quality goods and other claims.
- Ordering medicines from the warehouse of a wholesale company.
Sometimes the topic of consultation concerns not only the issues of purchasing and taking medicines, but goes beyond the scope of pharmaceutical activities. Here it is important to clearly understand the main ethical principle of the work of any physician - do no harm! If the caller, listing symptoms, demands a diagnosis and prescription of medications, it is not professional to follow his lead. It is your sacred duty to refer the patient to the attending physician. A correct diagnosis can only be made after full diagnostics and personal examination by a doctor, and help over the phone may not be life-saving, but disastrous. The scope of a telephone consultation is somewhat expanded if it is provided by a specialist doctor - phlebologist, neurologist, ophthalmologist, etc.
Pharmacy hotline
If there are a lot of calls and patients complain that it is difficult to reach your pharmacy, you should consider organizing a pharmacy-based hotline. To do this, you will need a multi-channel telephone or a multi-channel number - several people can call it at the same time (depending on the technical equipment - from five to infinity). None of them will hear a busy signal, and you will need additional staff to answer calls.
The questions received by the hotline are very varied. They may require a short answer or a detailed consultation, so it is impossible to predict the time an employee will spend on one telephone conversation. It is important to have enough resources to satisfy the need for consultation of all callers - this includes equipment, personnel, and Information Support operators. In fact, this is a full-fledged call center, and developing its activities on the basis of a pharmacy is not always rational and cost-effective. To organize and maintain the hotline, you can involve specialists outside the pharmacy.
When does a pharmacy need a hotline? First of all, during promotions to stimulate demand. It is impossible for chain pharmacies to actively develop without a hotline - most pharmacy chains use the capabilities of call centers one hundred percent. It is important to ensure a quick response to all incoming calls - the potential buyer should not wait. An employee in a pharmacy or an operator in a call center must have maximum information on the activities of the pharmacy and be able to answer any question from the caller.
Currently, the city of Moscow has a procedure for preferential drug provision separate groups of the population entitled to benefits, approved by Order of the Moscow Government of August 10, 2005 No. 1506-RP “On the implementation of social support measures for certain categories of citizens of the city of Moscow to provide medicines and medical products dispensed according to doctors’ prescriptions free of charge or with a 50% discount” .
The above-mentioned order approved: A list of population groups for the outpatient treatment of which medicines and medical products are dispensed according to doctors' prescriptions free of charge or with a 50% discount, and a List of categories of diseases for the outpatient treatment of which medicines and medical products are dispensed according to doctors' prescriptions free of charge.
Federal Law of July 17, 1999 No. 178-FZ “On State social assistance» establishes the right to receive state social assistance in the form of a set of social services, which includes the provision, in accordance with the standards of medical care, of necessary drugs for medical use according to prescriptions for drugs, medical products according to prescriptions for medical products, as well as specialized medical products nutrition for disabled children, for certain categories of citizens specified in Articles 6.1 and 6.7 of the said Federal Law.
Providing certain categories of citizens with medicines and medical products according to doctors’ prescriptions free of charge or with a 50% discount is carried out through pharmacy organizations (pharmacies of various forms of ownership and pharmacy points located directly in medical organizations (outpatient clinics) in administrative districts at the place of residence) . The list of pharmacy organizations is approved by the Moscow Department of Health.
Pharmaceutical organizations providing logistics services for the provision of medicines to certain categories of citizens according to doctor’s prescriptions free of charge or with a 50% discount in the city of Moscow:
- Northern Administrative Okrug, North-Western Administrative Okrug, ZelAO of Moscow - LLC "TD "Pharm-center"
- Eastern Administrative District, North-Eastern Administrative District of Moscow - Moscow State Budgetary Healthcare Institution "Center for Drug Supply of the Moscow Health Department"
- South-Western Administrative District of Moscow - PJSC Pharmimex
- Central Administrative District, South-Eastern Administrative District, Southern Administrative District, Western Administrative District, TNAO of Moscow - State Budgetary Healthcare Institution of Moscow “Center for Drug Supply of the Moscow Health Department”.
Children from large families under the age of 18 are provided with medicines free of charge (these social support measures are provided to large families until the youngest child reaches the age of 16 (students in an educational institution implementing general education programs - up to 18 years) in accordance with the Moscow City Law No. 11/23/2005 No. 60 “On social support for families with children in Moscow.”
Informationon the procedure for providing citizens with a package of social services
In accordance with paragraph 2 of Article 6.3 of the Federal Law of July 17, 1999 No. 178-FZ “On State Social Assistance” (as amended on August 22, 2004, December 29, 2004), the period for providing citizens with a set of social services is a calendar year.
In accordance with paragraph 1.11 of the order of the Ministry of Health and Social Development of Russia dated December 29, 2004 No. 328 “On approval of the procedure for providing a set of social services to certain categories of citizens,” an application for refusal of a set of social services for the next year is submitted by a citizen to the territorial body of the Pension Fund of the Russian Federation annually within 1 October of this year. Citizens have the right to withdraw a submitted application for refusal to receive a set of social services ( social services) for the next year until October 1 of the current year.
It is permissible to refuse to receive a set of social services in full, or to refuse to receive social services provided for in paragraph 1 of part 1 of Article 6.2 of the Federal Law of July 17, 1999 No. 178-FZ (additional free help, including providing for the provision of necessary medicines according to doctor’s prescriptions, provision of vouchers for sanatorium-resort treatment if there are medical indications), and refusal to receive social services provided for in paragraph 2 of part 1 of article 6.2 of the Federal Law of July 17, 1999 No. 178-FZ (providing free travel on suburban railway transport, as well as on intercity transport to and from the place of treatment).
Information on the production of drugs from the world's leading brands
Official information on the localization of production of medicinal products of the world's leading brands on the industrial sites of Russian pharmaceutical manufacturers is published on the Internet on the following sites: https://rosminzdrav.ru, https://rg.ru, http://pharmvestnik.ru, http: //remedium.ru, http://gmpnews.ru, http://imemo.ru.
Search for withdrawn medicines
Information on the withdrawal of medicines can be found in the “Search for medicines withdrawn from circulation” service, posted on the website Federal service on supervision in the field of health care. http://www.roszdravnadzor.ru/services/lssearch
Quality control of medicinal products
Information regarding the quality of medicines in public circulation can be found on the website of the Federal Service for Surveillance in Healthcare in the section “Medicines/Quality Control of Medicines/Information Letters”
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