Future practice roles in pharmacy.

The blurring of distinctions between community and institutional pharmacy practice is described, and future practice roles are discussed. As ambulatory-care services, such as home-care programs, long-term-care programs, and nursing-care facilities, assume greater importance in the provision of health care, the roles of hospital-based and community-based pharmacists become blurred. The roles of health-care providers are changing from an inter-professional perspective also. Pharmacist prescribing, physician dispensing, and therapeutic interchange are examples. The issue of therapeutic interchange, as a collaborative arrangement between pharmacists and physicians, will become crucial as managed-care systems grow if pharmacists are to retain responsibility for drug-use control. Challenges facing both institutional and community pharmacy in the future include meeting man-power needs, ensuring quality educational opportunities for pharmacy students and practicing pharmacists, and justifying the cost benefits of progressive pharmaceutical services. The pharmacy profession should set standards of quality for pharmaceutical services in emerging care settings. Although practice roles in pharmacy are changing along with the health-care system, pharmacists in all settings should work together in furthering their common goal of providing quality patient care.