Deb Tirthankar, Das Alapan, Ojha Bisweswar, Das Prasanjit
Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Kalyani, Kalyani, West Bengal, India.
J Family Med Prim Care. 2024 Dec;13(12):5465-5471. doi: 10.4103/jfmpc.jfmpc_1226_24. Epub 2024 Dec 9.
The novel approach of "Community Pharmacology" integrates pharmacological principles with community health to achieve the "Health for all" goal through safe and efficient health care. Pharmacovigilance, medication errors (ME), irrational prescriptions, and antimicrobial resistance in the community could be the key areas. Though life expectancy and other health indicators have improved in India, the disparity between rural and urban quality healthcare access should be addressed. Despite India's enormous progress in vaccine manufacture, supply, and mass immunization through the Universal Immunization Programme (UIP) and Mission Indradhanush, issues remain in incomplete coverage and vaccine hesitancy. Other key challenges include high health expenditures, shortage of trained healthcare professionals, and lack of patient safety and irrational pharmacotherapy in remote areas. Community Pharmacology offers a multifaceted solution in community healthcare delivery through a well-designed integrated network equipped with skills in practical implications of pharmacology aimed at better medication supply, storage and dispensing, adherence to formularies according to the community needs, preparing Essential Medicine List and implementation of rational prescribing. Antimicrobial stewardship (AMS), adverse drug reaction (ADR) monitoring, and evidence-based usage of different drug formulations or drug delivery systems must be implemented beyond the tertiary level, involving both public and private stakeholders. Integrating Community Pharmacology into public health is crucial for fulfilling the global health initiatives to reach the Sustainable Development Goals (SDGs) as well as attaining India's ambitious overall development targets.
“社区药理学”这一新颖方法将药理学原理与社区健康相结合，通过安全有效的医疗保健实现“全民健康”目标。社区中的药物警戒、用药错误、不合理处方以及抗菌药物耐药性可能是关键领域。尽管印度的预期寿命和其他健康指标有所改善，但农村和城市在获得优质医疗保健方面的差距仍需解决。尽管印度在疫苗生产、供应以及通过扩大免疫规划（UIP）和“印度色彩行动”进行大规模免疫接种方面取得了巨大进展，但在覆盖不完整和疫苗犹豫方面仍存在问题。其他关键挑战包括高昂的医疗费用、训练有素的医疗专业人员短缺，以及偏远地区缺乏患者安全和不合理的药物治疗。社区药理学通过精心设计的综合网络，在社区医疗服务中提供多方面的解决方案，该网络具备药理学实际应用技能，旨在实现更好的药物供应、储存和调配，根据社区需求遵守处方集，编制基本药物清单并实施合理处方。抗菌药物管理（AMS）、药物不良反应（ADR）监测以及不同药物制剂或给药系统的循证使用必须在三级医疗机构之外实施，涉及公共和私营利益相关者。将社区药理学纳入公共卫生对于实现全球卫生倡议以达成可持续发展目标（SDGs）以及实现印度宏伟的总体发展目标至关重要。
