Introduction

Dr. Ooi Guat See

MPharm (Hons)(UK), MPharm (Clinical Pharmacy)(USM), PhD (USM)

Faculty of Pharmacy, AIMST University, Jalan Bedong, Semeling, 08100 Bedong, Kedah, Malaysia.

Pharmacy service in Malaysia came into existence in 1951 with the enactment of three main legislations governing its profession namely, the Registration of Pharmacist Act 1951, Poison Act 1952 and Dangerous Drug Act 1952. The establishment of the basic structure of pharmacy service within the public healthcare system in Malaysia can be explained in part by the history of the country. During the British colonization, pharmacy service in Malaysia was restricted primarily to the procurement, storage and distribution of drugs from the United Kingdom through the Crown Agents.¹

Following independence, pharmaceutical service in Malaysia has grown from being the nation’s supply of pharmaceuticals to regulating and ensuring quality, safety and efficacy of pharmaceutical products. The establishment of a Drug Control Authority (DCA) and its executive arm, National Pharmaceutical Control Bureau (NPCB) established under the Control of Drugs and Cosmetics Regulations 1984 gave rise to a more systematic pharmaceutical regulatory system in Malaysia. ¹

In the 1990’s, further expansion of pharmacy service was hampered by the shortage of pharmacists in the public workforce. Hence, in order to raise the number of pharmacists in the country to World Health Organization (WHO) recommended pharmacist to general population ratio of 1:2000 by year 2020, governments have taken measures to increase the number of local academic institutions offering undergraduate pharmacy course. In addition, the Ministry of Health and Pharmacy Board amended pharmacist registration process in 2005 to require a period of 4 years (which was then shortened to 2 years in 2011) mandatory government service in order to retain sufficient manpower in the public sector. The increase in the number of pharmacists in the public sector had allowed the establishment and expansion of clinical pharmacy service within the MoH.

The private sector is an important component in Malaysia's healthcare system as a health services provider, through private hospitals and clinics, laboratories and community pharmacies. There are 10762 registered private doctors throughout the country in the year of 2011. ² Consultation, treatment and medicines costs are charged separately in private hospital

and clinic. There are approximately 1700 community pharmacies in the whole country. ³ The patients pay only the medication costs when they visit to a community pharmacy as pharmacist consultation and dispensing services are free of charged. Dispensing separation is not being practiced in Malaysia whereby private doctors are allowed to dispense their medications.

Community pharmacy practice

In Malaysia, according to the latest statistic report, there are 10,077 registered pharmacists and approximately 3300 pharmacies are working in the private sectors including community pharmacies.⁴

Community pharmacy benchmarking guideline has been introduced and revised from time to time by the Ministry of Health to provide an overview of the requirements that community pharmacies are expected to fulfil in the area of infrastructure, equipment, personnel and practice. ⁵

Community pharmacies are premises with at least one pharmacist holding a Type A license issued under the Poison Act 1952 who can supply poison either by retails only or both retail and wholesale. For all community pharmacies, the executive board and share equity shall be represented by pharmacists.⁵ Other requirements and guidelines are shown in the table below.

Community Pharmacy Benchmarking Guidelines ⁶

Premises	·	Area: a minimum of 200 Sq. ft.
	·  Designated area for counselling, waiting area.
	·  Designated area for wet and dry compounding/dispensing.
	·	Exterior display:
		Signboard: Pharmacy/Advertisement Ratio?
		Logo
	·  Display of types of services available e.g. blood glucose,
		cholesterol, pregnancy, blood grouping tests or electronic
		blood pressure monitoring.
	·	Security
		Locks to main door/gate.
		Lock to Psychotropic drugs.
		Poison products under lock and key.
	·	Insurance
		Professional indemnity
		Public liability
		Fire and burglary
	·  Level of cleanliness and hygiene.
		Pest control
	·  General Environment for clients.
		Conform to occupational and safety health requirements :
		escape way.
		Noise level
		Arrangement/ display of OTC products; ease of selection of
		products.
		Temperature, lighting and ventilation.
	·	Availability of refrigerator.
	·  Method of pharmaceutical waste disposal. (For info only)
Equipment	·	Inventory control : computerisation/ stock cards.
	·  Availability of mortar and pestle, weighing balance, counting
		tray and measuring cylinders.
Personnel	·	Image presented, both RPH and staff dressing code.
	·	Training for staff.
Dispensing of	·	Dispensing must be under the supervision of the pharmacist.
Medicines		Dangerous drugs and Psychotropic.
		Prescription and Pharmacy Only Medicines (Group C)
		OTC medicines
		Cases of referral to pharmacists by pharmacy/sales assistants.
	·  Screening of prescription by the pharmacist. The Pharmacist
		must ensure that the patient receives sufficient info and advice
		to enable the safe and effective use of the medicines.
	·	Interventions.
	·	Records
	·  Dispensing container: use of amber bottle.
	·  Labelling (printed and hand written) bears the
		proprietary/generic names, strength, quantity, manufacturer’s
		name, batch no and expiry dates.
	·  Maintenance of Patient Medication Record. (By means of
		card, a record book, by computer)
Dispensing errors	·	Steps to minimise e.g. incorrect selection, incorrect
		interpretation.
	·  Checking procedures and cautions.
Inventory	·	External use - preferably to store separately from internal use
management		items.
	·  Control of expired and expiring stocks.
	·	Storage space/compartments.