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Q. What does a day of a research pharmacist look like? Not pharmacist at a drugstore.A day in the life of an industrial pharmacist: two perspectivesA day in the life of a clinical pharmacistA day in the life of an industrial pharmacist: two perspectivesTomorrow's Pharmacist 1 JAN 2005Sonia Patel is senior associate scientist, Pharmaceutical Research and Development, Pfizer Global Research and Development. Mel Smith is head of medical and pharmacy affairs, Reckitt BenckiserSonia PatelFulfilling, fascinating and fun are a few of the words I would use to describe my job as an industrial pharmacist. I could easily continue with other terms that evoke optimism and satisfaction but, as you read on, you will understand why there just is not the need.As is often the case in finding an enjoyable career, mine began with me being in the right place at the right time. Before I embarked upon the third year of the MPharm course, I attended a pharmacy conference where I met other industrial pharmacists. This was my first insight into the pharmaceutical industry and having already acquired community and hospital experience, I thought I would give industry a go.The following summer I secured a placement at Pfizer and it was this snapshot of the ever growing and changing industrial landscape of pharmaceuticals that totally embraced me. Immediately after registration, I obtained a full-time post in pharmaceutical research and development with Pfizer, and I have now been here for a year.The day begins . . .My day begins roughly when I want it to, thanks to flexible working hours. I opt to start at 8.30am and use the next half hour to check e-mail, voice-mail, post and diary to see what I have booked in for the day ahead. Each day varies, which makes describing “a day in my life” difficult, but it is this diversity, in addition to the fast-pace that makes the day whizz by.Meetings . . .I normally have my first meeting at 9.30am and this could be with my team, department or multidisciplinary groups composed of chemists, biologists, toxicologists or external visitors from academia or industry. Meetings currently account for approximately a third of my time and can take place anytime throughout the day. The way I manage the rest of my time is up to me, so effective time management is certainly a bonus.My own time . . .I spend the rest of my time completing duties and responsibilities that are “assigned” to me at the start of the year. I have used “assigned” loosely since although my manager sets these, as an individual I can contribute significantly to them. Furthermore, attaining goals and writing personal development plans to include career aspirations are greatly encouraged.My current role in generating quality biopharmaceutics data to help guide compounds in discovery through to early development requires me to divide time between various activities.These include conducting laboratory work, writing documents and presentations, responding to e-mails, reading articles and generally keeping up to date with everything.My role is varied, challenging and professionally fulfilling. Industrial pharmacy offers a wide choice of career structure no matter what area you join, including clinical trials departments, drug information, regulatory affairs or marketing. Whatever takes your fancy, the industry has lots to offer.I am thrilled to be part of this industry and look forward with excitement to the rest of my career.Mel SmithBefore starting on a description of my working day, it is important that it is placed into the context of my overall career. I started working in community pharmacy and after my preregistration year, I moved into the hospital service. While in the hospital service, I had the opportunity to work overseas and to develop an interest in computers. Armed with this background I embarked on my career in the pharmaceutical industry.In the industry, you are employed for what you know, what you do and how well you perform. There is no shortage of graduates to work in the industry and in the UK there is no job in the industry that is the monopoly of a registered pharmacist. This is not true in other parts of the world.Long and medium term projectsThe working day consists of several strands. First, there are long and medium term projects, which are planned and have milestones that have to be met. The major ones at the moment are the upgrade of the pharmacovigilance system. This includes the review of our systems and the rewriting of standard operating procedures. As with most projects within the industry, multidisciplinary teamwork is essential. This involves negotiation for resources from departments as diverse as quality assurance, telephony, security and information technology.Since the pharmacovigilance system is global, it involves links with our businesses in the rest of the world and even some of our business partners. Added to this list are the specialised agencies that we use and, where expertise is not readily available, negotiation with new service suppliers to bridge the gaps.Routine work and emergenciesMuch of the rest of the day is taken up with routine work and “emergencies”. Routine work involves keeping up to date with what is happening in the pharmaceutical arena in the UK, the US and Europe. This is done by e-mail correspondence, viewing the internet and reading several publications. There is so much information that it is necessary to scan journals and magazines. The need for quick, critical assessment is paramount and I find those articles which I think “that might be interesting” seldom get read.Ad hoc requestsThe final area covered is the ad hoc requests. These arrive, usually unsolicited, via e-mail, telephone or with a colleague. My interest in computing means I am asked several times a day to solve computer problems.My background in hospital and community pharmacy means I am used as a sounding board by the marketing department for their latest ideas. This is usually after the project has been approved and sometime after it has been launched.My pharmacy and computer skills are brought together when it comes to talking to the suppliers of the computer software for GPs and pharmacists. I am also called upon to supply information on the British National Formulary and the Drug Tariff to various departments in the business. Then there is replying to correspondence from outside the business.TeamworkIt would be churlish to let you believe that I do all this on my own, or that my role has consisted of this since I entered the industry. I have a great team that I manage on a day-to-day basis. This is what gives me a great buzz about working in the industry. The job is never the same two days running — you develop your own career path and the people you work with bring many different skills. It may mean that a pharmacy degree does not give you the security of a job, but it forms a great basis for the work.A day in the life of a clinical pharmacist29 Apr 2014clinical outcomes, pharmacy, quality, specialty pharmacyby Acacia StrachanWithin a healthcare system, clinical pharmacists are drug therapy experts, and routinely provide medication therapy evaluations and recommendations to patients and other healthcare professionals. Clinical pharmacists working in the specialty pharmacy sector are the experts for complex chronic medical conditions including HIV, oncology, multiple sclerosis, transplant, hepatitis C, rheumatoid arthritis and hemophilia.The specialty drugs used to manage chronic conditions are classified as complex medications with unique pharmacology profiles that require special handing and monitoring. Adherence to these life-saving medications is essential. Non-adherence leads to:Worse therapeutic outcomesHigher hospitalization ratesIncreased healthcare costs (estimated at $100 billion annually in the U.S.)Approximately 20% to 50% of patients are non-adherent to their medications. Why? Specialty medications are expensive and often come with complex regimens. Lack of education, a fear of adverse events and side effects, or simply a negative attitude toward medications can also be reasons for non-compliance.To combat these barriers and promote adherence to medications for chronic disease states, many pharmacies have implemented disease management programs.As an oncology clinical pharmacist, my daily routine involves managing patients enrolled in Commcare’s Oncology Assist management program. This means ensuring financial assistance for their medications, and providing clinical support and education throughout their course of therapy to ensure patient safety, minimize side effects and promote adherence to achieve optimal clinical outcomes.On any given day as a clinical pharmacist, I have to act as a research analyst… a pharmacokinetic guru… a patient advocate… or an educational psychologist.Let’s take a look at each of these roles by starting with where all clinical decisions for patients begin – the prescription.Research analystThe above prescription is for the oral oncology medication Tarceva. A clinical pharmacist ensures the medication prescribed is appropriate for Mr. Jones based on his diagnosis. Thus, an oncology clinical pharmacist would need to stay current with the treatment guidelines for NSCLC and have knowledge that Tarceva is indeed one of the first-line agents recommended for the treatment of patients with NSCLC with positive EGFR mutations.Pharmacokinetic guruPharmacokinetics, sometimes described as what the body does to a drug, refers to the movement of a drug into, through and out of the body. It describes the effects that food, other medications and the function of organs have on a particular patient.A pharmacokinetic guru has the clinical knowledge to understand that the absorptive property of this drug requires that the patient takes this medication on an empty stomach (1 hour before or 2 hours after a meal). If Mr. Jones consumed this medication with food still in his digestive tract, bioavailability increases to almost 100%, which can make the drug toxic and lead to Mr. Jones experiencing unwarranted side effects.Clinical pharmacists also perform a comprehensive review of all medications patients are taking, including prescription, over-the-counter and herbal medications. This review is vital, as drug interactions can lead to unnecessary adverse effects, suboptimal clinical outcomes or unwarranted hospitalizations.In Mr. Jones’ case, a pharmacokinetic guru would know that co-administration of Nexium (which lowers gastric pH prescribed for Mr. Jones’ GERD) can result in a loss of effectiveness of the Tarceva needed to treat his metastatic lung cancer. Thus, Mr. Jones would be advised not to take Nexium and switch to another class of medications to assist with management of his GERD.Patient advocateThe cost for a 30-day supply of Tarceva is about $6,000! A clinical pharmacist serves as a patient advocate, and will seek financial assistance from the manufacturer or from a 501c3 foundation to ensure the patient can afford the life-saving medication.Educational psychologistGuess where many patients search for answers to their prescription questions. Google and Yahoo!. Surprised?This is why the initial consultation with patients involves proper education on their medications and expected clinical outcomes. And clinical pharmacists take a psychologist’s approach to encourage patients to start (and continue) their medication regimen.In our case, Mr. Jones is counseled to take his Tarceva on an empty stomach, that he may experience side effects like rash and diarrhea, along with ways to manage those side effects. An individualized care plan is then developed, including the best administration times for all his medications. Finally, Mr. Jones’ clinical pharmacist will continue to counsel him to ensure adherence and manage side effects.Whew! That’s all in a day’s work! Let me know in the comments below if you’ve got another job title for clinical pharmacists that I missed!