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In this, the final section of the book, we are pleased to present perspectives from around the world. These perspectives are presented by individuals with a firsthand knowledge of developments in their respective countries. Moreover, they have contributed to their “national dialogue,” and have actively participated in the development of medication management services. Their observations serve to remind us that it will take a global effort to establish the urgency of the problem at hand and demonstrate the central role to be played by pharmacy in meeting the universal need for medication management services. Pharmaceutical “misadventuring” is a growing problem that requires immediate attention. The content of these reports reveals that consciousness is increasing and pharmacy is poised to participate with other health care professionals to address the problem with the necessary knowledge and analytic skills to make a significant contribution to human health and the economic consequences of drug-related morbidity and mortality.


The reports included here are not to be seen as a random selection, nor are the observations generalizable to other countries within the same geopolitical region. Rather, they are “samples of convenience” in that they represent a number of individuals with whom we have worked or are known to us as pharmacists committed to the development and implementation of medication management services in their countries. In sum, these reports provide a “snap shot” of activities that are being conducted outside of and in the United States to serve as a reminder that in many places pharmacists are extending their knowledge and practices into the health care system. Of course, this does not mean that there is an absence of challenges, conflicting professional expectations, or competing ideologies. Struggles abound! But, what comes out of this dialogue is clear evidence that there is a strong resolve to further develop pharmacy as a health profession, and move its members toward full participation, in collaboration with other health professionals, in the team work necessary to meet patient need and improve their therapeutic outcomes.


In Australia, for example, we find that consumer discontent played a large part in the formulation of the National Medicines Policy. Here, the government provided a comprehensive framework for the development of strategies to meet consumer demand. With a government mandate and consumer legitimation, the pharmacy profession, through the Pharmacy Guild of Australia and the efforts of individual pharmacists and academics, promotes a movement toward pharmacists playing a major role in primary health care. Home health visits appear to be the first recognized and reimbursed service for pharmacists here.


Moving to New Zealand we find that policy makers are focused on the need for “greater integration and collaboration” in the health care system. As with Australia, primary health care is central to health care provision for the pharmacist. Also, central is the issue of payment and the necessary divorce from dispensing. What is clear in both Australia and New Zealand is that government and regional health ...

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