30/10/2025
THE NEW ERA OF CLINICAL PHARMACISTS IN AMBULATORY PATIENT CARE.
Ambulatory Care Practice (also known as out-patient care practice) is not new generally in clinical practice including pharmacy practice, but is relatively new in terms of areas of specialization in both the field of Pharmacy and Nursing.
It exists in the field of Medicine but is not a particular area of specialization like that of Nursing and Pharmacy, as different specialists such as cardiologists, gastroenterologists etc working in out patient care settings can be said to be practising within ambulatory care.
Ambulatory Care Specialist Pharmacists are Pharmacists who provide integrated and accessible healthcare services to patients in outpatient settings with an *emphasis on comprehensive disease state and medication management , patient education and Continuity of Care*.
In the US, there are currently over 6000 pharmacists that are board certified in ambulatory care specially ( BCACP ).
While graduation from a pharmacy residency program is not mandatory, such a residency provides advanced training in managing common chronic conditions frequently seen in outpatient settings.
These Pharmacists primarily manage chronic medical conditions such as high blood pressure, diabetes, atrial fibrillation, congestive heart failure, asthma, chronic pain, mental health, chronic obstructive pulmonary disease(COPD), asthma, coronary artery disease(CAD), obesity and others, in collaboration with physicians and other prescribers.
They may also provide support for patients undergoing treatment who have Cancer and other complex medical conditions.
Many of these pharmacists also work in more specialized clinics which may manage patients with conditions such as HIV/AIDS, hepatitis , chronic kidney disease , and anticoagulation.
While most ambulatory care pharmacists work with adults, some work with children as well.
*These Paediatriç Ambulatory Care Pharmacy Specialists may work in collaborative practice centres for paediatriç primary care or adolescent medicine.*
The Ambulatory Care Specialist Pharmacist can work in primary care clinics, out-patient disease state management clinics in hospitals, and in "retail" community pharmacies ( better known as *First Line Pharmacies, and NOT retail*).
These pharmacists can also provide their expert services through Telepharmacy.
Furthermore, part of the responsibilities of the ambulatory care pharmacist is to engage in patient consultations and meet with patients to discuss medications, therapy goals, and also assess for side effects, adherence issues etc .
*In this role, the pharmacist may also perform physical assessments such as blood pressure and heart rate, order laboratory tests, and assess or interpret results.*
The pharmacist helps patients when a condition is deemed uncontrolled, or they experience side effects to medications. This can also include helping patients that are unable to adhere to a drug regimen.
It is the pharmacist's responsibility to adjust the patient's current medications, add new medications and/or discontinue medications.
As the pharmacist, you may need to educate patients on lifestyle changes,
These Specialist Pharmacists are also required to document each patient visits. This includes reporting subjective information ( what the patient told them), objective ( labs, vitals, physical assessment results) , their assessment ( is the patient at goal? ; and if not, what needs to be done ) , and the plan ( what will be done, such as starting or discontinuing a medication , adjusting doses, ordering labs, and when to follow up). *This documentation is in the patient's chart and is available for any other healthcare providers to read and make use of.*
A non ambulatory care specialist pharmacist can transition into the field of ambulatory care without residency but it requires a specific career transition strategy. This may include pursuing work experience, gaining some relevant certification or enrolling in a certificate program.
Some organizations such as American Society of Health System Pharmacists ( ASHP) offer some certificate programs focused on ambulatory care that can provide additional skills.
However residency training is seen as the gold standard especially by majority of the employers.
In summary, ambulatory care focuses on same - day services for patients who do not need to be admitted to a hospital overnight.
This can include a wide range of care from routine check ups and vaccination to some diagnostic procedures and minor surgeries, and it can involve all clinicians including ambulatory care Nurses and Clinical Pharmacists..
In Africa, the field of ambulatory care pharmacy is emerging and developing, but it is not yet widespread. While clinical pharmacy services have been adopted in some countries like South Africa since the 1990s and which offers the doctor of pharmacy ( PharmD) degree as a postgraduate program, the specialized practice of ambulatory care pharmacy faces significant challenges across the continent.
Collaborative programs, such as the one between Purdue University and USAID-AMPATH in Kenya, have helped provide clinical pharmacy services in both inpatient and outpatient settings, including adherence counseling for patients with HIV.
Many African countries lack adequate policy and legislation to formally recognize and expand clinical pharmacy practice. This leads to poorly defined career paths and a lack of formalized job descriptions for clinical pharmacists.
Edited by Dr Joseph Madu ( NIGERIA), PharmD, FPCPharm, mASOCLIP.
*COURTESY : African Society of Clinical Pharmacists (ASOCLIP)*.
To join ASOCLIP as a Pharmacist, kindly contact the following via WhatsApp chats only :
+227 90 96 53 39,
+233 24 482 5108,
+234 803 723 3500,
+256 703 541877
+234 803 336 7881
