Community pharmacy practice in China: past, present and future.

In 2009, China launched a new healthcare system, with reform of the primary healthcare system as its foundation and focus, to enable residents to access primary healthcare for simple health problems instead of seeking help at hospitals. Community pharmacies and pharmacists were to have increased responsibility in primary healthcare by delivering pharmaceutical care services in China in addition to their traditional roles of dispensing prescriptions and selling medicines.To describe the current status of Chinese community pharmacy education and practice, and discuss future directions.A literature search was conducted using MEDLINE and International Pharmaceutical Abstracts. Additional articles were identified through the cross-referencing of articles and books. Additional data were found from relevant websites.From the 313 publications identified, 98 were included. China currently has 388,000 retail pharmacies, corresponding to one pharmacy per 3,532 population. All pharmacies provide prescription and over-the-counter products, as well as prescription dispensing and patient counselling. However, the lack of reimbursement mechanisms reduces the willingness of pharmacists to offer high-quality dispensing and counselling services. There is a shortage of qualified pharmacists to meet increasing patient needs. This, coupled with a shortage of pharmacist training, has resulted in pharmaceutical care being a low priority for delivery in routine pharmacy practice. To meet the increasing demand for pharmacists, 25 universities have been allowed to offer BS, MS and PhD degrees (3-7 years in length) in clinical pharmacy since 2008. The adoption of Good Pharmacy Practice as a recommended standard for community pharmacy practice provides pharmacists with a framework to aid them in service delivery.A number of undertakings still require development, including the enactment of the Chinese Pharmacist Law, development of a standard for pharmaceutical care activities, development of the pharmacy workforce, increasing public awareness of pharmacists, and proper reimbursement for care provision. Although pharmaceutical care services are underdeveloped in China, they will become an integral part of the professional work of all pharmacists in the future, particularly in community pharmacy settings.