Transitions, part 1: beyond pharmaceutical care.

A systems view of the amalgamation of existing pharmacy practice models is proposed. Pharmacy's evolution is traceable as a series of stages. The stages in pharmacy's evolution have been manufacturing pharmacy, compounding, distribution, clinical pharmacy, and pharmaceutical care. Good pharmacy practice (GPP) represents an international attempt to unite various conceptualizations of practice, including pharmaceutical care. GPP in turn provides a foundation for a model to explain current and changing practice, the total pharmacy care (TPC) model. TPC combines five existing practice models: drug information, self-care, clinical pharmacy, pharmaceutical care, and distribution. TPC, as the sum of these models, asserts that there will be an ongoing need for all five existing models of practice, that the proportion of pharmacists employing each model will reflect the needs of a given health care environment at a given time, and that if changes in health care provide more opportunities for pharmaceutical care, pharmacists will shift increasingly toward that type of practice. Total pharmacy care is the delivery of a comprehensive range of services that result in the maximum possible contribution to the health of a nation's population within the limits of the health care delivery structure.