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Pharmacy practice in the Indian Health Service.

The current status of pharmaceutical services in the Indian Health Service (IHS) is described. IHS is a nationwide program for providing health-care services to more than 960,000 American Indians and Alaska Natives who live on or near federal Indian reservations. Because IHS pharmacy practice revolves around the needs of the patient, pharmacists have close and frequent contact with patients and must have an acute sensitivity to and respect for the cultural values and beliefs of the patients. Ambulatory-care services are emphasized; pharmacists often provide primary care to patients and make frequent use of prescribing authority. All prescriptions are filled directly from the patient's permanent health record, and private patient consultation rooms are used extensively. In the inpatient setting, pharmacists obtain medication and related histories from newly admitted patients and provide patient counseling at the time of discharge. Pharmacists are also actively involved in facility-wide programs and committees (especially those that deal with quality assurance and facility accreditation) and serve as preceptors of pharmacy residents and students. In the future, IHS pharmacy practice will emphasize the expansion of patient-care activities and primary-care programs, effective use of prescribing authority, and the refinement of patient consultation services, services for the elderly, home health-care services, and inpatient clinical services.