INTRODUCTION:

At present, people's health is seen as the highest social value, and the formation of proper conditions for the preservation of life and raising its quality appears as one of the most important directions of development of any state. Recently, more and more attention has been paid to analyzing the role of pharmacists in the process of saving people's lives and improving their quality, as well as on the rational use of limited health resources.

For several decades, the efforts of influential international organizations (World Health Organization-WHO and the International Pharmaceutical Federation-FIP) and scientists are aimed at redefining the current role of pharmacists and developing directions for increasing their activities in the pharmaceutical provision system of the population^1-3. Qualitative and quantitative changes in the modern pharmaceutical market, and between doctors, patients, operators of the pharmaceutical market, and state has resulted in a new vision of the role of the modern pharmacists in the context of pharmaceutical care^1,4,5. The introduction by the American scientists (C.D. Helper and L.D. Strand, 1989-1990 years) in use the term "pharmaceutical care", has been contributed to the basic preconditions for the formation of modern ideology of pharmaceutical activities in the health care system^1,2,7,8. Since the 90s of the last century and till now the questions of modernization of the role of pharmacists in the system of pharmaceutical provision of the population do not lose their relevance^2,6. Every year, the problem of increasing the effectiveness of providing pharmaceutical care and services is only deepening, and its solution requires the involvement of an increasing number of specialists. For example, at the International Pharmaceutical Federation (FIP), the 78th International Congress of Pharmacy and Pharmaceutical Sciences, which was held on September 2-6, 2018, under the slogan "Pharmacy: transforming the outcomes", the question of reviewing the current role and tasks of pharmacists in conditions of increasing the requirements for the effectiveness of medical and pharmaceutical care has become fundamentally new value in society^9,10. Particularly relevant is the question of reviewing the current role of pharmacists in addressing the issues of rational use of limited health care resources in developing countries and those who have chosen the social vector of developmen^11-15. Ukraine also is a country, in which the issue of increasing the efficiency of provision of medical and pharmaceutical care has recently become regarded as priority¹⁶.

Realizing the socially-oriented principles of the development of Ukrainian society, declared in early 2014, Ukraine has started a public procurement program, including buying medicines through the open electronic program "ProZorro" from 2015. In addition, since 2017 year, the state program "Available medicines" has been introduced in Ukraine^17-18. Thus, according to the state program "Available medicines" reimbursement of the cost of medicines used in the treatment of cardiovascular pathologies, type II diabetes and bronchial asthma is foreseen. September 2018 in the program "Available medicine" take part more than 7,000 pharmacies, representing approximately 40.0% of the total number of pharmacies that operate in the country ¹⁸. Socio-economic efficiency of this program is largely dependent on the effective organization of pharmacists, which ought to be built in the direction of increasing the availability and rational provision of public health care and pharmaceutical services. The purpose of our study was to analyze the role of pharmacists in the modern paradigm changes in the organization and provision of pharmaceutical care and relations between actors in the system of pharmaceutical provision of the population.

The object of research was the data of the regulatory and legal base and special literature, which covered the issues of organizing the work of pharmacists in order to increase the effectiveness of cooperation between doctors, patients and operators of the pharmaceutical market under the current conditions of development of the pharmaceutical provision system of the population and society in general. In addition, special attention is paid to the consideration of the introduction of pharmaceutical practice innovative approaches and models of rational organization of public pharmaceutical care and services. In the studies we used dialectical, historical, comparative, systematic, logical-semantic, structural and functional, and other methods of scientific knowledge and search.

Pharmaceutical care as a historical, social, economic and regulatory category in health care system:

Understanding the modern role of pharmacists in the pharmaceutical industry and society should be considered in the context of the development of such an important concept as "pharmaceutical care". The first-stepers in this direction were American scientists and representatives of practical medicine and pharmacy. For the first time, a scientific understanding of changes in the practice of pharmacists under the influence of a set of factors was made in the works of great American scientist William E. Smith^{19-20. In the distant 1967 year, William E. Smith first
identified the need to review the role of pharmacists in organizing the
provision of effective pharmaceutical services to hospitalized patients as an
important component of medical care provided in hospitals 19}. It should be noted that the successful work of prominent American scientist in this area continues even now, as in his work he covers a range of issues in the work of clinical pharmacists as well, and pharmacists working in pharmacies of different ownership^19-23. American experience of the active introduction of effective pharmaceutical services provided to patients in hospitals to form objective preconditions for the formulation of the very concept of "pharmaceutical care." With the emergence and introduction into scientific circulation of this scientific category (C.D. Helper and L.D. Strand, 1989-1990), the practical activity of pharmacists acquired a fundamentally new meaning^1,6-8,13.

The nature of the development of pharmaceutical activity has become consistent with the contemporary challenges of society, which began to grow more and more socially every year. At the same time, it should be noted that the works of scientists that have been carried out for several decades in this direction, as well as the consistent and balanced position of international organizations, primarily the WHO and the FIP, have allowed the formation of a fundamentally new ideology in pharmaceutical practice^{1,3,4,6,13,24,25}. Because of the active position of American scientists and consolidated and socially responsible policies of European scientists and international organizations currently global pharmaceutical community has modern concept of implementing pharmaceutical care and services ^{2,10,11,22,26-29. In our opinion, it must be emphasized once again
that the WHO and the FIP played a key role in understanding the current role
and direction of pharmaceutical workers. It is the implementation of this
concept that allows us to effectively address all the challenges of society in
the direction of organizing the functioning of public health.}

Since the second half of last century, the term "pharmaceutical care" as a historical category was a difficult way of formation. Organizing data relevant regulatory framework and specialized literature allowed us to identify the following four stages of development and establishment of pharmaceutical care in health care and pharmaceutical provision of the population. Thus, according to the logical content of these stages of pharmaceutical care each stage we have given conditional definition. First of all, these are the following stages: "Stage I-Accumulation of information for scientific understanding of objective changes in the practice of pharmacists", "Stage II-Transition of quantitative indicators of development of pharmaceutical care to qualitative characteristics of the process", "Stage III-Adaptation of basic international documents about pharmaceutical care to the realities of the development of medicine, pharmaceutical market and adjacent medicine and pharmacy sectors”, "Stage IV-Further development of the main components of pharmaceutical care and state recognition of the need for conducting a new pharmaceutical practice around the world under active cooperation with WHO and FIP». The essence of these stages of development of pharmaceutical care is given in the table 1.

For more details, we will focus on the key points in the development of pharmaceutical care and the understanding of the current role of pharmacists in the health care system. Thus, Stage I of pharmaceutical development can be described as a period of chaotic accumulation of information and a gradual understanding by specialists of the need for the introduction of new forms and methods for organizing the pharmaceutical provision of patients with a chronic course of the disease, as well as in the hospital sector of the health care system. Already in the early 70's of the last century, due to the rapid development of medicine, pharmacy and related fields of knowledge, the quantitative and qualitative characteristics of the drug market have significantly changed^{7,8,14,22,27,30}. From a professional point of view, pharmaceutical workers were not ready to implement an active marketing policy of manufacturers and wholesale market operators, and to significant increase of counterfeit and substandard products on the pharmaceutical market, the emergence of a practice of selling medicines via the Internet, mail, manufacturers managers, etc.^2,5,31. In the economically developed countries, the stereotype of the behavior of pharmacists from the passive role in the organization of the medical and prophylactic process (manufacturing of drugs, dispensing of drugs) to the active position, as the regulators of relations between the patient and the doctor for the whole complex of medical-pharmaceutical, organizational-economic and normative-legal questions ^8,22,32,33.

Table 1: The essence of the main stages of the development of pharmaceutical care as an important historical category in the system of scientific knowledge and a set of practical skills in the health care system

Period and conditional names of the stage of category development" Pharmaceutical care"	The essence of the period
Stage I Beginning of the 70's of the last century until 1992 Accumulation of information and scientific understanding of objective changes in the practice of pharmacists	Under the influence of a whole range of factors, both external and internal origin, there was an objective need to revise the current role, content and socioeconomic value of the activities of pharmaceutical workers in health care and scientific reflection on objective changes in pharmaceutical provision of the population. First of all, regarding the increase of the commercial burden on the part of pharmaceutical companies that produce pharmaceuticals for pharmacists in the context of a substantive expansion of the range of medicines presented on the pharmaceutical market. Increasing the level of professional responsibility of pharmacists in matters of rational consumption of drugs by patients in outpatient and inpatient settings.
Stage II 1993-2000 The transition of quantitative indicators of the development of pharmaceutical care to qualitative characteristics of the process of its becoming as an important scientific category in the system of scientific knowledge and a set of practical skills	Internationally developing basic documents and forming a consolidated position of international organizations on the need to implement the concept of pharmaceutical care in practical health care and pharmaceutical provision of population of different countries.
Stage III 2001-2010 Adapting basic international documents on pharmaceutical care with the realities of medicine and the pharmaceutical market and related to medicine and pharmacy disciplines	Active cooperation of international organizations (WHO, FIP) with different countries of the world in order to develop basic health documents that are more adapted to the realities of health care development. First of all, documents containing conceptual provisions and directions for providing effective pharmaceutical assistance and services that are consistent with the effective implementation of the main objectives of the National Drug Policy (accessibility, rationality, quality) and the International Basic Drug Concept.
IV stage from 2011 and continues to this day IV.1 Further development of the main components of pharmaceutical care and state recognition of the concept of its development in different countries in the context of active cooperation with WHO and FIP	Recognition of the current role of pharmacists in the society at the state level in the countries of the world, which are aimed at solving the main goals of the National Drug Policy. Adoption at the state level in different countries of the world a complex of legislative acts which declared the main conceptual approaches to the organization of pharmaceutical assistance and services in a wide range of activities of pharmacists. Strengthening humanistic tendencies in the development of health systems and pharmaceutical activities. Improvement of the complex of state methods and approaches regulating the availability of medicines in the pharmaceutical market. Further development of active cooperation of national health systems with international organizations in order to develop and implement adapted versions of basic documents on the organization of provision of pharmaceutical care and services to the population.
IV.2 Formation and active implementation in pharmaceutical practice integrative model* of pharmaceutical care*	Active involvement in the organization of providing medical and pharmaceutical care and services to the population. For example, immunization of the population, provision of emergency medical care in the event of emergencies, participation in the complex of measures for the disposal of drugs as pollutants in the surrounding area, the implementation of advisory services in the programs of post-hospitalization patients, active participation in the organization of provision of palliative care, etc. Given the significant expansion of the functions of pharmacies, the pharmacist in the modern paradigm of knowledge and skills is considered an important regulator in the formation of models of rational use of limited resources of the health care system in conditions of increasing the requirements of consilience to the efficiency of providing medical and pharmaceutical services.

On the other hand, the strengthening of humanistic principles in the society of socially oriented states of Western Europe and North America has led to an increase in the requirements of citizens for their health, treatment outcomes, quality of life assessment, etc. As a result, significant structural changes in drug consumption and increased need for more effective and safe drugs have taken place. National health systems, which have mechanisms for reimbursing the cost of provided medical care and medicines, are not ready for the rapid increase in the costs of medical and pharmaceutical provision of citizens. Under existing conditions, state structures have demonstrated financial inability to effectively implement publicly guaranteed guarantees for the provision of high-quality health care. Under these conditions, there was an objective need to review the role of pharmacists in the organization of medical and pharmaceutical provision of the population and the introduction of effective mechanisms for state regulation of drug consumption, in which pharmacists and pharmacies, in particular, would have a key position. Thus, at the first stage of the development of pharmaceutical care, the issue of rational use of medicines ceased to be of a purely medical significance, but was considered in the area of socio-economic, regulatory and market relations in society. It should be noted that the term "rational use of drugs" appeared in the scientific circulation relatively recently. It was first used in the resolution of the international conference of experts, held under the auspices of WHO in Nairobi (Kenya) in 1985 According to WHO, rational use of drugs is the possibility of obtaining patient medications appropriate to their clinical needs, in doses that meet individual needs of patients within the required time at the lowest prices³⁴. At the end of the 80s, Willian E Smith, C.D. Helper and L.D. Strand formulated basic principles for the provision of pharmaceutical care in the hospital health sector by clinical pharmacists. This allowed for the development make a project for the provision of pharmaceutical care and services that was successfully tested in Minnesota (USA) during 1992-1996. First of all, it was determined that "Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve patients' quality of life" (CD Helper and LD Strand)^7,8. Later, after discussion and debate at the international level in 1998 FIP, was made clarification on the definition of "pharmaceutical care» ("achieving definite outcomes that improve or maintain a patient's quality of life")²⁵. Since that time both quantitative and qualitative characteristics of professional activity of pharmacists have changed, the spectrum of their services has considerably expanded ^{3,14,25,35-37}. As a result, the essence of the main functions performed by the pharmacy in the system of pharmaceutical provision of the population has changed.

At the first stage of the development of pharmaceutical care in this area of international affairs, the following conferences were held: "The role of pharmacists in the retail and hospital pharmacy" (Spain, Madride, 1988); "The Content of Pharmacy and Pharmacist Functions" (India, Delhi, 1990)³⁸. Due to the active position of WHO and FIP, the problem of organizing effective models of relationship between a pharmacist, a patient and a doctor in modern health care has ceased to be considered only in the area of the elimination of the professional interests of pharmaceutical and medical workers. The mentioned problem has become inter-sectoral and has been considered in an international format as a global issue.

At the beginning of the Stage II of the formation of pharmaceutical care observed dialectical transition of quantitative indicators (increase in irrational use of drugs, shortage of hospital budgets allocated to provide patients with drugs, economically unjustified costs for centralized procurement of drugs, strengthening professional burden on pharmacists, etc.) in a fundamentally new qualitative characteristics of the process. Thus, during the specified period of development of pharmaceutical care an important document was developed and adopted which defined strategic directions and tactical measures on the reformatting of the role of pharmaceutical workers in the organization of maintenance of the population of the drug and medical care of patients. Back in 1992, FIP was developed and presented standards for pharmacy services under the heading «Good pharmacy practice in community and hospital pharmacy settings». The text of this document was subsequently submitted for discussion at the Tokyo conference "Pharmaceutical Quality Service-the benefit to the state and society" in 1993³⁸. According to the results of the conference, the text «Good Pharmacy Practice» (GPP) was approved, and its resolution formulates the concept of pharmaceutical provision, which stated the need to accentuate the role of pharmacist in the interests of patients. In 1994 WHO presented resolution WHO47.12 «Role of the pharmacist in support of the WHO revised drug strategy», which outlined the role and main tasks of pharmacists in the implementation of an international strategy to provide the population with medicines ²⁴. Following the WHO review process and the related revision, GPP standards for European countries were published under the title "Good Pharmacy Practice in Communal and Hospital Pharmacies"³⁹. Following the recommendations of the WHO Expert Committee and the endorsement of the FIP Council in 1997, the FIP/WHO joint document on GPP was published in 1999 in the thirty-fifth report of the WHO Expert Committee on Specifi cations for Pharmaceutical Preparations (WHO Technical Report Series, №885)⁴⁰.

In the future, all subsequent documents developed at the international and national levels for the implementation of the pharmaceutical care principles in practical public health concept based on the principles declared in GPP WHO/FIP. Later started work on adapting the standard version of GPP WHO/FIP. Thus, in 1996 Pharmaceutical Group of the European Union–PGEU worked out the standarts GPP WHO/FIP for europine countries⁴¹.

Under the auspices of the WHO and the FIP, two meetings were organized (Vancouver, Canada - 1997, The Hague, the Netherlands - 1998), which addressed issues of increasing responsibility of pharmacists for the final outcome of treatment, the rational use of limited health care resources, and increased professional requirements for professionals in the system of pharmaceutical provision of the population⁴². During this period responsible self-treatment is recognizes as a modern direction in the organization of medical and pharmaceutical provision of the population in the context of a permanent increase in health care expenditures in socially-oriented countries. The introduction of responsible self-treatment in pharmacological practice leads to a significant expansion of professional competencies of pharmacists. A joint WHO/FIP statement on the role of pharmacists in responsible self-treatment was published in The Hague in September 1998⁴². The said application contained general requirements for pharmaceutical care and a description of comprehensive measures for the effective organization of its implementation in practical health care.

In 1998, for the newly independent states (the republics that were part of the colossal USSR), a strategic document "Focus on the patient" was developed, which stated the following. Under the conditions of reforming national healthcare systems in the newly independent states, it is necessary to introduce new forms and methods of pharmaceutical provision of the population based on the interests of patients, quality assurances of medicines, physical, socio-economic and informational accessibility of medicines⁴³. Given the need for further adaptation of GPP standards to the realities of national health systems of different countries, already in the late 90's of the last century, international organizations began a large-scale process of preparing the next version of the leadership GPP. Based on the results of the 2001 WHO Special Pharmacology Project in the Newly Independent States, in collaboration with the WHO Center for Drug Policy and Development of Pharmaceutical Practice, a guideline has been made on the implementation of GPP standards in developing countries in the direction of introducing market relations into practical health care.

On May 2001 the WHO in Copenhagen (Denmark) was presented the publication "Guidelines for developing and implementing GPP standards in the Newly Independent States (NIS)"⁴³. This year can be considered the following key moment in the historiography of pharmaceutical care, which begins the Stage III of its development. The questions of safety and rational use of drugs, the modern role of pharmacists and patients were considered at the 62nd Congress of the FIP (France, 2002) and presented in the modern WHO concept "Health for all in the XXI century". In collaboration, WHO and FIP developed the first edition of practical guidance«Developing pharmacy practice a focus on patient care developing pharmacy practice a focus on patient care»³³. This publication presents the main strategic directions of development of pharmaceutical care in the current conditions of raising the public's requirements for the effectiveness of providing medical and pharmaceutical services. In addition, the guide outlines ways of effective professional activity of pharmacists in the modern paradigm of pharmaceutical theory and practice («Pharmacists in the health care team: a policy perspective» and «Pharmacists in patient care: a practice perspective»). It should be noted that in 2006 an updated version was presented«Developing pharmacy practice A focus on patient care»²⁵. Taking into account national characteristics in the organization of pharmaceutical assistance, especially in developing countries, WHO and FIP have done enormous efforts to develop modern approaches to the development and implementation of GPP rules in different countries in the practice of pharmacies. Thus, from 2005 to 2007 WHO and FIP conducted several pilot projects in countries such as Cambodia, Moldova, Mongolia, Paraguay, Thailand, Uruguay and Viet Nam in order to determine the necessary level of resource support in the implementation of the rules implementing GPP. In the following year, the FIP South-East Asia Pharmaceutical Forum announced the support of the basic principles of the organization of provision of pharmaceutical care on the main principles presented in the GPP. In the «Bangkok declaration on good pharmacy practice in the community pharmacy settings» once again emphasized the importance of organizing and expanding the spectrum of providing effective pharmaceutical care in the health care system to address the main problems of the development of the world community and expand its range of provision⁴⁴.

Through the active support of the global pharmaceutical community, WHO and FIP, “Joint FIP/WHO guidelines on good pharmacy practice: standards for quality of pharmacy services” were presented in 2011. The above guidance was issued after a long consultations with the 120 national members FIP⁴⁴. As stated in the guide, WHO and the FIP provided only guidance on the development and implementation of pharmacies' standards, the effective ways of which should be identified by national professional organizations and communities around the world. Stage ІV of the development of pharmaceutical aid as an important historical, socio-economic, regulatory and medical-pharmaceutical category continues today, as in the global pharmaceutical world as well as in individual countries. For example, an integrative model of the organization of provision of pharmaceutical care and services, in which the pharmacist plays a key role in the rational use of limited health care resources, actively participates in the prevention of socially significant and dangerous pathologies, the provision of palliative post-hospital patients and patients with chronic pathologies ^45-49. Particular attention is paid to the practical work of pharmacists on the issues of effective utilization of low-quality drugs that are dangerous for the environment, and so on. Increasing importance is given to improving the effectiveness of cooperation between pharmacists and doctors, both in outpatient and in hospital settings ^{29,50-53. A significant increase in the range of
pharmacists' responsibilities for the results of the provision to the
population of pharmaceutical}care forms objective requirements for increasing the level of improving training and retraining of professional staff^50,54. The modern role of pharmacists at the international level is considered by the international community as part of an effective implementation «United Nations Sustainable Development Goals» (Goal 3: Ensure healthy lives and promote well-being for all at all ages), as a global plan to combat the major problems of the development of the network community.

Modern role of pharmacists in solving global problems in national health systems:

Over the past years, significant changes have taken place in the role of pharmacists in their efforts to address global health problems, primarily in terms of improving accessibility, quality assurance of pharmaceutical care and services, and the rational use of limited health care resources. As a result of the systematization of the data presented in the special literature, we identified the following actual trends of change in the practice of pharmacists in modern society (an integrated model of development of pharmaceutical assistance and services):

· significant expansion of the spectrum of pharmacists activity for a whole spectrum of qualitative and quantitative parameters of its assessment (conditional designation of the direction of the area – «А»);

· enhance effective collaboration with medical staff and other stakeholders in the pharmaceutical provision of the population and adjacent pharmacy, medicine fields of science and practice in the community (a symbol for the direction of the area–«В»);

· strengthening the responsibility of pharmacists and the level of their professional training and retraining (a symbol for the direction of the area–«С»);

· leadership development and enhance ethical standards of conduct in dealing with patients and other business relations in the pharmaceutical provision of the population (a symbol for the direction of the area – «D»);

· The formation of a stable relationship between the patient and the pharmacist not only in the case of health problems, but also in order to maintain quality of life at the appropriate level, the active introduction of the Belgian model of the "family pharmacist" (a symbol for the direction of the area–«Е»).

The logical filling of the indicated directions of modern activity of pharmacists in the integrated model of development of pharmaceutical care and services is presented in the table 2. One of the important conditions for the effective implementation of the main areas of activity of pharmacists is the formation of favorable conditions for the state to develop pharmaceutical activities. First of all, in the national health systems, conditions should be created for the free development of the pharmacy business, which must effectively perform its social functions to ensure that the population has quality, affordable and rational use of the drug. That is, the mechanisms of state regulation of pharmaceutical activity should not restrict the growth of professional and social activity of pharmaceutical workers. An interesting example of the expansion of the spectrum of pharmacists' districts was the active cooperation of Singaporean pharmacists (2017-2018 years) with the provision of medical and pharmaceutical services by clients of homes for the elderly and the American population vaccination program in pharmacies («US vaccine care model» )^9,10,51-53.

More and more popular in the world, especially in the United States, is expanding the modern model of relations between pharmacists and pharmacy visitors using modern mobile gadgets^55,56. Special attention is paid to the questions of formation of long-term relations between pharmacists and clients of pharmacies as an example «Belgian «family pharmacist» concept»^9,10. The essence of this concept is to build a new relationship between the pharmacist and the pharmacy customer, based on the principles of trust and mutual understanding and active participation of the pharmacist in healthy life and preservation of decent quality. Thus, an agreement on the provision of pharmaceutical services for a whole spectrum of area is concluded between the pharmacist and the pharmacy client. The so-called "family pharmacist" in accordance with the conditions presented in the contract is a plan for the treatment of simple, from the therapeutic point of view of health disorders, prevention programs for recovery, the losing of the client and his family members. In addition, the family pharmacist helps to choose the most rational scheme of medicine consumption through the use of more affordable drugs are the pharmaceutical market. Now, in Belgium, approximately 80.0% of pharmacists work under the "family pharmacist" program. According to data from special literature, more than 400,000 contracts between pharmacists and pharmacy clients and members of their families have been concluded in Belgium today ^9,10. It should be noted that for the effective implementation of the concept in 2018, the “Association of Pharmacists of Belgium” received the FIP Award.

One of the most important and promising perspective areas for pharmacists is the maintenance of non-hospitalised patients with chronic diseases (arterial hypertension, diabetes mellitus, Aytsegaymer's disease, etc.)^47,48,56-65. Increasingly frequent cases are the active participation of pharmacists in the provision of palliative care to cancer patients outside hospitals and hospices ^46,66,67. September 2018 Cochrane report was published, together with «NHS Education Scotland Universities of Aberdeen, Brunel, California and Nottingham Tren», which reviewed and systematized the results of 116 scientific studies (up to 2015), in which 41851 patients from 25 countries of the world, mainly in the US, UK, Canada, Australia, etc., participated ⁶⁸. The aim of the study was to compare the effectiveness of provision of chronic services to patients with inpatient and outpatient care and services provided by pharmacists in pharmacies in the context of the implementation of the concept of provision of pharmaceutical assistance and services. The researchers noted that 41 of the 111 studies analyzed the effectiveness of providing non-hospitalized patients with pharmaceutical care were significantly higher than those of patients who were provided with medical care, including specialized care. In general, specialists point out that pharmaceutical services provided by non-hospitalized patients may have significantly higher clinical outcomes than medical care provided by hospitals. This is especially true for patients with chronic diseases that require long-term care and treatment ^{58,60,65,69-71}. The said expansion of the spectrum of pharmacists' activities will allow more efficient use of limited health care resources, and the free allocation of funds to address more relevant and socially significant problems of public health^{72-74.
In this direction,
the expansion of the practice of pharmacists with each passing year becomes
more relevant to the resilience of clinical pharmacists in the organization of
treatment and prevention process at the level of hospitals and facilities of
general health and social care 27,28,35,36,75,76}. The issue of expanding the range of pharmacists is not only relevant for countries with high levels of medical and pharmaceutical assistance. Particularly relevant, this direction of activity of pharmacists takes place in poor countries with low levels of access to medical care for ordinary citizens. Unfortunately, in such countries, most pharmacy establishments are the only healthcare facilities that can be close to chronic patients by geographical indication, and pharmacists are the only healthcare providers who can professionally provide first-aid emergency care.

CONCLUSION:

By systematizing the results of the conducted studies, we can state the following. The process of introducing pharmaceutical care as an important historical and socio-economic category is characterized by the complexity of development. The path of development of pharmaceutical care corresponds to the main features of the dialectical development of any process that comes from the influence of a whole range of factors of the external and internal environment. Given the increased social load on pharmacies, the range of professional responsibilities will be constantly expanded. It is equally true that the level of professional and social responsibility of pharmacists will only be upgraded. Consequently, the introduction of innovative forms and methods of providing pharmaceutical care to the population and practical health care services will be continued. Taken together, this will necessitate a constant review of the content and forms of organization of the activities of pharmacists and the level of their professional training and retraining in the modern health care system.

CONFLICT OF INTEREST:

The authors declare that they have no conflict of interest to disclose.

CONTRIBUTING AUTHORS:

The research was conducted by the authors without financial support from any organizations or funds.

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Received on 06.10.2018 Modified on 10.11.2018

Research J. Pharm. and Tech 2019; 12(2):817-826.

DOI: 10.5958/0974-360X.2019.00142.2

A symbol for the direction of the area	The content of modern areas of pharmacists
Direction «А»	Active participation in vaccination of the population, advisory services on the issues of rational use of medicines and post-hospital monitoring of patients' health, healthy lifestyle and responsible self-treatment, use of innovative technologies (telemedicine, use of mobile devices, gadgets, etc.) aimed at formation of an individual approach to each pharmacy client, aimed at achieving the maximum therapeutic effect under the conditions of existing resource provision. Special role of pharmacists is realized in socially important and related fields of medicine and pharmacy, first of all in the organization of palliative care for incurable patients, immigrants, who are relieved of accidents. A separate area for the activities of pharmacists is professional care to women-caregivers who take on the main burden of care for people with disabilities and orphans in society..
Direction «В»	The introduction of new models of communication relations with various entities providing public pharmaceutical systems aimed at achieving the maximum effect from the use of a drug and quality of life of patients. Actively promote effective cooperation with experts from various disciplines addressing issues of significant public importance.
Direction «С»	Pharmacists must be responsible for the quality of the drug at all stages of their advancement through the commodity network, as well as after acquiring them in pharmacies. Pharmacists should be actively involved in solving the issues of collecting and disposing of drugs that were not used in outpatient settings by patients or lost their eligibility. The spectrum of their responsibility should be constantly expanded, from purely professional to criminal. In addition, pharmacists must meet the modern requirements for improving the efficiency of provision of pharmaceutical care and services in the conditions of rational use of limited health care resources, as well as constantly increase the level of their professional training and retraining in various areas of activity, including for those that currently do not correspond to the main areas of activity of pharmacy establishments. For example, it's a matter of preserving the environment, providing emergency assistance, that is, pharmacists must be at the forefront of the organization of effective pharmaceutical and medical care in national health systems.
Direction «D»	Taking into account the fact that pharmacists are in close proximity to the population, it requires them to possess a whole set of knowledge, skills and abilities. These skills and skills should be based not only on professional principles but also on moral and ethical and legal standards for the implementation of humanistic approaches in building community relations in society. At the same time, the direct proximity of pharmacists to patients allows the most effective solution to the complex issues associated with the implementation of "United Nations Sustainable Development Goals." It forms the ultimate objective conditions for social stability in society. In this direction, pharmacists should become leaders who have a set of key competencies in various areas of healthcare.
Direction «E»	In the national health systems and in society as a whole, socially adapted forms and methods of service to pharmacies and patients need to be implemented. For example, according to the example of the introduction of the "family pharmacist" institution, the so-called "Belgian" family pharmacist "concept." A whole range of issues related to the maintenance of health and quality of life for patients and drugstore visitors should be resolved with the family pharmacist. This significantly reduces the financial cost of medical care for patients and improves the efficiency of the provision of medical and pharmaceutical services to the population.