Practice Guidelines for Clinical Pharmacists in Middle to Low Income Countries Elmien Bronkhorst * , Andries G. S. Gous and Natalie Schellack School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa The profession of pharmacy is maturing as a clinical profession in South Africa and has experienced significant development over the past 10 years. The development of clinical pharmacy in Southern Africa started in the late 1980s. The Director-General of Health and Welfare requested an expansion of the pharmacist’s role in Southern Africa, in 1988, when he challenged pharmacists to be “more than just dispensers.” South Africa experience human resource challenges in terms of healthcare service delivery and the shortage of pharmacists has been acknowledged. Due to the human resource shortage, it is very difficult to allocate pharmacists to work in a clinical unit on a daily basis. This document serves to set out practice guidelines for clinical pharmacy in South Africa, and to indicate areas where clinical pharmacist should concentrate to build practice. Keywords: clinical pharmacy, pharmaceutical care, key-performance indicators, outcome measures, national drug policy INTRODUCTION The profession of pharmacy is maturing as a clinical profession in South Africa and has experienced significant development and growth over the past 10 years. It is presently well positioned to transform itself from a product-orientated (including procurement, preparation and evaluation of drug products), to a patient-oriented profession (Hepler and Strand, 1990). The clinical pharmacist must fulfill an important role in the National Health Insurance (NHI). This strategic document represents a comprehensive narrative on the role of the clinical pharmacist in UHC through NHI for South Africa. The American College of Clinical Pharmacy (ACCP) in 2006 defined the primary difference between clinical pharmacists and general registered pharmacists by clinical pharmacists’ ability to interact with patients and the fact that they can recommend specific drugs and patient specific drug dosages to improve patient well-being (Hepler, 2004). From clinical pharmacy, the term pharmaceutical care was born. The two concepts are compatible and seem to have similar goals. One way to distinguish between the two can be to describe clinical pharmacy as a practice of pharmacy within a larger pharmaceutical-care system, where the pharmacist will contribute. The goal is to achieve pharmacotherapeutic and quality-of-life patient outcomes (Murphy et al., 2006). Pharmaceutical care can be defined as “the direct, responsible provision of medication-related care for achieving definite outcomes, which improve a patient’s quality of life” (American Society of Hospital Pharmacists, 1992). Thus, pharmaceutical care can be considered as a form of clinical pharmacy. Frontiers in Pharmacology | www.frontiersin.org June 2020 | Volume 11 | Article 978 1 Edited by: Jean-Marie Boeynaems, Universite ´ libre de Bruxelles, Belgium Reviewed by: Varsha Bangalee, University of KwaZulu-Natal, South Africa Mohamed Izham Mohamed Ibrahim, Qatar University, Qatar *Correspondence: Elmien Bronkhorst Elmien.bronkhorst@smu.ac.za Specialty section: This article was submitted to Pharmaceutical Medicine and Outcomes Research, a section of the journal Frontiers in Pharmacology Received: 24 February 2020 Accepted: 16 June 2020 Published: 30 June 2020 Citation: Bronkhorst E, Gous AGS and Schellack N (2020) Practice Guidelines for Clinical Pharmacists in Middle to Low Income Countries. Front. Pharmacol. 11:978. doi: 10.3389/fphar.2020.00978 POLICY AND PRACTICE REVIEWS published: 30 June 2020 doi: 10.3389/fphar.2020.00978