Authors' response

We truly appreciate the response by Dr Newmark about our recent letter and would like to clarify a few points raised by him. First, he expressed his concerns about our credibility and authority to suggest recommendations for healthcare issues in Pakistan, based on our affiliation with a Malaysian university. For all of our readers' information, the first author of our letter is a qualified practising clinical pharmacist from Pakistan and currently is affiliated with the Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences at Universiti Sains Malaysia for his PhD studies. As a pharmacist in the ground work, Mr Fahad is well versed with the situation in Pakistan to a great extent, especially to the region in which he is currently practising (Balochistan).

Second, Dr Newmark has also argued that our recommendations are merely based on western treatment guidelines and are not suitable for application in Pakistan. Based on the authors' current observation of recent practice in Pakistan, we are afraid that he missed the point that things had changed positively over the last few years. There are now adoptions of a number of standard international guidelines in practice, such as the Joint National Committee, British Society of Hypertension Management, European Society of Cardiology, and Canadian Hypertension Education Program, the employment of more foreign trained doctors, and an increasing awareness of evidence-based practice by practitioners and national health authorities.

The initial letter that we wrote was to highlight the issues related to non-adherence and poor knowledge towards hypertension and, as practising pharmacists, to develop or at least discuss a mechanism to improve the condition. The word ‘pharmacist’ is relatively new to the people, and the profession is still struggling to be recognised by the healthcare team and institution. Therefore, it was stressed in the letter that interprofessional roles have to be strengthened and the pharmacist must work out of traditional domains of dispensing and supply, and start looking ahead for further responsibilities in patient care.

The letter had nothing to do with the treatment guidelines, the manner of how hypertension is treated, or to discuss singular versus multiple-risk factors. It was an effort to promote the role of pharmacists that will be beneficial for all. We are quite sure that if the new system is implemented and the pharmacist is ready to be moulded into a new shape, practical application of these ideas can be achieved even in the least developed areas of Pakistan. It's better to try than to sit and wait for a miracle to happen.

• © British Journal of General Practice, 2010.