Pharmaceutical Care

The term Pharmaceutical Care was coined in by

Heppler and Strand Definition: The responsible provision of drug therapy for the purpose of achieving definite outcomes which improve the patient quality of life.
It also involves designing, implementing and monitoring

a therapeutic plan that will produce specific therapeutic outcomes for the patient.

Pharmaceutical Care
Responsible for the outcomes of drug therapy, that is to

refocus clinical pharmacy activity from process to outcomes.

 Drug

Dosage form
Dose Schedule and

Duration of therapy

Students should state the reasons for avoiding specific drugs in their therapeutic plans
Drug allergy, Drugdrug or drug Renal or hepatic

disease interactions, Patient age

impairment Adverse effects Poor compliance, Pregnancy, and high treatment cost.

I. Risk management
Devise system of data collection

Perform prospective drug utilization review

Document therapeutic interventions and activities Obtain over-the-counter medication history Calculate dosages for drugs with a narrow

therapeutic index Report adverse drug events to FDA Triage patients needs for proper referral Remain abreast of newly uncovered adverse effects and drugdrug interaction

II. Patient advocacy

Serve as patient advocate with respect to social,

economic, and psychological barriers to drug therapy Attempt to change patients medication orders when barriers to compliance exist Counsel patients on new and refill medications as necessary Promote patient wellness Maintain caring, friendly relationship with patients Telephone patients to obtain medication orders called in and not picked up

III. Disease management

Provide information to patients on how to manage their

disease state/condition Monitor patients progress resulting from pharmacotherapy Carry inventory of products necessary for patients to execute a therapeutic plan (e.g., inhalers, nebulizers, glucose monitors, etc.) Supply patients with information on support and educational groups (e.g., American Diabetes Association, Multiple Sclerosis Society)

IV. Pharmaceutical care services marketing

Meet prominent prescribers in the local area of

practice Be an active member of professional associations that support the concept of pharmaceutical care Make available an area for private consultation services for patients as necessary Identify software that facilitates pharmacists patient carerelated activities

V. Business management
Use technicians and other staff to free up the

pharmacists time

 The likelihood of adherence with the regimen and patient

tolerance come into play in the selection of dosage forms. The economic, psychosocial, and ethical factors that are applicable to the patient should also be given due consideration in designing the pharmacotherapeutic regimen. An alternative plan should also be in place that would be appropriate if the initial therapy fails or cannot be used

Chrombosal test
Test for validity and reliability of questionnaire

>7, good
Deleting and re-deleting of questions in order to maximize

the score

Pharmaceutical public health

The application of pharmaceutical knowledge, skills and resources to the science and art of preventing disease, prolonging life, promoting, protecting and improving health for all through the organized efforts of society. Walker R, 2001

Pharmaceutical public health

Includes services to populations, such as

local guidelines and treatment protocols

medicine use review and evaluation national medicine policies & essential medicines lists

Pharmacovigilance
needs assessment and Pharmacoepidemiology

Triage
Designates a system whereby a group of casualties or

other patients is sorted according to the seriousness of their injuries or illnesses so that treatment priorities can be allocated between them.

counseling pharmacists should consider

Name & description of the medication (which may include the

indication). Dosage, dosage form, ROA, and duration of therapy. Special directions or procedures for preparation, administration, and use. Common and severe ADEs, interactions, and contraindications (with the action required should they occur). Techniques for self-monitoring. Proper storage. Prescription refill information. Action to be taken in the event of missed doses.

 USP-DI Volume II, Advice for the Patient: Drug

Information in Lay Language.