Qais Alefan

R.Ph, B.Pharm, M.Pharm, PhD

The number of medicines on the market has increased dramatically over the last few decades (quality & rational use?) Efforts to provide health care, including pharmaceutical care, are facing new challenges:
Rising costs of health care Limited financial resources A shortage of human resources in the health care sector Inefficient health systems The huge burden of disease The changing social Technological, economic & political environment Globalization has led to new complexities due to increased travel & migration

Access to medicines of assured quality is a major concern One third of the worlds population do not yet have regular access to essential medicines

The affordability of medicines is a major constraint

The economic burden falls most heavily on the poor Moreover, in many developing countries 10%-20% of sampled medicines fail quality control tests

Appropriate to their clinical needs

At the lowest cost

Patients receive medications

In doses that meet their own individual requirements

For an adequate period of time

More than half of all prescriptions are incorrect More than half of the patients fail to take their medications correctly There is growing concern at the increase in the global spread of antimicrobial resistance These challenges underscore the urgency of the need for global health sector reform

Public health interventions

Pharmaceutical care

Effective medicines supply management

An accessible, sustainable, affordable & equitable health care system which ensures the efficacy, safety & quality of medicines

Rational medicine use

Pharmacist
improve therapeutic outcomes & patients quality of life

managing drug therapy & concurrent nonprescription or alternative therapies

communicate the correct information to patients are as important as providing the medicine itself

Counselling

Patient-centred care

Providing drug info

Monitoring drug therapy

Medicines supply management

Pharmaceutical care Evidence-based pharmacy Meeting patients needs Chronic patient care-HIV/AIDS Self-medication Quality assurance of pharmaceutical care services Clinical pharmacy Pharmacovigilance

Pharmaceutical care is a revolutionary concept in the practice of pharmacy It includes emotional commitment to the welfare of patients as individuals who require & deserve pharmacists compassion, concern & trust

However, pharmacists often fail to accept responsibility for this extent of care. As a result, they may not adequately document, monitor & review the care given
Accepting such responsibility is essential to the practice of pharmaceutical care

Pharmaceutical care

Population-based pharmaceutical care

Individual pharmaceutical care

Population-based pharmaceutical care

establish formularies or medicine lists develop & monitor pharmacy policies

develop & manage pharmacy networks

prepare & analyse reports of drug utilization/costs

conduct DURs educate providers on medicine policies & procedures

Individual pharmaceutical care

manage drug therapy

monitor medicine-related illness effectively individual drug therapy decisions

reaching concordance

In an increasingly complex health care environment, it has become difficult to compare the effectiveness of different treatments Health care interventions can no longer be based on opinion or individual experience alone Scientific evidence, built up from good quality research, is used as a guide, & adapted to each individual patients circumstances

Pharmacist
Informed patients Counseling

Reduce DRPs

Reduce wastage
Improve adherence

Pharmacists help in HIV/AIDS prevention

Treatment & prevention services

Adherence to chronic HIV/AIDS treatment

Advise both on the choice of medicines and their safe and effective use

Donabedian defined the three elements of quality assurance in

health care as structure process & outcome

Structure
individual patient care in a practice setting

Process
provision of drug therapy

Outcome
improved or maintained quality of life

counselling
monitoring of treatment provision of drug information or education

institutional patient care

Describe the work of pharmacists whose primary job is to interact with the health care team, interview & assess patients, make specific therapeutic recommendations, monitor patient responses to drug therapy & provide medicines information Clinical pharmacists work primarily in inpatient settings & hospitals

Pharmacovigilance is a structured process for the monitoring & detection of ADRs in a given context Pharmacists have an important contribution to make to post-marketing surveillance & pharmacovigilance