Documenti di Didattica
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I. INTRODUCTION
Pharmacists
– Chemistry of drugs
– Formulation of medicines
– Drug usage to manage diseases
– Community
– Academia
– Pharmaceutical advisor
– Community facilitator
– Pharmaceutical industry
A. COMMUNITY PHARMACY
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c. GP-Pharmacist Links
– Doctors realized pharmacists had many possible additional roles, and they made
use of their services.
– Recently, in the extension of clinical pharmacy into the community, the
pharmacists:
• provide doctors advice on formulary development.
• undertake patient medication reviews.
• take responsibility for specific clinics following agreed protocols
d. Responding to Symptoms
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– Aids patients to comply with & maximize the benefits of their medicine
regimen (important contribution of pharmacy to health care).
– Patient compliance – extent a patient takes or uses his medicine in accordance
with the directions /follows the doctor’s general health advice.
– Pharmacist ensures patient has enough information in an understandable form.
g. Health Education
– Limited to the provision of a range of leaflets (ex. Diet to reduce the development
of disease)
– relatively few examples of extensive health promotion in pharmacies.
B. HOSPITAL PHARMACY
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b. 24-hour Service
c. Increased Research
C. PHARMACY EDUCATION
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b. Continuing Education
c. Higher Degrees
d. Research
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– professional audit/assessment
• a tool to improve the quality of service provided by pharmacy
a. Pharmacist
The trusted healthcare professional that is given the responsibility for safe-guarding
and supplying medicines to the individual patient within the legal system of a
country.
b. Global Organizations
World Health Organization (WHO)
• Directing and coordinating authority for health within the United Nations
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a. Healthcare Team
Requires skills:
▪ Listening Skills
▪ Questioning Skills
▪ Respect
▪ Helping
▪ Sharing
▪ Collaborating
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▪ Communication
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❖ Pharmacy Technician
▪ Make up prescriptions issued by doctors.
- Reading prescriptions and translating doctor’s instructions
- Counting solids and measuring liquids
- Prepare accurate labels for medicines
- Selling medicines and complementary preparations
- Referring to pharmacists when appropriate
- Small-scale or individual preparation of extemporaneous products
- Maintaining and managing stock within the pharmacy
- Record-keeping and audit
- Being aware of legal requirements relating to prescribing and supply
of medicines
b. Role in Teamwork
Essential Skills:
• Leadership,
• Delegation and
• Negotiation
C. CONCORDANCE
occurs when the patient and the healthcare professional participate as partners to
reach an agreement on when, how and why to use medicines, drawing on the
expertise of the healthcare professional, as well as the experiences, beliefs and
wishes of the patient (Marinker et al, 1997)
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3. Providing information
- Information should be provided in a manner which takes account of
what the patient may already know and what, and how much,
information they would like to receive.
- Verbal information can be supported with written information like the
patient information leaflet (PIL).
- Decision aids may also be used.
- Criteria used to judge quality of information provided:
a. Information accuracy, comprehensiveness and reliability
b. Clarity of aims and target audience
c. Comprehensibility and balance of the information
d. References to sources
e. How up-to-date it is
f. Support for shared decision-making
g. Transparency of authorship and sponsorship (if any)
- Providing Information (Communicating risk)
• To provide information on the effectiveness of a medicine or the
likelihood of a side-effect occurring
• Use of both verbal or text information and numerical or graphical
information on risks can aid patient understanding
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4. Therapeutic alliance
Four Issues:
1. Time
- Practice makes for efficiency
- Address patient issues openly
- De-couple the provision of information about option from the constraints
on consultation length
2. Anxiety
- Present information on both positive and negative effects of treatment, in a
manner understandable to lay people, that links into lay theories of illness
and treatment and which promotes informed choice
3. Participation
- People need to be involved in decision-making to the extent that they want
to be. The best way to do this is to ask them.
4. Demands
- Concordance is about both parties expressing their views and if a healthcare
professional has reservations about a certain treatment option, he needs to
explain the rationale to the patient.
REFERENCE: Rees, JA, Smith, I and Watson, J. (Ed.) (2014). Pharmaceutical Practice 5th Ed.
Churchill Livingstone Elsevier: China. pp.121-133, 163-172.
• Behavioral Science
– the scientific study of human behavior
• Psychology
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– explains an individual’s actions and relates this to the society in which he lives
– concerned with relationship between society and the individual which influence the
experiences of health and illness
– includes the way individuals respond to health and illness and to other people
– Helps the pharmacist to meet patient’s needs
• WHO defines health as “a state of complete physical, mental and social well-being”.
• Symptom Iceberg
– seeing a doctor/dentist
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• Illness Behavior
– concept used to describe the steps that people go through in order to decide that
they are ill
– visit a doctor or pharmacist
– for: therapeutic benefit and recognition of the sick role
• Help-seeking behavior
– lay referral system
– network of colleagues, relatives and friends
A person is likely to consult a health professional when the perceived benefits outweigh
the perceived costs.
• Health motivation
– the level of interest an individual express in health issues
• Susceptibility
• Severity
– the perceived seriousness of certain illnesses
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People often seek help from a pharmacist before seeking doctor’s help.
Pharmacists
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