PHARMACEUTICAL

CARE
2015
Armenia

Slogan

Only with
pharmaceutical
care, pharmacy job
is professional job

introduction

Have you ever find sick patient without diagnosed?

Have you ever find patient treated with the drug without
indication?
Have you ever meet patient treated with the drug with a n
under/upper doses?
Have you ever find patient suffer from the symptoms
related to drug side effect?
Have you ever met patient using the drug not in a proper
time/schedule?
Have you ever heart patient complain that his or her
disease could not be controled/relieved?
Have you ever found prescription not in a proper
combination?
Have you ever met patient that not be able to buy drugs?

If your answer is yes

It means that those

situations need pharmacist
interventions

Course contents

Introduction and PC coverrages

Hystory : from compounding to caring
Communication techniques
Drug used and health care system
DRP and pharmaceutical Care
Pharmaceutical care and EB Phacotherapy
Hospital Formulary and Therapeutical Guide
Implementation of and Competence for PC
PC in ICU

PC
PC
PC
PC
PC
PC
PC

in
in
in
in
in
in
in

CVD
RD
GITD
geriatry
pediatry
hazard cases
Infective diseases

GOAL

better patient care

service

E
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Backgrown

number of medicines on the market has

increased dramatically
quality and rational use of medicines
rising costs of health care
limited financial resources
more than half of all prescriptions are incorrect
morethan half of the people involved fail to
take medicines correctly.
the increase in the global spread of
antimicrobial resistance
Patient Protection

Pharmacy Practice dimencions

Pharmaceutical care
Evidence based
Meeting patient needs
Chronic patient care HIV/AIDS
Self-medication
Pharmacovigilance (ADRs on specific
patient)

OBJECTIVES

overall goal of the course are:

to teach the philosophy of practice

patient care process,
to introduce the steps necessary
to establish a pharmaceutical care practice

Targets

To be able to:
Identify
Prevent
Solve the DRP

THE EFFECTIVE,
SAFETY AND
EFFICIENT
DRUG THERAPY

Definition
Pharmaceutical care is the
responsible provision of drug
therapy for the purpose of
achieving definite outcomes that
improve a patients quality of life.

Good Pharmacy Education

Practice

Pharmacist as (8 stars pharmacist):

a caregiver
Communicator
decision-maker
Teacher
life-long learner
leader and
Manager
Interpreneur

FOCUSED ON

allows these responsibilities to be met

according to the standards of practice,
the standards for professional behavior,
the philosophy of practice, the patient
care process,
documentation standards required to
provide pharmaceutical care to patients.
to provide the student with a rational,
systematic, and comprehensive approach
to the patient, the patients medical
conditions, and the patients drug
therapy

understanding of pharmacy practice and

introduces the structure that is needed to
learn the skills and knowledge required to
integrate and apply patient, disease, and
drug information to improve the
effectiveness and safety of drug
therapy

new challenges

rising costs of healthcare

limited financial resources
a shortage of human resources in the
health care sector
inefficient health systems
the changing social, technological,
economic and political environment

key components

Ensuring the Quality and the Safety of

Medicinal Products to Protect the Patient

Policy on Control of Resistance to

Antimicrobials

rational medicine use and effective medicines

supply management

ensures the efficacy, safety and quality of

medicines.

Patient care: How?

through managing drug therapy and

concurrent non-prescription or alternative
therapies.

Health is a state of complete physical,

mental and social well-being, not merely
the absence of disease or infirmity.

PRINCIPLES OF PHARMACEUTICAL
CARE:
Functions:
participating in the process of drug use decisions;
selecting the drug product dosage form;
determining the dose and dosage schedule;
preparing the drug product for patient use;
providing the drug product to the patient;
providing drug information to the patient;
monitoring the patient to detect adverse drug reactions
and drug interactions; and
monitoring the patient to enhance the probability that
therapy proceeds in accord with patient care objectives

outcomes oriented pharmacy practice

providers to promote health,

to prevent disease,
to assess, monitor, initiate, and modify
medication use assure that drug
therapy regimens are safe and effective.

The goal of Pharmaceutical Care

to optimize the
patient's healthrelated quality of
life, and achieve
positive clinical
outcomes, within
realistic economic
expenditures

PENYAKIT, OBAT DAN DRP

DRP
Dosis terlalu rendah
Dosis terlalu tinggi
EFEKTIF
DRP
REGIMEN DOSIS
Perlu obat lain
Obat tak diperlukan
OBAT

EFISIEN

AMAN

DRP

DRP

Tak efektif
Reaksi tak diinginkan
Interaksi obat

Tak patuh

INDIKASI

PENYAKIT

LUARAN

eight categories of drug-related

problems

taking/receiving a drug for no medically

valid indication
needs pharmacotherapy but is not receiving
it
taking/receiving the wrong drug
taking/receiving too little of the right drug
taking/receiving too much of the right drug
taking/receiving drug inappropriately
experiencing an adverse drug reaction
experiencing a drug interaction

REQUIREMENTS

professional relationship must be

established and maintained.
Patient-specific medical information
must be collected, organized,
recorded, and maintained
Patient-specific medical information
must be evaluated and a drug
therapy plan developed mutually
with the patient.

Practice Principles

Data Collection
initial interview with the patien
initiating the patient's pharmacy record

What will you do with pediatrics,

geriatrics, critical care, language
barrier ?
pharmacist should work directly with
the patient's parent, guardian, and/or
principal caregiver.

 The

interview is organized, professional,

and meets the patient's need for
confidentiality and privacy.
uses health/physical assessment
techniques (blood-pressure monitoring,
etc.) appropriately and as necessary to
acquire necessary patient-specific
uses appropriate secondary sources to
supplement the information
creates a pharmacy record for the
patient and accurately records the

Information Evaluation are

collected information subjective and
objective ? Useful for:
(1) opportunities to improve and/or assure the
safety, effectiveness, and/or economy of
current or planned drug therapy;
(2) opportunities to minimize current or
potential future drug or health-related
problems; and
(3) the timing of any necessary future
pharmacist consultation.

records the conclusions

discusses the conclusions with the patient, as
necessary and appropriate

Formulating a Plan: objectives:

1) improve and/or assure the safety,
effectiveness, and/or cost-effectiveness of
current or planned drug therapy; and/or,
(2) minimize current or potential future healthrelated problems.
formulates plans to effect the desired outcome

Includes:
patient-specific drug therapy protocol
modify prescribed drug therapy,
develop and/or implement drug therapy
monitoring mechanisms,
recommend nutritional or dietary modifications
add non-prescription medications or non-drug
treatments
refer the patient to an appropriate source of
care, or institute an existing drug therapy
protocol.

NOTES

considers

the
patient's needs
reviews the plan
and desirable
outcomes with
the patient and
with the patient's
other healthcare
provider
documents the
plan and
desirable
outcomes in the
patient's medical

Implementing the Plan

pharmacist and the patient take the steps necessary
to implement the plan
works with the patient to maximize patient
understanding and involvement in the therapy plan
assures that appropriate mechanisms are in place
(ensure proper medications, equipment, and supplies
are received by the patient in a timely fashion)
documents in the medical and/or pharmacy record
the steps taken.
communicates the elements of the plan to the
patient and/or the patient's other healthcare provider

Monitoring and Modifying the

Plan/Assuring Positive Outcomes:
regularly reviews subjective and objective monitoring
parameters in order to determine if satisfactory
progress
determine if the original plan should continue to be
followed or if modifications are needed
reviews ongoing progress in achieving desired
outcomes
A mechanism is established for follow-up with
patients
updates the patient's medical and/or pharmacy
record

Element needs to provide

quality pharmaceutical care
(1) knowledge, skill, and function of
personnel,
(2) systems for data collection,
documentation, and transfer of
information, (3) efficient work flow
processes,
(4) references, resources and equipment,
(5) communication skills, and
(6) commitment to quality improvement
and assessment procedures.

Pharmacist s practice functions

4 DIMENSION IN PC
PRACTICE
(i) Drug Information Source;
(ii) Information Gathering;
(iii) Patient Counseling; and
(iv)Drug Monitoring.

Q&A