Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Practice
Dispensing pharmacy Pharmaceutical
Care
Product business
Service (people)
business
Bring the product to
Bring the practitioner
consumer
to patient
Decisions focus on the Decisions focus on
business the patient
Inventory generates Patient care
revenue generates revenue
Available service Available products
supports products support service
One is not better than the other, but they require different
skills, knowledge, personnel, equipment, time, and resources.
Dispensing pharmacy Pharmaceutical
Care
Success measured as #
Success measured as
patient outcomes
of Rx
Space organized to
Space to display and sell
meet patient needs
Records kept for legal Documentation to
purposes provide quality care
Visits determined by Visits determined by
refill supply patient risk/benefit
Business passive via Practice grows via
prescriptions patient recruitment
Direct patient care
Assessment Follow-up
Care Plan Evaluation
Patient SELF CARE
Practitioner Practitioner
Pharmaceutical Care in Health Care
Responsibility in
Primary Knowledge
the drug use
Focus Base
process
Diagnosis
and
Medical Care Pathophysiology Prescribing
Treatment of the
patient’s disease
Giving care to the Biological,
Nursing whole patient psychological, social, Drug
Care during the cure or or spiritual human administration
treatment responses
Identifying and Identification,
Pharmaceutical meeting a patient’s prevention, and
Pharmacotherapy
Care drug-related resolution of drug
needs therapy problems
Pharmaceutical care
: Definition
patient's life.
Mutual respect
Trust
Open communication
Cooperation
Mutual decision making
Structure of the Pharmacotherapy
Workup
Drug Therapy Problem Drug Therapy Problem
Unnecessary drug therapy Dosage too low
Needs additional drug therapy
Effectiveness
Dosage too high
Safety
Drug Therapy Problem Drug Therapy Problem
Ineffective drug Noncompliance
Adverse drug reaction
Continuous Follow-up
EXAMPLE
Key Points
A database of 20,761 patients who received
years.
therapies.
.Frequency of patients by age
Frequency of patients by number of medical
conditions
Key Points
Patients >65 years (n = 2072), had an average of 5
medications.
Percent
Unnecessary Drug Therapy 6%
Indication 34%
Needs Additional Drug Therapy 28 %
Ineffective Drug 8%
Effectiveness 28%
Dosage Too Low 20 %
Adverse Drug Reaction 14 %
Safety Dosage Too High
19%
5%
Noncompliance 19 %
Compliance 19%
Total 100%
Table 7-6
Drug therapy problems by category.
PRIMARY METHOD OF RESOLUTION
OF DRUG THERAPY PROBLEMS
Protocol Carrier
Physician
(19%) Patient
(79%)
Table 2-24 Interventions Made to Resolve Drug Therapy Problems
Patients < 65 years Patients 65 year
% of interventions of intervention%
Required patient intervention only
Initiate new drug therapy 358 451
Change drug product 58 81
Change dosage regimen 293 352
Discontinue drug therapy 129 138
Initiate laboratory test 126 204
monitoring
Education beyond OBRA 330 430
Provided medication reminder 43 54
device
Removed patient barrier 126 131
Other 209 59
Total 1672 (77.6%) (81.7%) 1905
Required protocol/carrier intervention
Initiate new drug therapy 4 0
Change drug product 6 1
Change dosage regimen 4 0
Discontinue drug therapy 1 4
IMPACT OF PHARMACEUTICAL CARE
PRACTICE
Resolution of drug therapy problems with Physicians
initiate new drug therapy 31 %
change drug dosage regimens 23 %
change drug product 15 %
discontinue drug therapy 15 %
laboratory monitoring initiated 10%
other 6%
Change in Clinical Status at Follow-up Evaluation
4492 Patients and 10,485 Medical Conditions
Condition Declined
(16 %)
Condition Improved
or
Remained the Same
(84 %)
Clinical Outcomes
of the medical conditions requiring drug 84%
therapy, which were not already stable at
the time of the first pharmaceutical care
encounter, improved (69%) or remained the
same(15%) through the provision of
.pharmaceutical care