Services of pharmaceutical health population : Application of ph knowledge ,skills and resources to science , preventing disease , prolong life , improving

health .

 Care

that given patient requires and receivers which assures safe and rational drug usage

 Provision

of drug therapy for definite outcomes, Improve a patient's quality of life . Responsible provision ,and definite outcomes . Resolve drug therapy problems Prevent such problems

 1-

Develop a care plan to resolve /or prevent drug therapy problems . 2-Assess patient's drug therapy needs and Identify and potential drug therapy . 3- Implement care plan . 4-Evaluate and review care plan

 Step

1 assess needs and identify drug problems . 2-develop a care plan 3-implement care plan 4- monitor and review care plan

Patient Care

Involves a patient and a qualified practitioner Requires a face-to-face encounter Practitioner takes responsibility for patients need(s), his/her interventions and the patients outcomes Practitioner provides a service that is consistent, comprehensive and standardized Practitioner assess each patients needs, develops a car plan to meet these needs and follows-up to evaluated the outcomes.

PHARMACEUTICAL CARE PRACTICE

Think like a practitioner - Pharmacotherapy Workup Act like a practitioner - Standards of Practice Speak like a practitioner - Practice Vocabulary

HEALTH CARE SYSTEM

Product $$ Capitalism Competition Marketing Technology Patient Care Services $$$$$$ Patient Care Practice

Pharmacy Pharmacy Evaluation

Documentation Reimbursement

MANAGING DRUG USE

What is best for society? (Health Care Policy, Regulation, Legislation)

SYSTEM LEVEL

What is best for an organization, institution, disease state?

(formulary, DUE, DUR, protocol, disease state management)

INSTITUTIONAL LEVEL

Pharmaceutical Care

What is best for a patient?

PATIENT LEVEL

Pharmaceutical Care in Health Care

Primary Focus Medical Care
Diagnosis and Treatment of the patients disease Giving care to the whole patient during the cure or treatment Identifying and meeting a patients drugrelated needs

Knowledge Base
Pathophysiology

Responsibility in the drug use process

Prescribing

Nursing Care Pharmaceutical Care

Biological, psychological, social, or spiritual human responses Pharmacotherapy

Drug administration Identification, prevention, and resolution of drug therapy problems

Patient Care Process

Patient

Assessment

Practitioner
Pharmacotherapy Workup

Experience

Medication

Care Plan

Todays wants and needs Responsibilities

Philosophy of Practice Follow-up Evaluation Social Obligation Responsibilities Patient-centered approach Caring Therapeutic Relationship

DRUG THERAPY PROBLEM CATEGORIES

1. The drug therapy is unnecessary because the patient does not 2. 3. 4. 5. 6. 7.

have a clinical indication at this time. Additional drug therapy is required to treat or prevent a medical condition in the patient. The drug product is not being effective at producing the desired response in the patient. The dosage is too low to produce the desired response in the patient. The drug is causing an adverse drug reaction in the patient. The dosage is too high, resulting in undesirable effects experienced by the patient. The patient is not able or willing to take the drug therapy as intended.

THE PATIENT CARE PROCESS

ESTABLISH A THERAPEUTIC RELATIONSHIP
ASSESSMENT
What does my patient want and need?

CARE PLAN
What am I going to do for my patient?

EVALUATION
How will we know if it is working?

Continuous Follow-up

CARE PLAN
A structure for working together with a person who may have different understandings, expectations, concerns, and a different value system. Agree on goals of therapy Select interventions to achieve goals of therapy

EVALUATION
Scheduled follow-up intervals during which the pharmacist...
Evaluates current status and progress in meeting therapeutic goals Documents actual patient outcomes Determines whether new problems have developed

PRACTITIONER REQUIREMENTS TO PRACTICE

Philosophy of practice Therapeutic relationship with patients An understanding of the patients medication experience Rational thought process -pharmacotherapy workup and drug therapy problems Patient care process Documentation system Reimbursement system

Drug Therapy Decisions

erience medication exp tion of the tients descrip Pa concerns beliefs Curre nt me understanding preferences Presc dication re rip co OT C s produ tion produ rd ction cts cts ea ry rug r isto verse d Samp on h Ad ati les edic s M gie s Aller raphic mog ient De nder Medication-related review of systems Pat ge tion age cardiovascular renal hematology occupa t weigh musculo-skeletal pulmonary

Patients description of the medication experience

Indication

Drug product
Current medication record

Dosage regimen
Medication history

Outcomes

Patient Demographics Medication-related review of systems

The questions, hypotheses, and cues generated by the Pharmacotherapy Workup are in response to two basic questions:

Is the patients problem caused by drug therapy?

Can the patients problem be treated with drug therapy?

Identifying Drug Therapy Problems

Drug therapy problems are undesirable events or risks that the patient experiences that inhibit or delay him/her from achieving the desired goals of therapy. They are identified during the assessment process, so they can be resolved through individualized changes in the patients drug therapy regimens.

DRUG THERAPY PROBLEMS

Unique set of problems Demarcate professional responsibilities Central to your activities and practice

Drug Therapy Problems

The problem can take the form of a medical complaint, sign, symptom, diagnosis, disease, illness, impairment, disability, abnormal laboratory value, or syndrome.

Drug Therapy Problems

The drug therapy (products and/or dosage regimen) involved

Drug Therapy Problems

The relationship that exists (or is suspected to exist) between the undesirable patient event and drug therapy
This relationship can -be the consequence of drug therapy -require the addition or modification of drug therapy

Drug Therapy Problem

Description of the Drug Therapy Problem

Unnecessary Drug Therapy Needs Additional Drug Therapy Ineffective Drug Dosage too low Adverse Drug Reaction Dosage too high Non-compliance

The drug therapy is unnecessary because the patient does not have a clinical indication at this time Additional drug therapy is required to treat or prevent a medical condition The drug product is not being effective at producing the desired response The dosage is too low to produce the desired response The drug is causing an adverse reaction The dosage is too high, resulting in undesirable effects The patient is not taking the drug regimen appropriately

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