Content text 29. PHARMACEUTICAL CARE CONCEPTS.pdf
PHARMD GURU Page 1 Definition: It is defined as the responsible provision of drug therapy for the purpose of achieving definite therapeutic outcomes that improve the patient’s quality of life. THESE OUTCOMES ARE: Cure of the disease. Elimination or reduction of patient’s symptomology. Arresting or slowing of a disease process. Preventing a disease or symptoms. FUNCTIONS: 1. Collection of patient data. 2. Identification of problems. 3. Establishing outcome goals through a good therapeutic plan. 4. Evaluating treatment alternatives, by monitoring and modifying therapeutic plan. 5. Individualizing drug regimens. 6. Monitoring outcomes. 1) COLLECTION OF PATIENT DATA: Demographics. Current problems. Past medical history. Current medication. Social habits. Relevant laboratory data. 2) IDENTIFICATION OF PROBLEMS: The data collected can be used to identify actual or potential drug related problems. • ACTUAL: A condition that requires the initiation of a new or additional drug. • POTENTIAL: The patient may be at risk to develop a new medical problem. PHARMACEUTICAL CARE CONCEPTS
PHARMD GURU Page 2 These problems may be related to the patient’s current drug therapy, drug administration, drug compliance, drug toxicity, ADR’s and a failure to achieve desired outcomes by the treatment. 3) ESTABLISHING OUTCOME GOALS: Drug therapy can produce positive outcome: 1. Cure of the disease. 2. Elimination or reduction of patient’s symptomology. 3. Arresting or slowing of a disease process. 4. Preventing a disease or symptoms. 5. It may also produce negative result, i.e. resulting in disease morbidity and sometimes mortality. 4) EVALUATING TREATMENT ALTERNATIVES BY MONITORING AND MODIFYING THERAPEUTIC PLAN: Efficacy, safety, availability and cost of treatment and suitability of the treatment to the patient should be considered while evaluating. The risk-benefit ratio factors should also be considered: seriousness of the disease, complications if untreated, efficacy of drug, ADR’s. 5) INDIVIDUALISING DRUG REGIMENS: When more than one therapeutic alternative exist, the following factors to be considered: Patient factors: Diagnosis, treatment goals, past medical and medication history, contraindication, allergies, compliance. Drug factors: - Efficacy, adverse effects, dosage form, cost, drug-drug interactions. 6) MONITORING OUTCOMES: The goals are: Cure of the disease. Elimination or reduction of patient’s symptomology.
PHARMD GURU Page 3 Arresting or slowing of a disease process. Preventing a disease or symptoms. But often leads to suboptimal outcomes due to: Inappropriate or unnecessary prescribing or drug regimen. Dispensing error. Non-compliance. Inappropriate monitoring. To ensure good monitoring outcomes: Regularly should review whether satisfactory progression is made or not according to the therapeutic plan. To determine whether original plan should continue or any treatment modifications to be made or not. Reviews ongoing progress and provides report to patient’s other healthcare providers. Should regularly update patient’s medical/pharmacy records with information concerning patient’s progress. 7) PHARMACEUTICAL CARE IN HOSPITALS: Prescription monitoring. Prescribing advice to medical and nursing staff. Medication errors and adverse reaction monitoring. Medication history interview. Patient education and counseling. Pharmacokinetics and therapeutic drug monitoring. Hospital formulary.
PHARMD GURU Page 4 8) PHARMACEUTICAL CARE FOR THE COMMUNITY: Participate in health screening. Participate in health promotion and education. Serve as a source of drug and poison information. Collaborate with other health care professionals to develop treatment guidelines. Design and monitor procurement and drug distribution system including storage and disposal. 9) BARRIERS TO PHARMACEUTICAL CARE: Pharmacist barrier. Practice setting constraints. System impediments. Intra professional barrier.