Tiêu đề 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.