ASSIGNED BY: RESPECTECD SIR: DR MUDASIR ALI ARAIN
Group Members Names:
ARSLAN AHMER
GULZAR ALI BROHI
NABEELA LATIF
NAVEED AHMED DETHO
SABIT ALI NANGRAJ
What is Clinical Pharmacy? Slide No # 4
Aims of Clinical Pharmacist. Slide No # 6,7 & 8
How do Clinical pharmacist care for Patient? Slide No # 9 & 10
History of Clinical Pharmacy? Slide No # 11
Early Developments Slide No # 12 & 13
Latest Developments Slide No # 14
Latest Development of Analysis in Clinical Pharmacy Slide No # 15 16 & 17
SWOT Analysis Slide No # 18
Strength
Weakness
Opportunities
Threats
Drug Related Problems in Advanced Clinical Pharmacy Slide No # 19, 20, 21 & 22
Rational Medicine Use Slide No # 23, 24 & 25
What are the goals for clinical pharmacy ? Slide No # 26, 27 & 28
What is the evidence of the value of clinical pharmacy? Slide No # 29 & 30
Core and Advanced Clinical Pharmacy. Slide No # 31
It is a system which is
It is a branch of pharmacy concerned with rational therapy
which is concerned with (right and proper selection and
optimum use of medication to use of medicine) used for
cure the patient. patients to ensure patient is
receiving correct therapy.
Assess the status of the patient’s health problems and determine
whether the prescribed medications are optimally meeting the
patient’s needs and goals of care.
Evaluate the appropriateness and effectiveness of the patient’s
medications.
Recognize untreated health problems that could be improved or
resolved with appropriate medication therapy.
Follow the patient’s progress to determine the effects of the patient’s
medications on his or her health.
Consult with the patient’s physicians and other health care providers
in selecting the medication therapy that best meets the patient’s
needs and contributes effectively to the overall therapy goals.
Advise the patient on how to best take his or her medications.
Support the health care team’s efforts to educate the patient on other
important steps to improve or maintain health, such as exercise, diet,
and preventive steps like immunization.
Refer the patient to his or her physician or other health professionals
to address specific health, wellness, or social services concerns as they
arise.
Provide a consistent process of patient care that ensures the
appropriateness, effectiveness, and safety of the patient’s medication
use.
Consult with the patient’s physician(s) and other health care
provider(s) to develop and implement a medication plan that can meet
the overall goals of patient care established by the health care team.
Call on their clinical experience to solve health problems through the
rational use of medications.
Apply specialized knowledge of the scientific and clinical use of
medications, including medication action, dosing, adverse effects, and
drug interactions, in performing their patient care activities in
collaboration with other members of the health care team.
Rely on their professional relationships with patients to tailor their
advice to best meet individual patient needs and desires.
Until the mid-1960s, pharmacists were almost solely
involved in the purchase, manufacture and supply of
medicines. Then in the USA the development of clinical
pharmacy began and a more clinically oriented
pharmacy curriculum was developed with the award of
a Pharm-D degree. This affected the practice of
pharmacy in the UK.
Evidence from studies in the UK began to highlight
problems with medication errors at ward level and
clinical pharmacy began to develop. Firstly,
prescription and drug administration records were
introduced, followed by an increasing pharmacy
presence on hospital wards. Then masters degrees in
clinical pharmacy were introduced, the first in 1976,
supported by a textbook.
Clinical pharmacy can be delivered through activities known
as 'pharmaceutical care' or 'medicines management'. In 1990,
the term 'pharmaceutical care' was defined as 'the
responsible provision of drug therapy for the purpose of
achieving definite outcomes that improve a patient's quality
of life. Although this early definition focused on the use of
medicines, it has been developed in recent years and is now
regarded as including non-medicine-related care.
Pharmacists' roles are changing as a result of changes in the
National Health Services (NHS), people’s lifestyles and
expectations. Until recently, the majority of pharmacists
within the NHS could have been classified as either
community or hospital pharmacists. The former were based
in community pharmacies and tended to work in isolation of
primary health care teams. Their role was one of supply with
little 'clinical' activity. As described above, this situation has
changed in recent years.
Community pharmacists provide a range of clinical services
that may include medication review, health checks (e.g. blood
pressure monitoring) and domiciliary services. Hospital
pharmacists have a longer history of integration into clinical
teams at ward level. Their duties may range from the
patient's admission, in the form of medication history taking,
to discharge, where discharge counselling is provided and
liaison with community services promotes continuity of care.
An event or circumstance involving drug treatment that actually or
potentially interferes with the patient's experiencing an optimum
outcome of medical care.
Drug-related problems include medication errors (involving an error in
the process of prescribing, dispensing, or administering a drug,
whether there are adverse consequences or not) and adverse drug
reactions (any response to a drug which is noxious and unintended,
and which occurs at doses normally used in humans for prophylaxis,
diagnosis or therapy of disease, or for the modification of physiological
function).
Inappropriate prescribing •inappropriate regimen –drug, dosage form, dose,
route, dosage interval, duration
Unnecessary regimen.
Dispensing error Involved
Incorrect or inappropriate labeling
Incorrect or missing patient information or advice
Inappropriate delivery
Drug not available on Pharmacy
Patient cannot afford regimen
Biopharmaceutical barriers
Sociological barriers
Drugs should be prescribed to maximize effectiveness, minimize risks and
costs, and respect patient's wishes. In other words, prescribing should be
rational. Rational prescribing comprises five major components: • A defensible
formulation of the patient's problem
Clarity of therapeutic intention
Access to independent data on drugs
Communication with the patient
Follow-up.
Many strategies exist to promote rational prescribing, which
incorporate some of these major components. There follows a
discussion of some of these strategies.
• Assure optimal drug therapy outcomes
• Effective drug therapy
• Safe drug therapy
• Cost-effective drug therapy
• Assure pharmaceutical care is coordinated and provided
collaboratively with other pharmaceutical care
providers.
• Assure effective relationships with patients that lead to
patient involvement, understanding, adherence
• Assure efficient and patient focused delivery of care
Abundant number of publications documenting the value of clinical
services in inpatient and outpatient settings
Most pharmacists in published studies were full time clinical pharmacists on
interdisciplinary teams (i.e., generalists or specialists) and not pharmacy
generalists in an integrated system (i.e., performing distributive as well as
clinical functions)
Need for research comparing integrated, hybrid and coordinated practice
models.
30
Advanced and Specialized Clinical Pharmacy Services
• Prospective or concurrent treatment planning through consistent participation
on formalized interdisciplinary teams (rounds)
• Comprehensive medication therapy management through P&T approved
protocols for monitoring drug therapy and changing drug therapy (hospital wide
or department/division specific) or collaborative practice agreements
• Clinical specialists (usually PGY1 residency and PGY2 in specialized practice
areas: Critical Care, Oncology, Transplantation, Cardiology, Infectious Diseases)
