The Pharmacists approach to the Patient

1
The Pharmacists approach to the Patient
European Association of Faculties of Pharmacy
Conference, Lille, June 2008
Steve Hudson Professor of Pharmaceutical
Care University of Strathclyde, Glasgow, UK
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Pharmaceutical Science
Pharmaceutical Science (PS) is the application of
knowledge of the properties and actions of drugs
in the development and testing of medicines The
ultimate goal of the pharmaceutical sciences is
to provide medicines that are quality-assured in
terms of relative safety and effectiveness PS
gives pharmacists the tools of the profession and
the scientific understanding needed to optimise
the use of medicines
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Clinical Pharmacy and Pharmaceutical Care

• Clinical Pharmacy (CP) is the discipline
  concerned with the use of medicines in patients.
• The application of Pharmaceutical Science in
  order to solve drug therapy problems in
  individual patients.
• Pharmaceutical Care (PC) is the integration
  of Clinical Pharmacy knowledge, skills and
  attitudes into a system of multidisciplinary care
  which aims to provide quality assurance of
  medicines in use
• PC is recognised as the mission of the profession
  of pharmacy worldwide

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Pharmaceutical Care

• is the way
• Pharmacy uses a science base
• in clinical problem solving
• and targets patients needs
• by a systematic service
• and a duty of care

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The pharmaceutical care process is the quality
assurance of pharmacotherapy

• Pharmacotherapy in the Real World Setting
• Co-morbidity
• Polypharmacy
• Incomplete information
• Clinical uncertainty
• Decision-making in the absence of a full
  understanding
• Patients responses may be unpredictable
• Evidence base for medicine or combination
• within a treatment plan may be lacking

Clinical Trial (n1)
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The pharmaceutical care process is the quality
assurance of pharmacotherapy
As the Clinical Trial Proceeds Pharmaceutical
Care is about a monitoring and inquiry strategy
to VALIDATE the treatment plan
Pharmaceutical Care Plan Care Issues Checks or
Changes
Changes may lead to patient being treated
outside a Normal Protocol
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PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
Expectations defined by Clinical Standards
Design
Review
Modify
Evaluate
Adjust
Deliver
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PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
1
Deliver
Conventional Pharmaceutical Checks
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PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
1
Deliver
Conventional Pharmaceutical Checks
2
Treatment Monitored
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PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
1
Treatment Plan Confirmed
3
Conventional Pharmaceutical Checks
2
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PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
Expectations defined by Clinical Standards
Treatment Plan Verified
Design
Review
Modify
Evaluate
Treatment Plan Confirmed
Adjust
Deliver
Treatment Monitored
12
PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
Expectations defined by Clinical Standards
Treatment Plan Verified
Design
Review
1
Modify
Evaluate
Treatment Plan Confirmed
Adjust
Conventional Pharmaceutical Changes
Deliver
Treatment Monitored
13
PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
Expectations defined by Clinical Standards
Treatment Plan Verified
Design
Review
1
Modify
2
Evaluate
Treatment Plan Confirmed
Adjust
Conventional Pharmaceutical Changes
Deliver
Treatment Monitored
14
PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
Expectations defined by Clinical Standards
Treatment Plan Verified
Design
Review
1
Modify
2
Evaluate
Treatment Plan Confirmed
Adjust
3
Conventional Pharmaceutical Changes
Deliver
Treatment Monitored
15
PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
Expectations defined by Clinical Standards
Treatment Plan Verified
Design
Review
1
Modify
2
Evaluate
Treatment Plan Confirmed
Adjust
4
3
Conventional Pharmaceutical Changes
Deliver
Treatment Monitored
16
PHARMACEUTICAL CARE The Quality Assurance Model
of Medication Use
Expectations defined by Clinical Standards
Treatment Plan Verified
Design
Review
1
5
Modify
2
Evaluate
Treatment Plan Confirmed
Adjust
4
3
Conventional Pharmaceutical Changes
Deliver
Treatment Monitored
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The pharmacists approach includes handling
patient data and drug data
Clinical Cues Signs, Symptoms, Laboratory
Markers, Patient Interview
Changes
Checks
Care Issues Potential or Actual Drug Therapy
Problems
Pharmaceutical Care Plan Potential or Actual
Drug Therapy Problems
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The Pharmacists approach to the Patient
European Association of Faculties of Pharmacy
Conference, Lille, June 2008
Steve Hudson Professor of Pharmaceutical
Care University of Strathclyde, Glasgow, UK