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    Pedoman Ibu Hamil

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    The document outlines the key components of pharmaceutical care practice including: 1) Risk management to ensure patient safety, 2) Patient advocacy by serving as an advocate for patient needs, and 3) Disease management such as providing education to help patients manage their conditions. It also describes the differences between traditional dispensing-focused pharmacies and pharmaceutical care, which focuses on patient-centered services and outcomes over product sales. Finally, it discusses the importance of care planning, problem identification, goal setting, and follow-up evaluation in the pharmaceutical care process.

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    Pedoman Ibu Hamil

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    49 views20 pages
    The document outlines the key components of pharmaceutical care practice including: 1) Risk management to ensure patient safety, 2) Patient advocacy by serving as an advocate for patient needs, and 3) Disease management such as providing education to help patients manage their conditions. It also describes the differences between traditional dispensing-focused pharmacies and pharmaceutical care, which focuses on patient-centered services and outcomes over product sales. Finally, it discusses the importance of care planning, problem identification, goal setting, and follow-up evaluation in the pharmaceutical care process.

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    The document outlines the key components of pharmaceutical care practice including: 1) Risk management to ensure patient safety, 2) Patient advocacy by serving as an advocate for patient needs, and 3) Disease management such as providing education to help patients manage their conditions. It also describes the differences between traditional dispensing-focused pharmacies and pharmaceutical care, which focuses on patient-centered services and outcomes over product sales. Finally, it discusses the importance of care planning, problem identification, goal setting, and follow-up evaluation in the pharmaceutical care process.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    49 views20 pages

    Pedoman Ibu Hamil

    Uploaded by

    and
    The document outlines the key components of pharmaceutical care practice including: 1) Risk management to ensure patient safety, 2) Patient advocacy by serving as an advocate for patient needs, and 3) Disease management such as providing education to help patients manage their conditions. It also describes the differences between traditional dispensing-focused pharmacies and pharmaceutical care, which focuses on patient-centered services and outcomes over product sales. Finally, it discusses the importance of care planning, problem identification, goal setting, and follow-up evaluation in the pharmaceutical care process.

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    of 20

    Drug Therapy Cycle

    ​Patient’ Complaint
    ↓ ↑
    ​Diagnosis ​ ​Undesired
    Desired
    ↓ ↑ ↑
    Modes of therapy​​ ​Clinical
    Response
    ↓ ↑
    Drug Therapy​​ Drug Usage
    ↓ ↑
    Prescription → ​Dispensing

    Rational Drug Therapy

    ​Patient (Conditions)
    ↕ ↕
    ​Disease ​ ↔ ​Drug

    ​Pharmaceutical care process 


    Pharmaceutical process 
     
    PHARMACEUTICAL CARE PRACTICE
    DOMAIN
    (Dresselle, S.P., 2005, Pharmaceutical Care as a Management Movement, in
    Pharmacy Management​, Dresselle, S.P. and Zgarrick, D.P. Eds., pp 3-18,
    McGraw-Hill, New York)

    I. Risk Management
    a. Devise system of data collection
    b. Perform prospective drug utilization
    review
    c. Document therapeutic interventions and
    activities
    d. Obtain over-the-counter medication
    history
    e. Calculate dosages for drugs with a narrow
    therapeutic index
    f. Report adverse drug events to regulatory
    agent
    g. Triage patients’ needs for proper referral
    h. Remain abreast of newly uncovered
    adverse effects and ​drug-drug interactions
    II. Patient Advocacy
    a. Serve as patient advocate with respect to
    social, economic, and psychological
    barriers to drug therapy
    b. Attempting to change patients’
    medication orders when barriers to
    compliance exist
    c. Counsel patients on new and refill
    medications as necessary
    d. Promote patient wellness
    e. Maintain caring, friendly relationship
    with patients
    f. Telephone patients to obtain medication
    orders called in and not picked up

    III. Disease Management


    a. Provide information to patients on how to
    manage their disease state/condition
    b. Monitor patients’ progress resulting from
    pharmacotherapy
    c. Carry inventory of products necessary for
    patients to execute a therapeutic plan (e.g.,
    inhaler, nebulizers, glucose monitors, etc.)
    d. Supply patients with information on support
    and educational groups (e.g., Diabetes
    association, Multiple Sclerosis Society)

    IV. Pharmaceutical Care services


    marketing
    a. Meet prominent prescribers in the local area of
    practice
    b. Be an active member of professional associations
    that support the concept of pharmaceutical care
    c. Make available an area for private consultation
    services for patients as necessary
    d. Identify software that facilitate pharmacist’
    patient care-related activities

    V. Business Management
    a. Utilize technicians and other staff to free up the
    pharmacist’s time
    b. Ensure adequate workflow for efficiency in
    operations

    Differences between Dispensing Products and


    Providing Pharmaceutical Care

    Dispensing Pharmacy Pharmaceutical Care


    (New Paradigm)
    (Old Paradigm)

    Product business Service (people) business

    Objective is to bring Objective is to bring the


    product to the customer pharmacist to the patient
    Decisions focus on the Decisions focus on the
    business patient
    Inventory generates
    revenue
    Available service Patient care generates
    supports the product revenue
    Available product
    Success measured as supports the service
    number of prescriptions
    Success is measured as
    patient outcomes

    Space is organized to
    display and sell
    products Space is organized to meet
    patient’s needs
    Records are kept
    primarily to meet legal Documentation supports
    requirements patient care
    concerning the drug
    product

    Schedule for follow-up


    Schedule for refill determined by risk and
    benefit of drug therapies
    determined by
    and needs of the patient
    customer supply of
    drug product Business is actively sought
    through the recruitment of
    Business is passively patients
    sought through the
    generation of
    prescriptions

    Reference

    Cipolle, R.J., Strand, L.M., Morley, P.C., 1998, ​Pharmaceutical Care


    Practice,​ McGraw-Hill, New York

    TO BE SUCCEDED IN PHARMACEUTICAL CARE


    PRACTICE

    Pharmaceutical care requires:


    1. an expert knowledge of therapeutics,
    2. a good understanding of disease processes,
    3. knowledge of drug products,
    4. strong communication skills,
    5. drug monitoring, drug information, and
    therapeutic planning skills,
    6. The ability to assess and interpret physical
    assessment findings.

    ▪ DRUG THERAPY PROBLEMS, NOT


    MEDICAL PROBLEMS

    Medical problems are disease states; that is,


    problems related to altered physiology that result
    in clinical evidence of damage.
    Drug therapy problems are patient problems that
    are either caused by a drug or may be treated with
    a drug.

    ▪ FIVE STEPS IN THE PHARMACEUTICAL


    CARE PROCESS​​:

    1. A professional relationship with the patient


    must be established.
    2. Patient-specific medical information must be
    collected, organized, recorded, and maintained.
    3. Patient-specific medical information must be
    evaluated and a drug therapy plan developed
    mutually with the patient.
    4. The pharmacist must ensure that the patient has
    all supplies, information, and knowledge
    necessary to carry out the drug therapy plan.
    5. The pharmacist must review, monitor, and
    modify the therapeutic plan as necessary and
    appropriate, in concert with the patient and
    health care team.

    Care planning for patient involves establishing


    therapeutic goals and determining appropriate
    interventions to:

    1. Resolve all existing drug-therapy problems,


    2. Achieve the goals of therapy intended for each
    active medical problem,
    3. Prevent future drug-therapy problems that
    have a potential to develop.

    The steps involved in solving drug-related problems​​:


    1. Identification of real or potential drug-related
    problems.
    2. Determination of the desired therapeutic
    outcome.
    3. Determination of therapeutic alternatives.
    4. Design of an optimal individualized drug
    therapy plan.
    5. Identification of parameters to evaluate the
    outcome.
    6. Provision of patient counseling.
    7. Communication and implementation of the
    drug therapy plan.

    The elements of a care plan​​:


    a. Medical condition​​: list the disease state for which
    the patient has drug-related needs.

    b.Drug-therapy problems​​: state the drug-therapy


    problems by including the patient’s problem or
    condition, the drug therapy involved, and the
    association between the drug(s) and the patient’s
    condition(s).

    c. Goals of therapy​​: state the goals of therapy. Goals


    should be realistic, measurable and/or observable,
    specific, and associated with a definite time frame.

    d.Interventions​​: in collaboration with the patient,


    the practitioner develops and prioritizes a list of
    activities to address the patient’s drug-related
    needs.

    e. Follow-up plan​​: Determine when the patient


    should return for follow-up and what will occur at
    that subsequent visit.

    Follow-up Evaluation

    The purpose of a follow-up evaluation is ​to evaluate


    the positive and negative impact of the care plan on
    the patient​​, to ​uncover new drug-therapy problems​​,
    and to ​take appropriate action to address new
    problems​​ or adjust previous therapies as needed.

    The evaluation involves comparing goals of therapy


    with the patient’s current status.

    Cipolle et al.​​ developed terminology to describe the


    patient’s status, the medical conditions, and the
    comparative evaluation of that status with the
    previously determined therapeutic goals

    Status Definition

    Resolved Goals achieved, therapy


    completed
    Stable Goals achieved, continue
    same therapy
    Improved Progress being made,
    continue same therapy
    Partial Progress being made, minor
    improvement adjustment required
    Unimproved No progress yet, but
    continue same therapy
    Worsened Decline in health, adjust new
    therapy
    Failure Goals not achieved, initiate
    new therapy
    Expired Patient died while receiving
    drug therapy

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