HOSPITAL PHARMACY

Lab Exercise No. 12

CLINICAL PHARMACY PRACTICE
The American College of Clinical Pharmacy (ACCP) in 2006 defined the primary difference between clinical pharmacists and general
registered pharmacists by clinical pharmacists’ ability to interact with patients and the fact that
they can recommend specific drugs and patient specific drug dosages to improve patient well-being (Hepler, 2004).

From clinical pharmacy, the term pharmaceutical care was born. The two concepts are compatible and seem to have similar goals.
One way to distinguish between the two can be to describe clinical pharmacy as a practice of pharmacy within a
larger pharmaceutical-care system, where the pharmacist will contribute. The goal is to achieve pharmacotherapeutic
and quality-of-life patient outcomes (Murphy et al., 2006).

Pharmaceutical care can be defined as “the direct, responsible provision of medication-related care for achieving definite outcomes,
which improve a patient’s quality of life” (American Society of Hospital Pharmacists, 1992).
Thus, pharmaceutical care can be considered as a form of clinical pharmacy.

I. Objectives:

1. To provide knowledge and an appreciation with the basic concepts of Clinical Pharmacy practice and service.
2. To know the roles of Clinical Pharmacists.

II. Procedures:
1. Illustrate and discuss the Pharmaceutical Care Process
The Pharmacist's Patient Care Process endorsed by the Joint Commission for Pharmacy Practitioners (2014)

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Lab Exercise No. 12

- The pharmaceutical care process involves systematical and consistent actions that will provide optimal patient care
to improve the quality of life. There are t essential steps in this process: (1) collecting subjective and objective
information about the patient, it is important to know everything about the medical history or the patient and other
information that may be helpful in prescribing and administration of drugs, (2) assessing the collected data to identify
problems, determine the adequacy of current treatments and set priorities, (3) create an individualized care plan
that is evidence-based and cost-effective, not only that a drug should be safe and effective but also it should not
have an expensive price since we want our patient to adhere to the treatment plan, (4) implement the care plan,
and lastly (5) monitor the patient over time during follow-up encounters to evaluate the effectiveness of the plan
and modify it as needed.

2. Discuss the desired outcomes of Pharmaceutical Care.

- According to the ASHP statement on pharmaceutical care, the main goal of pharmaceutical care is to improve the
patient’s quality of life through medication therapies. There are four desired outcome of pharmaceutical care: (1)
cure of a patient’s disease, with the use of a certain treatment plan and safe and effective medication, pharmacists
are able to cure a patient’s disease, (2) elimination or reduction of a patient’s symptomatology, what we want is to
reduce the signs and symptoms experienced by the patient in order to improve their quality of life and reduce
discomfort, (3) arresting or slowing of a disease process, slowing a disease process will alleviate the signs and
symptoms of the patient and then reducing the discomfort and pain felt by the patient, and lastly (4) prevention of
a disease or symptomatology, it is best to prevent a disease before it can even reduce the quality of life of the
patient,

III. Questions:
1. Differentiate Clinical Pharmacy from other fields of practice of pharmacy:
- Clinical pharmacy is the practice of pharmacy that exists in multiple settings. They can work in hospitals, nursing
homes, and other medical centers like hospital pharmacists. Their aim to provide and ensure optimal use of
medications for the best outcomes through provision of drug information and monitoring for drug safety and
efficacy. They are well known for their mastery of drug interactions to prevent adverse reactions of different
medications.
a. Community Pharmacy
o Community pharmacy, also known as a retail pharmacy, is the most popular type of pharmacy that provides
medication and health advice to the general public. It is the healthcare facility that is responsible for
providing pharmaceutical services to a certain community group or region and is traditionally known as a
chemist. Most community pharmacies have a commercial store with a mix of prescription-only medicines
and those that can be bought over-the-counter.
b. Hospital Pharmacy
o Hospital pharmacy is a specialized field of pharmacy wherein pharmacists are into patient care inside a
medical institution. Such institutions include a hospital, outpatient clinic, poison control center, etc.
Hospital pharmacists are responsible for choosing, preparing, storing, compounding, and dispensing
medications directly to the patient or delivering the medication to other medical staffs such as nurses. They
can provide patient counseling for safe and effective use of medication
c. Industrial Pharmacy
o Industrial pharmacy deals with the pharmaceutical industry. Industrial pharmacists are responsible for
researching, production, packaging, quality control and assurance, marketing and sales of pharmaceutical
goods. They advocate for the use of the product and to inform practitioners about the actions and benefits
of the drug itself.
d. Pharmaceutical Research
o With this field of pharmacy, it involves research and development as well as drug discovery. Research
pharmacists work on developing new drugs; they research for actions, effectiveness, side-effects and other
drug interactions.
e. Pharmaceutical Education
o Pharmaceutica education involves works in the academe. They are responsible for molding new
pharmacists that are highly competitive and can ensure safe and effective drug use.
f. Regulatory Pharmacy

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Lab Exercise No. 12

o Regulatory pharmacy is also known as government pharmacy, they are responsible for creating different
rules and policies as well as regulations for the safe and effective use of medicines as well as to promote
positive health outcomes. Regulatory pharmacists work in government agencies such the DOH and FDA.

2. Enumerate and discuss the Competencies required for a Clinical Pharmacist.

- According ACCP there are six domains that clinical pharmacists should be experts at: (1) direct patient care, clinical
pharmacists should be able to maintain a good relationship with their patient and to be able to communicate to the
patient everything about their medication, (2) pharmacotherapy knowledge, it is important that all clinical
pharmacists are knowledgeable when it comes to how a drug works in order to prescribe and administer the right
drug to the patient, (3) systems-based care and population health, the clinical pharmacist should be knowledgeable
and are able to fully understand the whole population, (4) communication, they should be able to communicate with
not only the patients but also with the other medical staffs, (5) professionalism, they should be able to keep things
professional and make sure that they have a good relationship with their coworkers, and lastly (6) continuing
professional development, clinical pharmacists should be able to continue learning since new drugs are always being
discovered.

3. Enumerate and discuss the barriers and limitations in the implementation of Clinical Pharmacy Service
- According to research done in Brazil, several challenges are faced by clinical pharmacists to provide different
services. With regards to local healthcare network, some find it a barrier that there are lots of shortage of devices
and drugs as well as lack of adequate physical structure in health units. Some also pointed out the unfavorable
political, administrative and economic environment. For the healthcare team, not all medical staffs are
knowledgeable with all the medical departments in the hospital wherein there could be a problem, and work ethics
as well. They also find insufficient education and training can be a limitation in providing clinical pharmacy services.
Also, there is difficulty in recruitment since there are only few pharmacists. Lastly, the lack of understanding with
regards to all the services provided by clinical pharmacists can also be a barrier.

4. In the Philippines, cite the different organizations implementing Clinical Pharmacy Practice and discuss the services they
provide to the patients.
- I could not find any specific organizations implementing clinical pharmacy practice but there are some organizations
for pharmacists which are the PPhA or the Philippine Pharmacists Association, their vision is to provide medication
expertise. They also aim to make Filipino pharmacists globally competitive in providing quality health care. They
make sure to place the well being of the patient at the center of professional practice and to promote the welfare
of each individual.
- Clinical pharmacists provide direct patient care in different medical institutions. They provide patient counseling for
those who wish to learn more about the medication they have to take. Some of their responsibilities are to procure,
select, choose, dispense, compound, and administer some medication for the patient.

References:
Araujo, G. et al. 2018. Perceived barrier to the implementation of clinical pharmacy services in a metropolis in Northeast Brazin.
Accessed from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206115
Haines, S. Kliethermes, M. & Sorensen, T. The Patient Care Process. Accessed from:
https://accesspharmacy.mhmedical.com/content.aspx?bookid=1861&sectionid=174720532#1148276438
Sasee, JJ. Et al. 2017. ACCP Clinical Pharmacist Competencies. Accessed from:
https://pubmed.ncbi.nlm.nih.gov/28464300/#:~:text=This%20paper%20is%20an%20update,professionalism%2C%20and%2
0continuing%20professional%20development.
Smith, Y. 2019. Community Pharmacy. Accessed from: https://www.news-medical.net/health/Community-Pharmacy.aspx
Smith, Y. 2019. Hospital Pharmacy. Accessed from: https://www.news-medical.net/health/Hospital-Pharmacy.aspx
Smith, Y. 2019. Types of Pharmacy. Accessed from: https://www.news-medical.net/health/Types-of-Pharmacy.aspx
PPhA. Accessed from: https://philippinepharmacists.org/about-us

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