Clinical Pharmacy PHR 405: Chapter 1: General Considerations
Clinical Pharmacy PHR 405: Chapter 1: General Considerations
Clinical Pharmacy PHR 405: Chapter 1: General Considerations
PHR 405
Chapter 1: General considerations
Course Instructor:
Md. Samiul Alam Rajib
Senior Lecturer
Department of Pharmacy
BRAC University
Activities of Clinical
Pharmacists
Consulting:
Analysing
therapies,
advising
health
care
Drug
information:
Seeking
information
and
critically
products
and
devices
according
to
acceptable
Drug
use
studies
and
research:
Drug
use
studies/
and
outcome
studies
to
determine
cost-
effectiveness evaluations.
Dispensation & Administration: Dispensing and
administration of medicinal products and devices:
studying and developing systems for the dispensing
and administration of medicinal products and devices
that can guarantee a higher security in administration,
Clinical trials
Clinical pharmacists are also actively involved in clinical trials at
different levels: participating in ethical committees; study monitoring;
dispensation and preparation of investigational drugs
Formularies
Drug information
The focus of
attention is Drug
Clinical pharmacy
is more oriented to
the analysis of
population needs
with regards to
medicines, ways of
administration,
patterns of use and
drugs effects on the
patients
The focus of
attention is patient
or population
Pharmaceutical
care
Medication-related
problems
Untreated indication
Treatment without indication
Improper drug selection
Too little drug
Too much drug
Non-compliance
Adverse drug reaction
Drug interaction
Medication-related
problems
Clinical guidance on medicines adherence
Medication
reconciliation
Lets watch a movie and make
some ideas about Medication
reconciliation
Medication reconciliation
Medication reconciliation has been defined as:
Collecting information on medication history
using the most recent and accurate sources
of information to create a full, and current,
list of medicines.
Verifying this list against the hospital drug
chart and ensuring that any discrepancies
are identified and acted upon;
Documenting and communicating any
changes, omissions or discrepancies.
This process requires the name of medicines,
dosage, frequency and route of
administration to be established for all
medicines taken prior to admission.
The information collected as part of
medicines reconciliation is a pre-requisite
Assessm
ent
Care
plan
Evaluati
on
Purpose
Consultation process
Descriptions of
pharmaceutical consultation
have been confined largely to the use of
mnemonics such as WWHAM, AS METTHOD and
ENCORE.
These approaches provide the pharmacist with a
rigid structure to use when questioning patients
about their symptoms but, although useful, serve
to make the symptom or disease the focus of the
consultation rather than the patient.
Research into patients' perceptions of their
illness and treatment has demonstrated that they
are more likely to adhere to their medication
regimen, and be more satisfied with the
consultation, if their views about illness and
treatment have been taken into account and the
ENCORE
Evaluate the symptom, its onset, recurrence
and duration.
No medication is always an option.
Care when dealing with specific patient
groups, notably the elderly, the young, nursing
mothers, pregnant women, those receiving
specific medication such as methotrexate and
anticoagulants, and those with particular
disease, for example, renal impairment.
Observe the patient for signs of systemic
disturbance and ask about presence of fever,
loss of weight and any accompanying
physiological disturbance.
Refer when in doubt.
Explain any course of action recommended.
Home assignment
Please watch Video 5 and Video
6 and determine which
Mnemonic has been used to
for the counseling.
Pharmaceutical
consultation
Undertaking a pharmaceutical consultation can
Undertaking a pharmaceutical consultation can
be considered as
phases,
each
goal
and
set
of
to
draw
upon
range
of
Table 1: Pharmaceutical
consultation
process
Element
Goal
Examples of associated
competencies
Introduction
Building a therapeutic
relationship
Invites patient to discuss
medication or healthrelated issue
Data collection
and
problem
identification
Actions and
solutions
Establishing an
acceptable
management plan with
the patient
Closure
Negotiating safety
netting
strategies with the
patient
Table 3: Consultation
behaviors
Active listening
Appropriate use of open and closed questions
Respect patient
Avoid jargon
Demonstrate empathy
Deal sensitively with potentially embarrassing
or sensitive issues