10 - Evolution to Pharmaceutical Care

Question 1

Describe shifting emphases/roles of pharmacy practice in the U.S.

Answer 1

Apothecary
00-60’s preparing/selling meds

Clinical Pharmacy
60’s-90s = transitional period –> patient oriented
70’s - 80’s = embraced clinical pharmacy movment

Pharmaceutical CARE
late 80’s –> became a ‘True’ clinical profession

Question 2

Define clinical pharmacy

Answer 2

used to distinguish functions that were primarily

• *Informative & Advisory**
• from the more standardized / distributive fxns of drug-use control*

Question 3

Define and conceptualize pharmaceutical care

the determination of drug needs for a given individual and
the provision not only of the drug required
but the necessary services to assure
optimally safe & effective therapy

Bordie / Parish / Poston 1980’s

Answer 3

VVVVVV
practice that involves a covenantal relationship
between a patient & a pharmacist where the
Pharmacist performs drug use contron functions

Helper 1987

Question 4

Compare pharmaceutical care with pharmacy services

Answer 4

Pharmacy SERVICES
Functions + Activities, focus on drug & it’s delivery to abstract
biological systems rather than individual patients
Histories / PK dosing / Therapeutic monitoring / DI
Rounds / IV services / Distribution

Pharmaceutical CARE
in ADDITION to services –>
include interdisciplinary collab / QOL considerations
OUTCOME-ORIENTATED PERSPECTIVE / ethics / competence
RESPONSIBILITY & accountability

Question 5

Describe value in patient outcomes

Answer 5

under Pharmaceutical Care & is Multidisciplinary:
To achieve VALUE in patient outcomes:
E-C-H-O
Ecomomic / Clinical / Humanistic outcomes
& to..
MINIMIZE & PREVENT
drug-related problems

Question 6

Clinical Pharmacists

Answer 6

Participants in the DRUG THERAPY Decisions
drug experts / specialist

1960’s - 1980s
growing # of pharmacists with PharmD / Residency
start to practice clinical pharmacy in hospitals

Question 7

Transition from
Clinical Pharmacy –> Pharmaceutical Care

Late 1980’s

Need to define the societal purpose of pharmacy
to become a TRUE Clinical Profession

Answer 7

Fundamental purpose was to serve society by being responsible for
safe & appropriate use of drugs
to PREVENT drug-related morbidity / mortality

Free pharmacist time (automation + technicians)
&
Propel ClinicalPharmacy –> PHARMACEUTICAL CARE

Question 8

• *PHARMACEUTICAL CARE**
• *Helper & Strand = 1990**

KNOW THIS ONE

Answer 8

Responsible provision of DRUG THERAPY to achieve
DEFINITE OUTCOMES
( cure of disease / elimination +reduction of symptoms / slow down disease / preventing disease)
that IMPROVE a Patient’s QUALITY OF LIFE

Process through which pharmacists cooperates with others in identifying potential & actual drug-related problems, resolving actual drug-related problems, and preventing potential problems

Question 9

Fxn / Skills for Pharm Care

Answer 9

Identifying therapeutic objectives, designing therapeutic plan, implementing the plan, and monitoring its progress

Information:
gathering, analysis, consultation with other care givers,
informed decision-making, and effective communication

Question 10

ECHO Model

Answer 10

Economic Outcomes
impact of intervention on costs

Clinical Outcomes
measurable changes in health status from treatment
onjective measures of clinically meaningful outcomes

Humanistic Outcomes
impact of disease / treatment on Quality of Life
patient satisfaction

Question 11

Define:

An event or circumstance involving a patient’s drug treatment
that actually, or potentially interferes with the
achievement of an optimal outcome.

Answer 11

DRUG RELATED PROBLEMS

Question 12

Mission of Pharmacist

Answer 12

To help people make the best use of their medications
stated in terms of the
individual pharmacists –> individual patient

best way to fulfill this mission was to PRACTICE
PHARMACEUTICAL CARE