Introduction to clinical pharmacy

Question 1

What is the evolution of clinical pharmacy

Answer 1

product-orientated role → patient-orientated role

Question 2

How was clinical pharmacy evolved (2)

Answer 2

1. Publication of influential reports in the mid-late 1980s furthered the development of clinical pharmacy services
2. “the achievement of better patient care and financial savings through the more cost-effective use of medicines and improved use of pharmaceutical services obtained by implementing a clinical pharmacy service”

Question 3

What is pharmaceutical care (4)

Answer 3

1. “the responsible provision of drug therapy for the purpose of achieving definite outcomes which improve the patient’s quality of life”
2. “a practice in which the practitioner takes the responsibility for a patient’s drug-related needs and is held accountable for this commitment”
3. “a co-operative patient-centred system for achieving specific and positive patient outcomes from the responsible provision of medicines.
4. The provision of clinical pharmacy services is an essential component in the delivery of pharmaceutical care”

Question 4

What are the steps followed each time a patient requires treatment that defines pharmaceutical care (7)

Answer 4

1. Establishing the need for the drug therapy
2. Selecting the most appropriate medicines
3. Administering the medicines appropriately
4. Supplying the medicine
5. Monitoring of therapy
6. Patient education
7. Evaluating efficacy

Question 5

What are examples of clinical pharmacy practice (11)

Answer 5

1. Medicines reconciliation
2. Prescription monitoring
3. Prescribing advice
4. Patient counselling
5. Discharge planning
6. Efficacy and safety monitoring
7. Therapeutic drug monitoring
8. Medication errors and ADRs
9. Formulary and protocol development
10. Training and education
11. Auditing and service development

Question 6

What are the principles to a patient-centred approach & medicines optimisation (4)

Answer 6

1. Aim to understand te patient’s experience
2. Evidence-based choice of medicines
3. Make medicines optimisation part of routine practice
4. Ensure medicines use is as safe as possible

Question 7

What is the future of clinical pharmacy (4)

Answer 7

1. Significant variation in the number of prescribing pharmacists and in total pharmacy and medicines expenditure across trusts
2. “the NHS needs to focus the pharmacy workforce to drive optimal value and outcomes from the £6.7bn it spends on medicines”
3. Need for ‘Hospital Pharmacy Transformation Programme’
4. 80% of pharmacist resources should be directed at medicine optimisation

Question 8

What is a clinical pharmacy in the community (5)

Answer 8

1. Clinical pharmacy is no longer the preserve of hospital pharmacists
2. Increasing roles for pharmacists in the community, specifically in general practice
3. Resolving problems with medicines in a similar fashion to hospital pharmacists
4. Prescribing
5. Auditing and quality improvement