Lecture 7 - Advanced Practise Roles for Pharmacists in Neurology

Question 1

Describe the evolution of the pharmacy practice

Answer 1

Chemists -> Compounding -> Distribution (pharmaceutical elegance - communication with patients) -> Evidence-based medicine -> Pharmaceutical care (tailoring of a drug product to a patients needs)

Question 2

Describe the evolution of pharmacy towards patient-oriented care

Answer 2

Evolution of the pharmacy practice has lead to the breakdown of traditional barriers in patient care. The patient equals the hallmark of pharmaceutical care with the drug used as a secondary vehicle to achieve the desired patient outcomes

Question 3

What does the undergraduate program recognize and teach?

Answer 3

Pharmacists are the only health professionals whose education is entirely devoted to medications and their use. Students are taught more about therapeutics than any other health profession. They apply extensive knowledge of diseases to selection of optimal treatment. Students need: more basic assessment skills, access to student records and an enhanced understanding of diagnostic testing

Question 4

What does the success of an interprofessional team require?

Answer 4

Focus on the team rather than on rank or power
Individual contributions amongst disciplines not be summated
Flexible schedule
Earlier integration of health disciplines during experiential placements that will facilitate the ability of the team to think as one unified body
Varying degrees of cross training to facilitate role reversal
Understanding the specialized functions of other disciplines

Question 5

What primary care services does a pharmacist offer?

Answer 5

Frontline person for vaccines, new prescriptions, assessments, smoking cessation, diabetic intervention, pain assessment

Question 6

What do these new professional designations/certifications for pharmacists mean?

Answer 6

Pharmaceutical care. Extended practice pharmacists, medical clinical assistants, vaccinations certifications, continued care, prescribing of medications, patient assessments

Question 7

What are the steps required to break new ground? (ex. become a MS medical clinical assistant)

Answer 7

Step 1: Support
Step 2: Application process
Step 3: Training requirements
Step 4: Roles and responsibilites
Step 5: Liability coverage
Step 6: Approval and Official listing on MPHA College and Part 2 of the College of Physicians and Surgeons
Step 7: Sponsorship - Registration Fees and Licensure
Step 8: Creating New Law

Question 8

What type of support is required (step 1)?

Answer 8

From the dean of pharmacy/medicine, registrar of MPHA, neurology/anesthesia/rehab medicine departments, MS medical practitioners, colleagues, inter-professional MS team,

Question 9

What is involved in the application process?

Answer 9

A formal examination

Writing a detailed job description (document what you actually do and sell yourself)

Question 10

What types of training requirements are necessary?

Answer 10

Doctoral level training, valid license with MPHA, criminal record check, child/adult abuse registry check, specified practice sight, first aid and advanced CPR, one-to-one physician mentorship with >1500 patients, pass 4 competency levels

Question 11

What is the first competency level?

Answer 11

The CA will assist and preform his or her own duties will working with supervising physcian

Question 12

What is the second competency level?

Answer 12

The CA will preform their duties while under the active supervision of the supervising physcian

Question 13

What is the third competency level?

Answer 13

The CA will be able to preform their duties in an efficient, safe and competent manner with a greater degree of decreased supervision. There will be less need for direct supervision

Question 14

What is the fourth competency level?

Answer 14

As for level 3, the CA will be able to preform their duties with minimal supervision

Question 15

What types of roles and responsibilities need to be recorded?

Answer 15

Attending daily patient rounds, independant patient history, physical exams, formally document all findings, dictations, independent prescribing (except narcotics), patient management/initiating referrals

Question 16

What does liability coverage mean?

Answer 16

Coverage through the Manitoba Society of Pharmacists (MSP)

Question 17

What type of sponsorship is required?

Answer 17

Faculty of medicine, faculty of pharmacy, MPHA, MSP, the Canadian Foundation of Pharmacy, College of Physician and Surgeons

Question 18

Does every patient require inter-professional practise teams?

Answer 18

No, however, chronic diseases that involve multiple problems such as asthma, geriatrics, epilepsy, MS, parkinsons, alzheimers, chronic pain, oncology, HIV and palliative care are examples where inter-professional care is essential

Question 19

What are the potential benefits of pharmaceutical advancements?

Answer 19

Reduces fragmentation, optimize medications, reduction of medication errors, improved access to medications and health services, decreases costs of inappropriate drug use, reduction of visits to physician allowing acutely ill patients more time with their MDs, patients are involved in their own health care decisions

Question 20

What are the pros to implementing advanced pharmacy practice?

Answer 20

Patient power of choice, full utilization of knowledge and skills, periodic reviews and government involvement, patient contact vs. dispensing, combination of education and competence

Question 21

What are the cons to implementing advanced pharmacy practice?

Answer 21

Not all pharmacists should or may want to prescribe, Other disciplines cooperation, increased liability, increased responsibility, increased patient access, billing, legislation

Question 22

What facts need to be considered when embracing change?

Answer 22

Health Care is a dynamic environment that calls for constant learning and change. A shift to evidence based health care require new skills. Changes are needed in the relationship between providers and patients as patients take a more proactive role in their health and health care. Changes in how health care services are delivered have a direct impact on the mix of skills expected of health care providers. New role models are needed to reflect the different ways of delivering health care service. Canadians expect more emphasis on health promotion, wellness and disease prevention as an essential part of their health care system