PPCP

Question 1

The patient care services pharmacists provide have improved what?

Answer 1

1. adverse
   drug events
2. improve patient safety
3. optimize medication use
4. health outcomes

Question 2

the profession of pharmacy is continuing its evolution from a principal focus on medication product
distribution to…?

Answer 2

expanded clinically-oriented patient care services.

Question 3

Pharmacists contribute to improving patients’ health by providing patient care services as authorized under their scope
of practice and facilitated by?

Answer 3

collaborative practice agreements.

Question 4

Who developed the pharmacist patient care process (PPCP)?

Answer 4

Hepler and Strand in
the 1990s.

Question 5

What is the purpose of the PPCP?

Answer 5

Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to
optimize patient health and medication outcomes.

Question 6

What is an essential first step that supports engagement and effective communication with patients, families, and caregivers throughout the process?

Answer 6

the establishment of
a patient–pharmacist relationship

Question 7

What did the Joint Commission of Pharmacy Practitioners (JCPP) mention in 2014 about pharmacists?

Answer 7

Patients achieve optimal health and medication outcomes with pharmacists as essential and accountable providers within patient-centered, team-based healthcare

Question 8

What needs does the PPCP fulfill in terms of pharmacist service delivery?

Answer 8

1. Consistency (with other pharmacists)
2. Predictability
3. Measurability (to demonstrate our value to the healthcare team)

***PPCP gives pharmacists a tool to be all 3 things

Question 9

What is at the center of PPCP?

Answer 9

Patient (Patient-Centered care)

Question 10

What the is the “who” in collect phase of PPCP?

Answer 10

• Patient
• Caregiver/family member
• Other healthcare provider
• Medical Record
• Dispensing Record
• Medication list

Question 11

What the is the “what” in collect phase of PPCP?

Answer 11

Information related to patient’s:
1. Medical history (health and wellness, test results, physical assessment findings)
2. social history (lifestyle/habits, beliefs/preferences, health goals, socioeconomic status)
3. medication history (Rx and OTC, herbals and supplements)
4. history of present illness (acute illness, medication refill, adherence concern)
5. ***identify Subjective and objective information

Question 12

What the is the “how” in collect phase of PPCP?

Answer 12

1. interview (open-ended questions, active listening)
2. conversation
3. medical records review
4. point of care testing (strep test, blood pressure, etc. don’t ned to wait for lab result)

Question 13

In the access step of PPCP, what are the 2 things that pharmacists’ need to identify and prioritize?

Answer 13

1. health
2. medication related problems: medication use, overall health status (disease states, conditions, social determinants) preventative care

Question 14

What is the pharmacist checking for in “access” medication use?

Answer 14

Medication list (what, how, adherence)
1. What medications does patient take (Rx and OTC)?
2. How does patient take these medications?
3. How often does the patient miss a dose of medications?

Question 15

What is the pharmacist checking for in “access” overall health status?

Answer 15

Disease states, conditions, social determinants
1. health status
2. Risk factors such as strong family history
3. Cultural factors
4. Health literacy
5. Access to care (can they afford medication, does it fall under their insurance?)

Question 16

What is the pharmacist doing for in “access” preventative care?

Answer 16

1. immunizations
2. health and wellness screenings

Question 17

What is the PPCP?

Answer 17

It is a process that promotes a consistent approach to patient care delivery in any pharmacy practice setting

**a critical thinking/clinical reasoning process that can be applied in any patient care setting

Question 18

When was the PPCP approved? And who approved the PPCP?

Answer 18

The PPCP was officially approved by JCPP in May 2014 and was supported by 13 national organizations

*the PPCP was recognized as a KEY DRIVER for ACCOMPLISHING the Vision JCPP set forth for pharmacists

Question 19

In the PPCP, what is the center?

Answer 19

the patient and the focus of the process
Care is individualized

Question 20

How can we best utilize the PPCP process?

Answer 20

1. Collaborate: with providers and family members
2. Communicate (must be clear and effective with all parties with whom we are collaborating – even if we work with the entire health care team as well as the patient and family, we can accomplish very little if we can’t communicate well)
3. Document

Question 21

Assessing medication use in the assess step will lead to identified concerns which are considered medication-related problems (MRPs). What are the medication related problems?

Answer 21

1. Indication: unnecessary medication, need for medication
2. Safety: unwanted side effect or toxicity, drug interaction
3. Efficacy: health goals not met, acut illness not resolved
4. Adherence: not taking as prescribed

Question 22

What are we looking for in the “indication” medication-related problem?

Answer 22

Indication: unnecessary medication, need for medication

• does every medication the patient is taking match up with a disease state or condition.
• If the patient has high BP is the patient taking a BP medication.
• If the patient is taking a medication for GERD, does the patient still have GERD.

Question 23

What are we looking for in the “safety” medication-related problem?

Answer 23

Safety: unwanted side effect or toxicity, drug interaction

• how safely is the medication being used.
• Is the patient experiencing any unwanted side effects or toxicity? Is the patient taking the correct amount of the medication (more than one pill or more than one time per day)?

Question 24

What are we looking for in the “efficacy” medication-related problem?

Answer 24

Efficacy: health goals not met, acute illness not resolved

• how well is the medication working to treat the disease state or symptoms. This could refer to conditions that have acuter resolution (like an antibiotic for a sinus infection) or chronic control (like a blood pressure medication used with heart failure).
• If the medication is not effective, the dose could be increased or a new medication added.

Question 25

What are we looking for in the "adherence" medication-related problem?

Answer 25

Adherence: not taking as prescribed (is the patient taking the medication as it has been prescribed. This may refer to the patient missing doses or skipping doses OR it may refer to the patient taking too many doses.)

Question 26

What type of information is considered when determining medicaton related problems?

Answer 26

Subjective and Objective information (that is why it is so important to gather both types of information) **As you COLLECT information, identify as subjective or objective

Question 27

When developing a plan what should you consider?

Answer 27

evidence and cost **We MUST involve the patient in the plan This is in an effort to ensure we are truly keeping our patient at the center of the process and individualizing the plan. If we come up with the best plan in the world for our patient, it won’t make any difference if he or she cannot execute it.

Question 28

For the Plan step, we need to develop plan for each problem, which includes?

Answer 28

1. Consider evidence and cost 2. Include patient, caregivers, health care providers 3. Individualize

Question 29

Within each plan you want to be sure to include these components:

Answer 29

1. **Address the identified MRPs in order of priority.** We have already discussed the need to prioritize the MRPs when assessing the information. That same prioritization should be carried through in the plan. 2. **Set goals in context of health outcomes.** Setting goals helps the patient feel as though he or she is working towards something and it gives us a benchmark to determine how efficacious the medication therapy is. Goals can range from objective goals such as blood pressure or blood glucose to subjective goals such as resolution of symptoms. No matter what the MRP is, you should always consider what the goal of therapy should be 3. You want to make sure you always provide the patient with education and directions on how to self-monitor when appropriate. Remember to first ask the patient what he or she knows about the health condition being treated and the medication being used to treat the condition so that you can build on his or her foundational knowledge. The goal is to empower the patient to be knowledgeable and provide education strategically to fill in the knowledge gaps. 4. Finally, you want to include the plan for follow up, either with a pharmacist or other health care provider. As mentioned previously, the follow-up step of the patient care process is often forgotten so including it in the plan holds the patient responsible as well.

Question 30

When you want to "implement" the agreed upon plan. This can fall under one of two roles:

Answer 30

1. Role of the patient: patient implementing the plan (patient makes doctors appointment 2. Role of the Health Care providers (this can mean many things including administer a vaccine, recommend an over-the-counter medication, send a prescription to a prescriber to sign off on, start a diet/exercise plan, or administer medications. ) **Highlights WHO is doing the work

Question 31

What is the most forgotten step of the PPCP?

Answer 31

Follow up

Question 32

What are the components of follow up step of PPCP?

Answer 32

1. Monitor safety: side effects of medication, medication adherence 2. Evaluate efficacy: did you meet goal? is the plan resolving the problem? patient understanding of therapy (when to pick refills, how to use the medication) 3. Modify in collaboration as needed (minimize adverse effects with administration timing, possibly adjust dose of medication or add medication), enroll in auto refill program ****We are not collecting these items (which would take us back to where we started), but instead we are **suggesting **that these parameters be observed and monitored