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Pharmaceutical Care Module Part I Direct Patient Care Practice: An Overview Lalitha Raman-Wilms, PharmD, FCSHP Associate Professor Leslie Dan Faculty of Pharmcacy, University of Toronto Section I – Overview of Practice • Part I • Part II • Direct Patient Care Practice: An Overview • Practitioner Requirements to Practice, including the Patient Care Process Part I - Learning Objectives At the end of this session, students will be able to: • Demonstrate an understanding of the evolution of pharmacy practice • List key elements of a patient care practice (for any health profession) • List the primary focus and responsibility of a pharmaceutical care practitioner • List the practitioner requirements for a patient care practice Evolution of Pharmacy Practice • 1930s and 1940s: compounding; preparing drugs • 1950s: dispensing of medications • 1960s: Patient Counselling; Clinical Pharmacy in hospital setting • 1990s: Pharmaceutical Care defined– direct patient care provided by pharmacists – Ongoing practice and research in this area Pharmaceutical Care Practice Packaging of product; dispensing mechanisms Pharmacy Technician Pharmacist Ensure patient’s drug therapy problems are identified & resolved Work with other HCPs Patient Education Documentation in medical record Drug Product GOOD DISPENSING PRACTICES PATIENT DRUG INFORMATION SYSTEMS, THERAPEUTIC DRUG MONITORING, etc Develop new Practices Sustainable Business Model KNOWLEDGE & SKILLS A Patient Care Service • Involves a patient and a qualified practitioner • Requires a face-to-face encounter • Practitioner takes responsibility for patient’s needs, the specific interventions carried out and the patient’s outcomes • Service provided must be consistent and comprehensive • Practitioner assess each patient’s needs, develops a care plan to meet these needs and follows-up to evaluate the outcomes Slide used with permission from Dr. L.Strand Health Care Needs of a Patient Nursing Care Geriatric Care Mental Health Care Medical Care PATIENT SELFCARE Pharmaceutical Care Dental care Eye Care Pediatric Care Medication Use System SYSTEM LEVEL • What is best for society? (Health Care Policy, Regulation, Legislation) INSTITUTIONAL LEVEL • What is best for an organization, institution, disease state? (formulary, DUE, DUR, protocol) PATIENT LEVEL • What is best for a patient? Pharmaceutical Care Slide used with permission from Dr. L.Strand Knowledge and skills required to practise Pharmaceutical Care Primary Focus • • • • • Identifying and meeting a patient’s drug-related needs Knowledge Base - Pharmacotherapy Skills – patient care requires a lot of practise Attitude – a caring approach Responsibility - Identification, prevention, and resolution of drug therapy problems Pharmaceutical Care Pharmaceutical care is a patient-centered practice in which the practitioner assumes responsibility for a patient’s drug-related needs and is held accountable for this commitment.1 1Cipolle, R.J., Strand, L.M., Morley, P.C. (2004). Pharmaceutical Care Practice: The Clinicians Guide New York: McGraw Hill. Patient Care Process Patient Experience Medication Responsibilities Care Plan Pharmacotherapy Workup Today’s wants and needs Practitioner Assessment Follow-up Evaluation Philosophy of Practice Social Obligation Responsibilities Patient-centered approach Therapeutic Relationship This slide, used with permission, from Dr. L. Strand. Caring Practitioner Requirements • Philosophy of Practice • Professional / Therapeutic Relationship with Patient • An understanding of the Patient’s Medication Experience • Systematic Thought Process: Pharmacotherapy Workup and Patient’s Drug Therapy Problems • Patient Care Process • Documentation System • Reimbursement System Part I Overview • Evolution of pharmaceutical care practise • Key elements of a patient care practice • Role of the pharmacist in providing pharmaceutical care • The three components of the Patient Care Process • New Terminology