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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