Download Do Pharmacists Need Problem-Solving Skills?

Do Pharmacists Need Problem-Solving Skills?
Kerry Wilbur, PharmD, Maguy El-Hajj, PharmD, Nadir Kheir, PhD, Peter J. Jewesson, PhD
Pharmacy Program, Qatar University, Doha, Qatar
Critical Thinking and Decision Making in PC
Pharmacists and Pharmaceutical Care
!! In the PC model of practice, pharmacists determine the patient’s
drug-related health outcomes by first establishing a trusting
relationship or partnership
!! Pharmacists collect, synthesize, and interpret relevant patient data
!! Patient’s actual or potential DRPs are identified, listed, and
prioritized and desired drug therapy outcomes established
!! Accomplishing these steps require pharmacists to recognize, obtain,
and process relevant drug disease and patient information in a
problem-solving format
!! Pharmacists organize a list of therapeutic alternatives, engage in
critical thinking to consider the best solution, and individualize a
therapeutic regimen in collaboration with the physician and patient
!! Pharmacists design and implement a specific therapeutic and
monitoring plan with patient follow-up and documentation
!! Pharmacists are medication experts.
!! Historically, professional functions were limited to drug dispensing
and patient counseling.
!!Pharmacy practice has now evolved to include a broader scope of
roles and responsibilities in response to the increasing complexity
of pharmacotherapy.
!! Pharmacists promote the rational use of medications as clinical
practitioners in hospital or community environments, as educators,
researchers, and consultants in many other settings.
!! Pharmacists practice pharmaceutical care, the responsible
provision of drug therapy for the purpose of achieving definite
outcomes that improve a patient’s quality of life.
Drug Therapy Outcomes for Patients
!! Pharmaceutical care (PC) is a patient-centered practice.
!! Pharmacists accept responsibility for optimizing drug therapy to
achieve the following outcomes:
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DECISION ALGORITHM FOR IDENTIFYING DRUG-RELATED PROBLEMS
Cure a disease
Eliminate or reduce patient symptoms
Arrest of slow disease progression
Prevent disease or symptoms
Normalize a physiologic parameter
!! Pharmacists collaborate with the patient and other health care
providers to design, implement, and monitor a therapeutic plan
aimed at producing specific drug therapy outcomes.
Drug-Related Problems
!! Drug-related problems (DRPs) are actual or potential undesirable
signs or symptoms experienced by a patient that are related to the
use of a medication
!! Eight main DRPs are characterized. The patient may be:
DRP #1
Receiving drug therapy without a
valid indication
DRP #2
Requiring but not receiving drug
therapy
DRP #3
Not receiving/taking the correct
drug therapy
DRP #4
Receiving/taking too little drug
(low dose)
DRP #5
Receiving/taking too much drug
(high dose)
DRP #6
Not receiving/taking prescribed drug
therapy properly
DRP #7
Experiencing an adverse drug reaction
!! 5-year (173 Credit-Hour) BSc (Pharm) and 6-year (207 Credit-Hour)
PharmD degree programs
!! Competency-based curriculum
!! Problem-solving and critical thinking skills are general educational
outcomes required across all courses
!! Graduates will be able to utilize the principles of scientific inquiry,
thinking analytically, clearly and critically, while solving problems
and making decisions during daily practice.
!! Graduates will be able to systematically find, analyze, evaluate and
apply information and shall make informed, defensible decisions.
!! Concept and practice of PC is incorporated into curriculum from an
early stage enabling students to provide patient-centered and
outcome-oriented care when they assume professional roles
!! Instructional strategies and technologies support diverse learner
needs
!! Use and integration of teaching and learning processes develop
graduates who become self-directed, life-long learners
Accreditation
!! Provisional accreditation by the Canadian
Council on Accreditation of Pharmacy
Program (CCAPP) is being sought in 2008
!! Accreditation resources include:
!! Association of Faculties of Pharmacy
of Canada educational outcomes (1998)
!! NAPRA Professional competencies for
Canadian Pharmacists at Entry to Practice (2007)
DRP #8
Experiencing a drug interaction
(drug-drug, drug-disease, drug-lab)
Problem-Solving Skills
!! Critical thinking and problem-solving skills are essential for the
competent delivery of PC. Major functions in PC include:
!! identifying potential and actual DRPs
!! resolving actual DRPs
!! preventing potential DRPs
!! Pharmacists must apply knowledge of the patient, diseases, and
drugs to make clinical decisions as to whether or not a DRP exists.
QU Pharmacy Program Curriculum
!! International accreditation ensures our pharmacy graduates have
portable credentials to facilitate diversity for their future practice
!! Qatar University Pharmacy Program will be the first international
program reviewed by CCAPP for the purpose of accreditation
Figure 1. Drug-Related Problem Identification Decision Algorithm
Pharmacy Program
Qatar University