Post on 26-Nov-2020
Dr. Yusi Anggriani, M.Kes, AptMita restinia, S.Farm., M.Farm, Apt
Contents
Definition1
Pharmaceutical Care Plan Process2
4
Pharmaceutical Care Plan
Pharmaceutical Care Plan is the process in which
pharmacist cooperates with the patient and health
care provider in:
Designing Implementing Monitoring
Pharmaceutical Care Plan
It describes specific services
activities through which an
individual pharmacist
cooperates with patients
and other health care
professionals in designing,
implementing & monitoring a
therapeutic plan that will
produce specific outcomes
for the patient
The Pharmaceutical Care Cycle
5
How will you know
you did it?
(monitor and follow-up)
Why do anything?
(identify the problem)
How will you do it?
(develop a care plan)
What do you want
to do?
(set goal)
Source: Rovers J. Des Moines, IA: Drake University College of Pharmacy.
How to implement Pharmaceutical Care
Plan?
Not all patients require a written PCP.
Pharmacists must assess their own patients and
identify specific areas on which to focus.
The pharmacist identify patients with specific diseases
(e.g., asthma, hypertension, diabetes mellitus, or
hypercholesterolemia).
The development of a PCP
Five step process involving the SOAP format (Subjective data, Objective data, Assessment, and Plan of care).
Developing Problem
Assesing Problem
Identifying Problem
Gathering Information
Step 4
Step 3
Step 2
Step 1
Evaluation the achievement
Step 5
Essential Components of Pharmaceutical Care Plan
1. Patient’s demographic date: age, sex, race etc. 2. Pertinent medical information 3. Medical history (current & past) 4. Family history 5. Dietary history 6. Medication history (prescription, OTC, social drugs,
allergies)7. Physical findings (weight, height, B.P)8. Lab results (serum drug levels, potassium levels,
serum creatinine levels relevant to drug therapy)9. Patient complaints, symptoms & signs
Step 1. Gathering Information
The pharmacist should gather an accurate:
• Medication history, both prescription and nonprescription medications
• The reasons the medications were prescribed or taken.
The pharmacist have to obtain some information from the physician, such as laboratory test results and hospitalizations.
The pharmacist should get written permission from the patient before soliciting this information.
Step 2. Identifying Problems
Example
From the patient's medication profile in, one
problem is evident: diagnosis of asthma.
Step 2. Identifying Problems
List subjective and objective findings correlated to the problem:
Subjective findings : those that the patient describes (e.g., 'I feel tired all the time, “I feel bloated,” or "I woke up coughing").
References describe methods to ascertain this information.
Objective findings are those that can be observed or measured by the pharmacist (e.g., patient appears tired, blood pressure is 180/105, pitting edema in ankles).
In the patient with asthma, the pharmacist would have the patient use a peak expiratory flow meter and record the results.
Step 3. Assessing Problems
The pharmacist analyzes and integrates the information gathered in steps 1 and 2 and draws conclusions in preparation for developing a patient-specific PCP
Step 3. Assessing Problems
For example, in the asthma case,
The pharmacist may first investigate the etiology of
the factors that exacerbated the asthma.
The pharmacist does not have to be involved in
skin testing, nor does the pharmacist have to conduct
a detailed, extensive history of all of the factors that
may have precipitated the asthma.
Step 3. Assessing Problems
The pharmacist should attempt to determine if drugs: (eg., aspirin, nonsteroidal anti-inflammatory agents, or beta-blockers) caused or exacerbated the asthma in the patient.
Next, the pharmacist assesses the severity of the asthma. This could be accomplished (as shown in the plan) by determining:
• the PEFR (Peak Expiratory Flow Meter).
• the patient's daily symptom
• peak flow diary, hospitalized
• placed on steroids or a mechanical ventilator.
Step 4. Developing the Plan
The pharmacist establishes:
1. goals linked to each of the patient's problems
2. specifies a course of action aimed at meeting
each goal.
Goal (i.e., desired improvement) should be stated in
terms of measurable outcomes that indicate
problem has been resolved.
Step 5. Evaluating the Achievement of
Outcomes
Outcomes that will be used to evaluate the success of the PCP.
Treatment plan must be meaningful, measurable, and manageable.
Outcomes are specific, measurable indicators for the goals of treatment.
Step 5. Evaluating the Achievement of
Outcomes
The outcomes listed for asthma, e.g:
Lower frequency and severity of acute exacerbations
Fewer physician office visits
Elimination of side effects
Fewer emergency department visits
Documentation
“if we didn’t document it, we didn’t do it”
Documenting the patient care provided during the
pharmaceutical care encounter is CRITICAL STEP in
Pharmaceutical care process
The Value of Documentation
Provided a permanent record of patient information that
the pharmacist has collected.
Efficiently communicates key information to colleagues at
the practice site or to other health care professional
Provides evidence of the pharmacist action and successes
in patient care
Serves as legal record of care provided
CONCLUSION: Requirements to conduct
pharmaceutical care
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Knowledge, skill, function of personnel
System for data collection and documentation
Efficient work flow processes
References, resources, and equipment
Communication skills
Quality assessment/improvement programs