Health is not only the absence of disease. It includes physical, mental and social well-being. Medicines play a major role in treating diseases, but they must be used correctly. Wrong or inappropriate use of medicines can harm the patient and increase treatment costs.
Across the world, pharmacists in community, hospital and clinical settings help patients use medicines safely. With their strong knowledge of therapeutics, pharmacists can:
- Identify drug-related problems (DRPs)
- Give solutions to the prescriber and patient
- Guide patients on safe and effective use of medicines
- Provide diet and lifestyle advice
Pharmaceutical Public Health focuses on health issues at the community or society level. Pharmaceutical Care focuses on health issues at the individual patient level.
Meaning of Pharmaceutical Care
The term “Pharmaceutical Care” was first used by Mikeal et al., 1975, who defined it as:
“The care that a given patient requires and receives which assures safe and rational drug use.”
In 1990, Hepler and Strand gave the most accepted definition:
“Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve the patient’s quality of life.”
This definition highlights that pharmaceutical care is:
- Patient-centered
- Goal-oriented
- Focused on improving quality of life
- Especially useful for chronic diseases
Difference from Routine Pharmacy Practice
In traditional practice, the pharmacist only dispenses medicines. In pharmaceutical care, the pharmacist:
- Reviews the prescription carefully
- Identifies drug-related problems
- Communicates with the prescriber
- Works with the patient
- Ensures safe, effective and convenient drug therapy
Principles of Pharmaceutical Care Practice
1) Establishing a Professional Relationship
Pharmaceutical care begins with a strong pharmacist–patient relationship based on:
- Caring
- Trust
- Open communication
- Cooperation
- Mutual decision-making
The pharmacist must be approachable, supportive and always prioritize the patient’s welfare. The patient, in return, should share correct medical and personal information.
2) Collecting Patient-Specific Information
The pharmacist must collect detailed information about the patient, such as:
- General health and activity level
- Past medical history
- Medication history
- Social and family history
- Diet and exercise habits
- Financial or insurance status
- History of present illness
Information can be obtained from the patient, caregivers, medical records, reports and other healthcare providers. All information must be recorded, updated regularly and kept confidential.
3) Evaluating Information and Developing a Drug Therapy Plan
The pharmacist should analyse all collected information to:
- Identify current or potential drug-related problems
- Ensure the drug therapy is safe and effective
- Minimize future health problems
A drug therapy plan is then developed together with the patient and, when needed, the healthcare team. The patient must be clearly informed about:
- Benefits and risks of each option
- Side effects
- Monitoring requirements
- Cost considerations
4) Ensuring the Patient Has Everything Needed
The pharmacist must ensure the patient has:
- The correct medicines and supplies
- Clear instructions for use
- Understanding of their disease and therapy
- Knowledge of monitoring tools (e.g., BP machine, glucometer)
5) Reviewing, Monitoring and Modifying the Therapy Plan
Pharmaceutical care is a continuous process. The pharmacist must monitor the patient’s progress and adjust the plan when necessary.
This includes:
- Checking therapeutic outcomes
- Evaluating lab results or clinical parameters
- Identifying and correcting problems like interactions or non-adherence
- Coordinating changes with prescribers
- Documenting every step
As the patient moves between home, hospital or long-term care settings, the pharmacist ensures continuity of care.
Practice Principles of Pharmaceutical Care
A) Data Collection
- Conduct a structured interview to build trust and gather information.
- Respect privacy and allow the patient time to talk.
- Collect subjective (symptoms) and objective (BP, labs) information.
- Refer to caregivers when direct communication is not possible.
- Record data accurately and maintain confidentiality.
B) Information Evaluation
- Evaluate patient data to identify opportunities to improve therapy.
- Record conclusions clearly.
- Explain findings to the patient in simple language.
C) Formulating a Plan
- Choose the best actions to improve safety and effectiveness.
- Create a plan addressing each identified problem.
- Include expected outcomes and monitoring parameters.
- Discuss the plan with the patient and other healthcare providers.
- Document the plan in the pharmacy record.
D) Implementing the Plan
- Coordinate with doctors when prescriptions need clarification.
- Help the patient overcome barriers such as cost or lifestyle changes.
- Educate the patient about medicines and monitoring.
- Ensure timely supply of medicines and devices.
- Document all steps and communication.
E) Monitoring and Modifying the Plan
- Review patient progress regularly.
- Modify therapy when required.
- Provide positive reinforcement when goals are achieved.
- Document all updates.
Detailed Notes:
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