HISTORY OF CLINICAL PHARMACY

clinical pharmacy

• A health science discipline in which pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention.

  • direct observation of the patient

    • (e.g., perform physical exam, palpation, train clinical eye)

pharmacy

• knowledge on synthesis, chemistry & preparation of drugs

  • focus on the drug itself

clinical pharmacy

• more oriented to the analysis of population needs with regards to medicines, ways of administration, patterns of use, drugs effects on the patients

  • patient-centered approach

  • patient outcomes

pharmaceutical care

“responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life”

• Cure of disease

• Arrest or slowing of a disease process

• Prevention of disease or symptoms

• Elimination or reduction of symptoms

Pharmaceutical Care Outcomes:

cure of disease

• full recovery

• infections by using antibiotics

arrest or slowing of a disease process

• HIV → anti-retrovirals

prevention of disease or symptoms

• vaccines

1. Identifying potential and actual drug-related problems

2. Resolving actual drug-related problems

3. Preventing potential drug related problems

major functions of Pharmaceutical Care

rational drug therapy

The rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and at the lowest cost to them and their community.

• use of pain relievers

• use of cough medicines

• use of habit-forming OTC agents

rational use of OTC drugs

Goals of Clinical Pharmacy

To promote the correct and appropriate use of medicinal products and devices

These activities aim at:

• minimizing the risk of treatment-induced adverse events

• maximizing the clinical effect of medicines

• minimizing the expenditures for pharmacological treatments

clinical pharmacy

arose out of dissatisfaction with old practice norms and the pressing need for a health professional with a comprehensive knowledge of the therapeutic use of drugs.

University of Michigan (1960s)

The clinical pharmacy movement began at the ______

David Burkholder
Paul Parker
Charles Walton

clinical pharmacy was pioneered by _______ at the University of Kentucky

Clinical Pharmacology

a professional discipline that combines basic pharmacology and clinical use.

Harry Gold

developed clinical pharmacology

1960

start of the emergence of clinical pharmacy due to poor medicine control system

USA

approach is unit dose dispensing and decentralization of pharmacy services

U.K.

unifies prescription & administration records in the ward – “ward pharmacy”

1970

signaled the transition to clinical pharmacy

1980

growth of clinical pharmacy practice because of the ability to promote cost effective medicines

1988

U.K. endorsed clinical pharmacy services to secure value for money

1997

pharmacists grade & time spent on wards were increased

• Hospitals

• Community pharmacies

• Nursing homes

• Home-based care services

• Clinics

• Any other setting where medicines are prescribed and used

CLINICAL PHARMACY SETTINGS:

technical model

compounding dispensing:

• lick

• stick

• count

• pour

• fill

• bill

clinical model

Managing & maximizing pharmaceutical outcomes brings challenges

• medication profile review

• patient education

• provider of drug information

• clinical pharmacy

• pharmaceutical care

  • pharmacotherapy

  • patient care provider

purpose of a Clinical Pharmacist

To ensure that quality drugs are used appropriately in collaboration with the medical, nursing and other para-medical groups so that effective and safe medication therapy is realized for each patient