Quizzam 1 Pharmacy Practice

What is patient-centered care defined as?

An individual’s specific health needs and desired health outcomes which are the driving force behind all healthcare decisions and quality measurements - partnership between the patient and the healthcare team.

What is the mission of the pharmacist?

To provide pharmaceutical care.

What is pharmaceutical care?

The direct, responsible provision of medication-related care for the purpose of achieving definite outcomes that improve a patient’s quality of life.

What are the medication related aspects of pharmaceutical care?

1. Decisions such as to use or not to use a med or which med, dose, route, administration.

2. Monitoring required.

3. Education and information

What are the responsibility aspects of pharmaceutical care?

1. Professional covenant: patient grants authority to the provider and the provider grants trustworthiness, competence, commitment, and accountability.

2. Personally accountable for patient outcomes from your actions and decisions.

3. Care is documented.

What are the quality of life aspects of pharmaceutical care?

Include the patient’s assessment and involvement in goal setting.

What are the outcome related aspects of pharmaceutical care?

1. Predefined medication related outcomes.

2. Medication related problems can interfere with outcome.

What are the care related aspects of pharmaceutical care?

1. 1:1 pharmacist and patient relationship

2. Care directly to patient for their benefit

3. Personal concern for their wellbeing and health

4. Act in patient best interest

5. Patient centered

What is the pharmacist’s role on the patient care team?

Identify, resolve, and prevent drug-related problems.

What is a drug-related problem?

Any undesirable event experienced by a patient which involves or is suspected to involve drug therapy and that interferes with achieving the desired goals of therapy and requires professional judgement to resolve.

What question do pharmacists ask themselves when dealing with an indication DRP?

Why is the patient taking or not taking the medication?

What question do pharmacists ask themselves when dealing with a safety DRP?

Could this medication harm the patient?

What question do pharmacists ask themselves when dealing with an effectiveness DRP?

Is the medication providing benefit?

What question do pharmacists ask themselves when dealing with an adherence DRP?

Is the patient able to take the medication as instructed?

What are the potential medication therapy goals?

1. Cure disease

2. Reduce or eliminate symptoms

3. Arrest or slow the progression of disease

4. Prevent a disease or symptom

What does ECHO stand for?

Economic Clinical Humanistic Outcomes.

What are some examples of economic outcomes?

Hospitalizations, emergency department visits, medication costs.

What are some examples of clinical outcomes?

Measurements and lab values, medication problem resolution, adverse drug events, adherence.

What are some examples of humanistic outcomes?

Patient medication knowledge, functioning, self-management capability, satisfaction, concerns about treatment.

What does PPCP stand for?

Pharmacist patient care process.

What is the PCPP?

A consistent process in the delivery of patient care that is applicable to any practice setting where pharmacists provide patient care services.

What does the PPCP emphasize?

Our unique approach to assessing a patient’s medication regimen and patient-centered care delivery.

What occurs under the “Collect” phase of the PPCP?

Gather information to understand relevant medical/medication history and clinical status of patient.

What are some potential sources of information that can be used in the “Collect” phase?

Patient records, patient interviews, other healthcare professionals.

What type of information is collected in the “Collect” phase?

A current med list and history of use, relevant health data, patient lifestyle habits, preferences, beliefs, and goals.

What occurs under the “Assess” phase of the PPCP?

The effects of the patient’s therapy are analyzed in context of the patient’s health goals.

What is the goal of the “Assess” phase?

To identify and prioritize problems to achieve optimal care.

How do pharmacists assess medications?

PharmD school, drug information sources, evaluation of literature, evidence-based guidelines.

What is each medication assessed for?

Indication, effectiveness, safety, and adherence.

What occurs under the “Plan” phase of the PPCP?

A individualized patient-centered care plan is developed with other healthcare professionals, the patient, and/or caregiver - evidence based and cost-effective.

What should the plan made in the “Plan” phase include?

1. Optimize medications by addressing drug related problems.

2. Goals of therapy.

3. Engagement of the patient through education, empowerment, and self-management.

4. Follow-up plan and/or transition of care.

What occurs under the “Implement” phase of the PPCP?

The pharmacist puts the care plan into effect in collaboration with other healthcare professionals and the patient/caregiver.

What happens during implementation?

1. Address drug related problems.

2. Initiate, modify, discontinue, or administer meds as authorized.

3. Preventative care such as vaccines.

4. Education to the patient or care giver.

5. Coordinate and schedule follow up care.

What occurs under the “Monitor and Follow-up” Phase of the PPCP?

1. The effectiveness of the care plan is evaluated.

2. The plan is modified in collaboration with other healthcare professionals.

What is monitored in the “Monitor and Follow-up” phase?

1. Medication appropriateness, effectiveness, safety, and adherence.

2. Clinical endpoints, outcomes of care, and progress towards goals of therapy.

What is at the center ring of the PPCP?

1. Communication

   1. With other healthcare professionals

   2. With patients and caregivers

2. Collaboration

   1. With other healthcare professionals

   2. With patients and caregivers

3. Documentation

   1. For your own records

   2. For the patient’s records

   3. For other healthcare professionals

What is at the core of the PPCP?

Patient-centered care and establishing a relationship with the patient.

What is clinical pharmacy?

Specialized knowledge, experience, and judgement to ensure optimal outcomes, can be conducted under collaborative practice agreements.

What is consulting pharmacy?

LTCF.

What is disease state management?

One on one with the patient and collaborative in nature with the patient’s other healthcare professionals - pertains to specific disease and providing the patient with the tools and knowledge to assume responsibility for their own care, can be conducted under collaborative practice agreements.

What is disease state education?

Similar to disease state management pharmacy but more information only, less collaboration.

What is disease screening?

Identify people with disease or promote awareness of disease states to improve diagnosis and appropriate treatment.

What is the goal of medication therapy management?

Optimize outcomes through improved medication use, reduced risk of adverse events, and improved medication adherence.

1. Improve patient’s knowledge

2. Identify and address patient’s concerns or problems

3. Empower patients to self manage their medications and health concerns

What are the core components of a MTM visit?

1. Medication therapy review (MTR)

   1. Systemically collect, assess, identify, and prioritize medication-related problems + create a plan to solve them

2. Personal medication record (PMR)

   1. Comprehensive record of medications intended for patient use

3. Medication-related action plan (MAP)

   1. Patient-centric document with action steps to track self-management progress

4. Intervention and/or referral

   1. Intervene to address DRPs and refer to other healthcare professional as needed

5. Documentation and follow up

   1. Consistent documentation of service and follow-up plan identified

What is comprehensive medication management?

Patient-focused rather than medication focused and are usually not directly billable.

Compared to MTMs, CMMs have increased?

Focus on clincal status, access to EHR, collaboration with a team, and use of a collaborative practice agreement.