PPC history

OBRA 1990(mandated patient counseling)

Ominous budget reconciliation act

For Medicaid Patients

1. Drug Regime Review(DUR)

2. Patient Counseling

3. Mandated electronic health records of prescriptions

Pharmaceutical Care Practice

patient-centered practice in which the practitioner assumes responsibility for a patient's drug-related needs and is held accountable for this commitment."

3 components of patient care process

Philosophy of Practice(1990)

-Pharmaceutical Care is a patient-centered practice in which the practitioner assumes responsibility for a patient’s drug-related needs and is held accountable for this commitment.

Patient Care Process(2014)

-Collect, Assess, Plan, Implement, Monitor and Evaluate

Practice Management System

-business plan

-documentation system

-reimbursement system

Medication therapy management core elements(MTM)

2004-under part D

1. Medication therapy review(MTR)

2. Medication action plan(MAP)

3. Personal medication recored(PMR)

4. Intervention/referral

5. Documentation/follow up

MTM qualifications

1. Have 3+ chronic illnesses(protected under part D law)

2. Take multiple(8 or more) part D drugs for chronic illnesses

3. Incur annual costs to the specific threshold of MTM program cost

7 medication related problems recommendations made as a result of MTM

1. Needs additional therapy

2. Unnecessary drug therapy

3. Dose too high

4. Dose too low

5. More effective drug available

6. Adverse drug reaction

7. Medication non-compliance/non adherence

medicaid

-state based income needs, pregnancy, and limited access to resources

-covers hospital, physician, laboratory/xray, home-health, basic prescription drug cost, eyeglasses, dental care

-no cost; available any time

Medicare

-federal program with 65 or older or younger individuals with disabilities

-low monthly premiums, deductibles for hospitalization, potential out of pocket costs

4 parts of medicare

Part A: covers inpatient care(hospital, home health care, hospice)

Part B: covers outpatient care(doctor visits, DME, a few prescription drugs)

Part C: Private insurance company benefit that combines A and B(patient must continue to pay part B premiums)

Part D: Voluntary prescription drug benefit

ECAPS(not passed yet)

Equitable Community Access to Pharmacist Services Act

-would ensure patients continue to have access to essential pandemic services provided by pharmacists

-pharmacists paid by Part B

Testing: COVID, influenza, respiratory syncytial virus(RSV), strep throat, or other public health emergence

Treatment: COVID, influenza, strep throat, RSV, or another public health emergency

4 mechanisms that allow pharmacists to provide naloxone to a patient in the us

1. OTC nasal spray

2. State wide standing order: blanket prescription from a state's health officer(PA)

3. Standing order - in collaboration with qualified prescriber

4. Pharmacy prescriptive authority

clinical pharmacy

-Area of pharmacy concerned with the science and practice of rational medication use and disease prevention

-occurs in all healthcare settings

Pharmacist credentialing

process performed to access and confirm pharmacist qualifications: education, licensure, training, expertise, any malpractice

Disease state management

a system of coordinated health care interventions and communications for populations with conditions in which patient self care efforts are significant

Collaborative Drug therapy management

agreements that are a strategy for expanding the role of pharmacists in team-based care with other providers

Comprehensive drug therapy management

session between patient/caregiver/pharmacist whenever all patients meds are evaluated: taking appropriately, correct therapy, avoid effects

Medical home

Focuses on patient-centered care; pharmacist and physician interaction that puts patient at the center

Pharmacist provider status that APA has been advocating for

Pharmacist provider status is the formal recognition of pharmacists as healthcare providers by federal and state laws and payers, allowing them to be reimbursed by health insurers for direct patient care services they deliver, such as medication management, vaccinations, and point-of-care testing.

What COVID-19 therapy has the FDA approved for pharmacist prescribing so long as the patient's medical record is able to be reviewed:

Paxlovid