PHAR 131: PPCP

Collect

The pharmacist assures the collection of necessary subjective

and objective information about the patient in order to understand the relevant medical/medication history and clinical status of the patient.

Examples of collect

Current medication list, medication use, relevant health data (physical assessment), patient lifestyle

HPI or CC

history of present illness OR chief compliant

PMH

past medical history

FH

family history

SH

personal/social history

ROS

review of symptoms

LOQQSAM

Location

Onset

Quality

Quantity

Setting

Associated Symptoms

Modifying factors

Location

Where

Onset

How long did it happen

Quantity

How bad

Quality

Is it blood or mucous

Setting

Have you traveled? Time of day

Associated Symptoms

Headache?

Modifying Factors

Meds taken?

Three C's Follow Up

Control, Compliance, Complications

Subjective History

Information told by patient e.g. pt talks about symptoms

Objective

Information gathered and written e.g. BP check or laboratory

Assess

The pharmacist assesses the information collected and analyzes the clinical effects of the patient's therapy in the context of the patient's overall health goals in order to identify and prioritize problems and achieve optimal care e.g. health factors

How to Identify Drug Therapy Problem

1. Unnecessary drug therapy

2. Need additional drug therapy

3. Ineffective drug

4. Dosage too low

5. Experiencing an Adverse Drug Reaction

6. Dosage is too high

7. Non-compliance/adherence

Plan

The pharmacist develops an individualized patient-centered care plan, in collaboration with other health care professionals and the patient or caregiver that is evidence-based and cost-effective

Questions to ask during plan

1. what goals of therapy

2. what are you going to do

3. what interventions

Primary goals of therapy

1. Cure a disease or illness

2. Prevent a disease or illness

3. Slow the progression of a disease or illness

4. Supplement nutritional, electrolyte, hormonal, or other deficiencies

5. Correct abnormal laboratory test results

6. Provide comfort or temporary relief from signs and symptoms of a

disorder

7. Assist in the diagnostic process

Secondary goals of therapy

1. Not complicating other disease states

2. Avoiding adverse effects

3. Providing cost effective therapy

4. Maintaining QOL

Implement

The pharmacist implements the care plan in collaboration with other health care professionals and

the patient or caregiver.

SOAP format

Subjective, Objective, Assessment, Plan

Follow up: Monitor and Evaluate

The pharmacist monitors and evaluates the effectiveness of the care plan and modifies the plan in collaboration with other health care professionals and the patient or caregiver as needed.

Question asked for follow up

1. Is it working?

2. Is it safe?

3. What's next?

To effectively monitor a drug plan you must:

1. Understand the pathophysiology of the disease you

are treating.

2. Understand the pharmacology of the drugs you are

using.

3. Understand the therapeutic guidelines and practice

standards available.

How to evaluate safety?

1. Lab tests

2. Physical assessments

3. Worsening of clinical symptoms

4. Identification of new symptoms