504:PPCP and Medication Related Problems

List information that should be included in a patient’s pharmacy profile

1. Patient Demographic information: name, address, phone number, age or date of birth, and gender

2. Insurance information

3. History of allergy and drug side effects

4. Current prescription and OTC medication list

5. A pharmacist’s comments relevant to the patient’s drug therapy

How long must a pharmacy keep records of dispensed medications?

5 years

How can a pharmacist use a patient profile when assessing adherence?

 A pharmacist can check whether a patient regularly comeback to a pharmacy on refill at a right duration or not.

Why is it important for a pharmacist to conduct drug interaction screenings?

It is because the computer software is not regularly updated, resulting newly discovered drug interactions are not up to the date.

What five steps are at the core of the process? Provide examples of each.

1.     Collect: A pharmacist collects patient’s information and verify through credible sources. For example, a pharmacist collecting the medical history of patients and confirm by the patient’s medical records.          

2.     Assess: A pharmacist accesses the patients’ medical record and use for later care plan. For example, a pharmacist can determine whether a patient need a vaccination based on the medical records.     

3.     Plan: A pharmacist with other health care provider designs a care plan for a patient. For example, a team can decided what medical problems they have to prioritize and communicate with the patients to discuss whether a care plan works for them.

4.     Implement A pharmacist can now begin a care plan with the patient with collaborating with other healthcare provider. For example, a pharmacist can provide a detailed explanation on how to take a medication and when drug should be refilled with the patient.

5.     Follow up: Monitor & Evaluation: Health care team members, including a pharmacist, check if a care plan is working for a patient. For example, a pharmacist can check if the medication is working for a patient. If it is not, they can change the medication after discussing with other health care providers.

What three components provide the foundation for person-centered care?

Communication, Collaboration, Document

Is the drug needed for the patient’s condition?

Indication

What Drug Therapy Problem are these examples?

• The patient is taking an antibiotic for a viral infection (no bacterial infection to treat).

• A patient is using two drugs that do the same job, but only one is needed.

• A drug is prescribed to treat a side effect that could be resolved by stopping or adjusting the original medication.

• A drug is used for a condition that can be treated effectively with non-drug therapy (e.g., lifestyle changes).

1. Unnecessary Drug Therapy → Indication
   A drug is being used when it is not needed

👉 The problem: The patient is taking a medication without a valid indication.

(make sure every drug has a disease state attached, and every condition has a drug, ex: if patient has an albuterol inhaler but does not have asthma, or if they have high blood pressure but no one has prescribed a blood pressure medication

What Drug Therapy Problem are these examples?

• A diabetic patient needs a statin for cardiovascular protection but is not prescribed one.

• A patient at risk of developing blood clots after surgery is not prescribed prophylactic anticoagulants.

• A patient has uncontrolled high blood pressure but is on too few medications.

Needs Additional Drug Therapy → Indication

A patient has a medical condition that requires a medication but isn’t getting it.

👉 The problem: There is a missing indication—a condition that should be treated or prevented with medication is not being addressed.

the dose too high ex: lisinopril is only supposed to be 40mg per day or biologic function ex: drug is cleared by kidney but has impaired kidney function or drug interaction (e.g. with pregnancy)

safety: adverse effect or dosage too high

too low of a dose (NOT SAFETY because it isn't doing a good job of being effective for the patient)

Ineffectiveness: ineffective drug and dosage too high

3 person-centered care: 

Collborate, Communicate, Document

Review a patient’s medications to see if they are safe

Assess

Stops a medication under a collaborative practice agreement

Implement

Obtain a blood pressure

Collect Objective Information

Find out which medications a patient is taking

Collect

Administers a vaccine

Implement

Calls a patient after a medication change to see if it is working

Follow Up

Asks the patient how much pain she is in

Collect subjective Information

Creates a course of action to manage a patient’s asthma

Plan

abnormal immune reaction (rash, hives, anaphylaxis) and what to do?

allergy —> avoid the drug

expected pharmacologic effect (e.g., diarrhea, nausea)

side effects→ not a contraindication, just needs monitoring or management.