Exhaustive Study Guide: Pharmacists' Patient Care Process (2025 Revision)
Organization and Background of the Pharmacists' Patient Care Process
Joint Commission of Pharmacy Practitioners (JCPP):
Established in to serve as a forum on matters of common interest and concern to national organizations of pharmacy practitioners and invited liaison members.
Member Organizations:
Academy of Managed Care Pharmacy (AMCP)
Accreditation Council for Pharmacy Education (ACPE)
American Association of Colleges of Pharmacy (AACP)
American Association of Psychiatric Pharmacists (AAPP)
American College of Clinical Pharmacy (ACCP)
American Pharmacists Association (APhA)
American Society of Consultant Pharmacists (ASCP)
American Society of Health-System Pharmacists (ASHP)
Hematology/Oncology Pharmacy Association (HOPA)
National Alliance of State Pharmacy Associations (NASPA)
National Association of Boards of Pharmacy (NABP)
National Association of Chain Drug Stores (NACDS)
National Community Pharmacists Association (NCPA)
National Pharmaceutical Association (NPhA)
Pharmacists' Role in Healthcare:
Pharmacists are medication experts and integral members of the health care team.
Over of physician office visits and hospital emergency room visits involve medication therapy.
Pharmacists provide diverse patient care services in varied practice settings to reduce adverse drug events, improve medication safety, optimize medication use, and enhance overall health outcomes.
Foundational Framework of Pharmaceutical Care Practice:
Developed by Cipolle, Strand, and Morley in , pharmaceutical care practice consists of three core components:
Philosophy of Care: Emphasizes the pharmacist's clinical responsibility to solve medication-related problems and support safe, effective patient medication use.
Patient Care Process: A consistent, structured clinical framework for service delivery.
Practice Management System: Encompasses the physical infrastructure, documentation systems, payment models, and quality improvement structures necessary to deliver effective care.
Evolution and Revisions of the PPCP:
Release: The JCPP released the original Pharmacists' Patient Care Process (PPCP) in May to articulate a uniform framework across all practice settings.
Institutional Adoption: The PPCP was integrated as a required element across pharmacy education and practice:
ACPE Accreditation Standards and Key Elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree ("Standards ", updated June ).
ASHP Accreditation Standard for Postgraduate Residency Programs (updated September ).
ACPE Accreditation Standards for Continuing Pharmacy Education (updated June ).
Validation: Validated via an implementation science approach in the Comprehensive Medication Management (CMM) in Primary Care study (July ).
Revision: Approved by JCPP on May , following work initiated in by the Patient Care Process Workgroup (WG).
Revision Methodology: Utilized a consensus-based modified Delphi method followed by a public comment period. Feedback was analyzed using qualitative methods and evaluated by the WG for incorporation.
Core Drivers of the Update:
Adoption of person-centered terminology.
Heightened focus on health equity, health disparities, and social determinants of health (SDOH).
Accommodation of expanded pharmacist scopes of practice.
Emergence of contemporary care delivery models (e.g., telehealth).
Reinforcement of interprofessional coordination, team-based care, and shared decision-making.
Integration of empirical findings from the CMM in Primary Care study.
PPCP Workgroup Roster
Workgroup Members and Organization Affiliations:
Jan Engle, PharmD, PhD (HON), FAPhA, FCCP, FNAP — Accreditation Council for Pharmacy Education
Kelly R. Ragucci, PharmD, FCCP, FNAP, BCPS — American Association of Colleges of Pharmacy
Miranda Steinkopf, PharmD, BCACP — American Association of Colleges of Pharmacy
Beth DeJongh, PharmD, FAAPP, BCPS, BCPP — American Association of Psychiatric Pharmacists
Amie D. Brooks, Pharm.D., FCCP, BCACP, CAE — American College of Clinical Pharmacy
E. Michael Murphy, PharmD, MBA — American Pharmacists Association
Paria Sanaty Zadeh, PharmD — American Pharmacists Association
Arnold Clayman, PD, FASCP — American Society of Consultant Pharmacists
Avra Thomas, PharmD, MS, BCGP, FASCP — American Society of Consultant Pharmacists
Mary Ann Kliethermes, BSPharm, PharmD, FAPhA, FCIOM — American Society of Health-System Pharmacists
Nicole Watts, PharmD, BCOP — Hematology/Oncology Pharmacy Association
Brooklyn Morgan, PharmD — National Alliance of State Pharmacy Associations
Allie Jo Shipman, PharmD, MBA — National Alliance of State Pharmacy Associations
Donna Wall, MS, RPh, DPh, CHC — National Association of Boards of Pharmacy
Kayla McFeely, PharmD — National Association of Chain Drug Stores
Hannah M. Fish, PharmD, CPHQ — National Community Pharmacists Association
Frank North, PharmD, MPA, DPLA, DASPL — National Pharmaceutical Association
Micah Cost, PharmD, MS, CAE — Pharmacy Quality Alliance
Anne Burns, BSPharm, FAPhA — Project Director, Pharmacy Horizons, LLC
Conceptual Framework and Delivery Mechanisms
Foundational Care Delivery Principles:
Pharmacists establish trusted clinical relationships and foster effective communication with patients, caregivers, support systems, and interprofessional care team members.
Services align with standard of care, scope of practice, and authorizing clinical mechanisms including collaborative practice agreements, statewide protocols, standing orders, and independent prescribing authority.
Applicable across all practice environments and modes of delivery, including in-person encounters and telehealth technologies.
Augmented by modern technological infrastructure that enables documentation and secure interprofessional data exchange (e.g., Electronic Health Records, digital health tools, billing systems conforming to standards such as ONC United States Core Data for Interoperability Version 5, March ).
Core Wheel Architecture:
At the center of the process is Person-Centered Care.
Surrounding the core are three continuous, overarching activities: Collaborate, Communicate, and Document.
The continuous cyclic process comprises five interconnected steps: Collect, Assess, Plan, Implement, and Follow Up: Monitor and Evaluate.
Step 1: Collect
Core Definition:
The pharmacist ensures the collection of necessary subjective and objective information about the patient to understand the relevant medication and medical history, overall health status, and other pertinent factors.
Information is gathered and verified from multiple sources, including the patient, caregiver, clinical observations, existing medical records, and other health care professionals.
Specific Actions and Elements Collected:
Patient-Centered Factors: Health concerns, patient priorities, personal health goals, lifestyle factors, personal beliefs, preferences, cognitive and functional status, and social determinants of health (SDOH) affecting health outcomes.
Medication Profile: Current active medication list and comprehensive past medication history covering prescription medications, nonprescription (over-the-counter) drugs, and other health products with therapeutic implications.
Medical & Pharmacotherapeutic Data:
Medical problem lists and history.
Physical assessment findings.
Documented allergies and adverse drug reaction intolerances.
Immunization history.
Vital signs and clinical laboratory values.
Genomic / pharmacogenomic data.
Clinical progress notes.
Diagnostic test results, diagnostic imaging, medical device data, and readings from digital health tools.
Care Coordination Details: Patient demographic details, health insurance and coverage information, and contact information for all active members of the patient's care team.
Step 2: Assess
Core Definition:
The pharmacist assesses the collected information to identify and prioritize patient needs to inform the establishment of a care plan, evaluated in the context of new and existing health goals.
Specific Actions and Assessment Categories:
Medication Therapy Assessment:
Evaluates each individual medication for indication, appropriateness, effectiveness, safety, interactions, tolerability, financial cost, physical/financial access, convenience, and regimen adherence.
Identifies medication therapy problems (MTPs) and medication-related needs using standard frameworks (such as the Pharmacy Quality Alliance MTP Categories Framework).
Medical Problem Assessment & Diagnosis:
Assesses existing medical conditions and identifies new medical problems.
Performs clinical diagnosis consistent with state and professional scope of practice (e.g., diagnosing self-care conditions, MTPs, or conditions evaluated via point-of-care diagnostic testing).
Evaluates necessity for therapeutic intervention, disease resolution, or specialist referral.
Social & Systemic Factors: Evaluates social determinants of health (SDOH), cultural considerations, and individual health literacy levels to detect barriers and opportunities for targeted intervention or community referral.
Preventive Care Assessment: Identifies preventive care and health-wellness needs, including necessary medications, immunizations, health screenings, and wellness education.
Goal Formulation: Formulates person-centered, evidence-based goals of care.
Step 3: Plan
Core Definition:
The pharmacist develops a person-centered, evidence-based, cost-conscious care plan in partnership with the patient and/or caregiver, and in coordination with other care team members.
Specific Action Steps:
Regimen Optimization: Addresses and resolves prioritized medication therapy problems (MTPs) and medication needs to optimize pharmacotherapy.
Comprehensive Care Integration: Incorporates prioritized medical conditions, lifestyle modifications, preventive health interventions, and interventions targeting social determinants of health.
Care Continuity & Transitions: Integrates continuity-of-care mechanisms, safe and timely care transitions across settings, formal referrals, scheduled follow-up encounters, and specific clinical monitoring parameters.
Alignment & Agreement: Engages the patient and/or caregiver to confirm thorough understanding of and explicit agreement with the proposed care plan and therapeutic goals.
Step 4: Implement
Core Definition:
In providing person-centered care, the pharmacist implements a prioritized care plan in partnership with the patient and/or caregiver and in coordination with other care team members.
Specific Implementation Actions:
Medication Prescribing & Administration: Takes direct action to resolve MTPs by initiating, continuing, modifying, discontinuing, dispensing, administering, and/or prescribing medications consistent with clinical scope of practice.
Diagnostic & Monitoring Tool Ordering: Orders and/or performs point-of-care laboratory tests and supplies home health monitoring equipment consistent with scope of practice.
Holistic Interventions: Executes tailored interventions addressing medical problems, lifestyle modifications, preventive care plans, and SDOH support.
Patient Empowerment & Education: Provides personalized patient/caregiver education, an accurate updated medication list, and actionable self-care strategies.
Coordination of Services: Schedules follow-up care appointments, initiates referrals to interprofessional care team members, and connects patients to supportive community resources.
Interprofessional Communication: Communicates care details to relevant interprofessional team members and thoroughly documents all care provided in clinical recording systems.
Step 5: Follow Up: Monitor and Evaluate
Core Definition:
The pharmacist follows up to monitor and evaluate the implementation of the care plan and the patient's overall health in collaboration with the patient, caregiver, and other care team members, as needed.
Specific Actions:
Outcome Evaluation: Monitors and evaluates clinical outcomes resulting from the care plan.
Progress Tracking: Evaluates progress toward achieving person-centered goals, resolving active MTPs and medication needs, and optimizing overall health.
Iterative Care Loop: Re-enters and continues the Pharmacists' Patient Care Process iteratively to address new or persistent health and medication needs.
Glossary of Terminology
Caregiver:
A person who provides support and assistance with various activities to a family member, friend, or neighbor.
Caregiving may be delivered in person or from a distance through emotional, financial, or direct hands-on assistance.
Cost-Conscious:
The pharmacist's active consideration of a medication's clinical effectiveness, total cost (to both the patient and the healthcare system), and accessibility.
Involves informed clinical decision-making regarding drug selection, dosage, and therapy duration to ensure pharmacotherapy is appropriate, affordable, and accessible.
Diagnosis:
The act or process of identifying or determining a disease, condition, or problem through systematic evaluation of patient history, physical examination, and laboratory/diagnostic data, consistent with the pharmacist's scope of practice.
Evidence-Based Practice:
The conscientious and judicious integration of current best empirical research evidence with clinical expertise and individual patient values to guide healthcare decision-making.
Lifestyle Factors:
Adaptable behaviors and daily habits that influence individual health and overall well-being, including nutrition, physical activity, and substance use (e.g., nicotine, alcohol, cannabis, and other substances).
Medication History:
A comprehensive record of all prescription and nonprescription medications and other health products with potential therapeutic impact (including herbal remedies, dietary supplements, complementary/alternative therapies, and illicit drugs) currently or previously taken by the patient.
Contains drug name, dose, route of administration, frequency, indication, duration, reasons for initiation or discontinuation, historical adherence, adverse events, allergies, intolerances, and reported financial or physical access barriers.
Medication Optimization:
A person-centered approach to safe and effective medication use ensuring individuals attain the optimal outcomes from pharmacotherapy.
Achieved by making necessary adjustments and improvements to both the medication regimen itself and the patient's medication-taking behaviors.
Person-Centered Care:
The delivery of healthcare services in ways that are deeply respectful of and responsive to individual preferences, needs, and personal values.
Guarantees that care recipients or their designated advocates actively participate in clinical decision-making.
Pharmacotherapeutics:
The branch of medical science focused on the use of medications to treat, manage, and prevent disease.
Combines principles of drug action (pharmacodynamics and pharmacokinetics), genomics, therapeutic objectives, and patient-specific factors to optimize medication regimens for clinical success.
Prescribing:
The formal authorization of the use of a medication, treatment, or medical device, performed consistent with a pharmacist's defined legal and professional scope of practice.
Quality Health Care:
The degree to which health services provided to individuals and populations increase the likelihood of desired health outcomes, aligned with evidence-based professional standards.
Characterized by seven core dimensions: services must be effective, safe, person-centered, timely, equitable, integrated, and efficient.
Self-Care:
The capability of individuals, families, and communities to promote health, prevent disease, maintain wellness, and cope with illness or disability with or without health provider support.
Positions individuals as active agents managing health promotion, disease control, self-medication, care for dependents, rehabilitation, and palliative care.
Social Determinants of Health (SDOH):
Nonmedical factors that significantly influence health outcomes, encompassing the conditions in which people are born, grow, live, work, worship, and age.
Shaped by broader economic policies, development agendas, social norms, social policies, and political systems.
Standard of Care:
The degree of care, skill, and diligence that a prudent and reasonable licensed or registered healthcare professional with similar education, training, and experience would exercise under similar clinical circumstances.