Role of Clinical pharmacist Prof.Dr/ Alaa Osman general surgery and surgical oncolgy
Definition
Clinical pharmacy is a health science field in which pharmacists provides patient care that optimizes medication therapy and promotes health, wellness and disease prevention. clinical pharmacists assume responsibility and accountability for managing medication therapy in a direct patient care setting whether practicing independently or in consultation or collaboration with other health care professionals.
Clinical Pharmacy Requirements for Patient care
Knowledge of drug therapy
Knowledge of non- drug therapy
Therapeutic planning skills A
Drug information skills
Physical assessment skills
Patient monitoring skills
Communication skills
Knowledge of laboratory and diagnostic skills
Knowledge of disease
Activities of Clinical Pharmacists
The principle activities of a clinical pharmacist include: Consulting Analysing therapies, advising health care practitioners on the correctness of drug therapy and providing pharmaceutical care to patients both at hospital and at community level. Selection of drugs Defining "drug formularies" or "limited lists of drugs" in collaboration with hospital doctors, general practitioners and decision makers. Drug information Seeking information and critically evaluating scientific literature; organising information services for both the health care practitioners and the patients.
Activities of Clinical Pharmacists cont’ •
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Medication Review Review medication chart, Review medication history Attending Rounds
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Drug use studies and research collecting data on drug therapies, their costs and patient outcome through structured and scientific methods. Pharmacokinetics/ therapeutic drug monitoring Studying the kinetics of drugs and optimising the dosage. Clinical Trials Planning, evaluating and participating in clinical trials
Activities of Clinical Pharmacists cont’ Clinical pharmacist researchers generate, disseminate, and apply new knowledge that contributes to improved health and quality of life. Within the system of health care, clinical pharmacist are experts in the therapeutic use of medications. Clinical pharmacists are primary source of scientifically valid information and advice regarding the safe, appropriate and cost effective use of medication. Clinical Pharmacy Practice areas Casuality care Critical care Drug Information Geriatrics and long –term care Internal medicine and subspecialties Cardiology
Endocrinology Gastroenterology Infectious disease Neurology Nephrology Obstetrics and gynecology Pulmonary disease Psychiatry Rheumatology Nuclear pharmacy Nutrition Pediatrics Pharmacokinetics Surgery Ward pharmacy •
Ward pharmacy has been defined as a system where the pharmacist visit ward regularly to monitor for completeness and accuracy of prescriptions, is available for consultation by medical and nursing staff and ensure that the drug distribution system is operating correctly.
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It enables pharmacists to offer advice and suggestions at the time prescribing decision are made.
Relationship between physician and pharmacist One of the most important aspects of practice for clinical pharmacists is their relationship with medical practitioners. Good collaborative relationships with medical profession depend on mutual respect, and on the pharmacist demonstrating clearly their commitment to the welfare of patients under the physician’s care. Specialist clinical pharmacy •
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Specialist clinical pharmacists have the opportunity to strengthen relationships with specialist medical practitioners in their fields by providing a high clinical support and specialized drug information through evidence based documents. Such attachments often happened because of the wish of the medical or surgical head of the unit to have a pharmacist on the team to assist in educating both patients and junior medical staff, and to act as a resource person for more general therapeutic information in very specialized setting.
Specialist clinical pharmacy
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Checking and monitoring patients’ prescriptions on hospital wards is frequently the starting point for monitoring and in most hospital
wards the prescription card and clinical observation charts (tempreture, pulse rate, blood pressure and so on) are typically kept at the end of the patients’ bed. Specialist clinical pharmacy
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The prescription is reviewed for the medication dosing errors, appropriateness of administration route, drug interaction, prescription faults, inappropriate prescribing and many other potential problems. Specialist clinical pharmacy
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Patients can be questioned on their medication histories, including allergies and intolerances, efficacy of prescribed treatment, sideeffects and adverse drug reactions (ADRs). The pharmacist then communicates his or her conclusions to the medical team in a clear and logical manner. Patient education
Helping patients to understand their medicines and how to take them is a major feature of clinical pharmacy In addition to providing face to face education and counseling on medicines, clinical pharmacists can also help patients by contributing to the preparation of written material and the audiovisual demonstration, or by using computer programs
Therapeutic drug monitoring
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Clinical pharmacist must understand the role of the laboratory monitoring can play in both the diagnosis of the disease and the monitoring of drug therapy. Therapeutic drug monitoring (TDM) has made both easier and safer to use drugs of narrow therapeutic index. However it needs to be remembered that many of the drugs for which TDM is used to guide dosing, can be used effectively and safely by the experienced clinician who do not have access to modern laboratory facilities.
Clinical audit ( scientific activities) •
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Clinical audit play an important role in patient care: it brings together professionals from all sectors of healthcare to review clinical evidence, promote education and research, develop and implement clinical guidelines, enhance information management skills and contribute to better management of resources- all with aim of improving the quality of care of patient Clinical pharmacist can be involved in many different types of audit. These may range from topics including audit of clinical services themselves (for example, clinical pharmacy intervention) or may examine which treatment are used and how they are included within the framework of drug use evaluations.
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