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Pharmacy Practice

Lecture (1)

By Prof. Yahya El-emam

18-2-2018
• Over the past four decades there has been a
trend for pharmacy practice to move away
from its original focus on medicine supply
towards a more clinical focus on patient care.
• The role of the pharmacist has evolved from
that of a compounder and supplier of
pharmaceutical products towards that of a
provider of services and information and
ultimately that of a provider of patients care.
• Increasingly , the pharmacist task is that the
patient drug therapy is :
1) Appropriately indicated.
2) The most effective available.
3) The safest possible.
4) Convenient for the patient.
• The new approach has been given the name
pharmaceutical care . The most generally
accepted definition of this new approach is:
• “pharmaceutical care is responsible provision
of drug therapy for the purpose of achieving
definite outcomes that improve or maintain a
patients quality of life
• In order to fulfill this obligation, the
pharmacist need to be able to assume many
different functions.
• The concept of the seven-star pharmacist
introduced by WHO sees the pharmacist as a:
• Care giver , communicator. Decision-maker,
teacher , life-long learner, leader , and
manager.
• Definition:
• Patient Counseling may be defined as
providing medication information orally or in
written form to the patient or their
representative or providing proper directions
of use, advice on side effects ,storage, diet and
lifestyle modifications.
• The importance of patient counseling:
• Patient counseling is a critical component of
the dispensing process, in order to ensure that
the patient receives and understand
important information such as the name of
the drug and the purpose of the medication.
• Patient counseling also provide a key
opportunity to identify potential dispensing
errors.
• Dispensing errors contributing factors:
1. Poor physician hand writing.
2. Failure to check the patient medication
history.
3. Assuming that the patient had take the
medication before.
4. Failure to check the prescribed dosages for
appropriateness.
• Counseling steps:
1) Introduce yourself as a pharmacist , explain
the purpose and expected length of the
session and obtain the patient agreement to
participate.
2) Assess the patient knowledge about his or
her health problems and medications,
physical and mental capability to use the
medication appropriately.
• Asked the patient to describe or show how he or
she will use the medication.
Patient returning for refill medications:
i. should be asked to describe or show how they
have been using their medications.
ii. They should also be asked to describe any
problems, concerns or uncertainties they are
experiencing with their medications.
3) Provide information orally and use visual aids
or demonstrations to fill patient's gaps in
knowledge and understanding.
• Open the medication container to show the
patient the colors, sizes shapes, and markings
on oral solids. For oral liquids and injectables ,
show the patients the dosage marks on
measuring devices.
• Demonstrate the assembly and use of
administration devices such as nasal and oral
inhalers.
As a supplement to face-to-face oral
communication, provide written handouts to
help the patient recall the information
4) Verify patient's knowledge and
understanding of medication use.
• Prime questions approach:
Three essential questions form the foundation
for the medication consultation. Each of these
questions probes the patients knowledge of a
specific area of comprehension needed.
• 1) What did the doctor tell you what the
medication was for?
• This question allows the pharmacist to prompt
the patient to discuss the purpose of the
medication in regards to:
• What it is supposed to do.
• What problems or symptoms it is supposed to
help.
2) How did the doctor tell you to take the
medication?
This question promotes discussion of how to use
the medication. Concerns that can be addressed
include:
How often the medication should be taken.
How much is to be taken and for how long.
What to do if a dose is missed.
3) What did the doctor tell you to expect?
This question allows the patient to discuss
expectations about the medication including:
• Good and bad effects.
• What precautions need to be taken.
• How to know if the medication is working.
• What should be done if there is a bad
reaction.
• if the patient does not know the answer to
any of these questions the pharmacist should
fill in the gaps with specific information before
moving on to the next essential question.