Sunday, April 29, 2012

CLINICAL PHARMACIST-CHANGE FROM PRODUCT FOCUSSED SERVICE TO PATIENT CENTERED APPROACH


CLINICAL PHARMACIST-CHANGE FROM PRODUCT FOCUSSED SERVICE TO PATIENT CENTERED APPROACH

Pharmaceutical care is, the responsible provision of drug therapy for the purpose of achieving definite outcome that improve or maintain a patient's quality of life
                        For years, there is a trend for pharmacy practice to move away from its original focus on medicine supply towards a more inclusive focus on patient care. His role is changed from a compounder and supplier of pharmaceutical product to some one  that of a provider of services and informations on pharmaceutical products and to improve patient care. The pharmaceutical industry in India is growing at a rapid rate with its new medicines are being introduced. Very often with the ever evolution of medicines, for the better treatment output, the pharmacist must respond positively to health service changes.  He must contribute all his efforts by ensuring that prescriber's intensions are translated into safe, effective and economic use of medicines, so that maximum benefit is available for the patient from their treatment.
Demographic and epidemiological changes, challenges of ageing populations, changes in the disease profile and pattern have imposed demands  in health service provision. Along with this the advancements in the technology, scientific breakthroughs, and development in the medical field which must be adopted by the hospital for the better patient care, changed the role and responsibility of clinical pharmacist.
            Complications of medical management is more in hospital set up, as hospital pharmacist work with doctors, nurses and other health care professionals. So in a patient oriented service  the hospital pharmacist, has to do  the following duties.
1.      The patients from various backgrounds may not ask all the aspects of medication to the doctors. In such cases the pharmacist should be approachable. He can provide more assistance and would be able to advise on administration of medicine with dose, frequency, contraindications, possible side effects, when to be taken, how long to be taken, special storage condition if any etc. Such enquiries from other health care department also can be handled by the clinical pharmacist.
2.      All medicines have side effects, and some of them are known, while many are still unknown, even though those medicines may have been in clinical use for several years. Rapid introduction of new chemicals to the market made difficulty in monitoring ADR. Since ADR reduces the therapeutic output and arises some economic burden to the patient, there is a need to train our hospital pharmacists in a well structured manner to build synergies for monitoring ADR. Many of the hospital pharmacy department follows the programme. This helps in improving treatment outcome.
3.      The changing responsibilities of hospital pharmacist include prescription analysis/audit, which is helpful to analyze and report use and misuse of drugs in the hospital. Irrational use of antibiotics, which is the major reason for antibiotic resistance, drug-drug interactions in the prescription can be properly analyzed and rectified. A modern pharmacist is always alert about the prescriptions. When judging the appropriateness of the prescription other factors also come in to play, including the effectiveness of the drug, its cost, and the effect on quality of life of the patient.
4.      Education of the patient and other health professionals is another key role of the hospital pharmacist. Medicines are changing and developing all the times and pharmacist need to  keep constantly an update on changes in the use of medicines as well as keep a tab on new medicines which have been launched.
       So the hospital authority should have the responsibility to update their hospital pharmacist with latest happenings and improvements in the field of hospital pharmacy practice. The innovations that come with technological advances require the adaptations of health system and enhancement of pharmacist knowledge base. The hospital adopts a practical approach that is based on National Accreditation Board for hospitals and Health care providers (NABH) standards. This helps in building confidence and improving commitment of the pharmacist towards compliance to NABH criteria, there by improving the efficiency of pharmacy services. The hospital can make use of the services of the pharmacist in wards. Along with ward pharmacy services, the pharmacist can attend ward rounds and can make suggestions on initiation, alteration, and ending of treatment. This does have other advantages in helping pharmacist to understand complexities of therapeutic decision making and in helping clinicians to consider wider aspects of drug treatment.

Therapeutic drug level monitoring, helps in reporting the concentration of drug in blood using pharmacokinetic calculations to recommend a new dose and frequency. This can be practiced as a part of pharmacy services. Unfortunately all these activities are largely undocumented and unrecognized.
All these show that the pharmacy practice has moved from historical orientation of product focused service to patient oriented approaches and enhanced the treatment output.

            Linu Mohan.P. Sr.Lecturer
            Dept. of Pharmacy Practice
            Al Shifa College Of Pharmacy
            Perinthalmanna, Malappuram,                                     linupanakkal@gmail.com

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