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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