Introduction to Clinical Pharmacy 2

8/3/2019 Introduction to Clinical Pharmacy 2

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Introduction to Clinical

Pharmacy


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Clinical Pharmacy

Pharmacy service that isfocused on the patient rather

than a product (the prescription).


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Focus of Practice

Selling a product

Patient care


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Clinical PharmacyDrug Information

Hospital practice

Clinic Practice

Clinical research

Clinical education

Pharmaceutical Industry


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Pharmaceutical CareIdentification, resolution, and prevention of drug-

related problems.

Untreated indications

Improper drug selection

Subtherapeutic dosage

Failure to receive drugs

Overdosage

Adverse drug reactions

Drug interactions

Drug use without indication


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Areas ofF

ocus for ClinicalPharmacy Efforts

Patient counselingDisease management

Medication safety

Drug Policy Management

Clinical research


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Common Diseases for Clinical

Pharmacy Services

Diabetes

Hypertension

Hyperlipidemia

Infectious diseases

Asthma

Cancers


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What Clinical Pharmacists Do

Provide direct patient care

Support physicians and nurses

Write drug policies / formularies

Conduct research

Review and evaluate drug use


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Clinical Pharmacy Services

The patient who comes to your pharmacy

Recommend the most appropriate non-prescription

medication for the patients condition.

Check to see if there are any interactions with other

drugs.

Assure there are no disease or allergy

contraindications

Provide recommendations for how to

take the medication.

Provide information about the drug

or disease.


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The patient in the hospital

Perform medication history. Check to see that the drug dosage is appropriate.

Check patient allergies.

Provide medication counseling before the patientleaves the hospital.


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The Hospital

Evaluate published studies to determine

which drugs should be used (Formulary)

Answer drug information questions from

physicians and nurses.

Perform reviews of medication use

(drug use evaluation)

Write guidelines for drug use


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The Community

Offer disease screening (diabetes,osteoporosis, hyperlipidemia, hypertension)

Offer lectures to community groups.

Provide immunizations. Patient counseling.


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Medical College of Georgia


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The Medical College of Georgia Teaching hospital for the State of Georgia

Medical, nursing, dental schools.

Associated with University of Georgia College of

Pharmacy.

500 hospital beds, many clinics, trauma center

Separate pediatric hospital 23 pharmacists, 45 pharmacy technicians


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Clinical Pharmacy in Augusta,

Georgia, USA

Drug Information Center

Renal transplantation service

Oncology

Pediatrics

Intensive care unit

Anticoagulation clinic

Emergency room


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Answer questions from physicians and

nurses.

Review clinical studies on new drugs.

Recommend drugs to add to hospital

formulary.

Conduct drug safety reviews.


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DrugF

ormulary A selected list of drugs that are

recommended for use in a health care

system. Most hospitals, government systems, and

insurance companies have formularies.

Should be based on evidence that theselected drugs are more effective, safer,

or less expensive.


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Promote Medication Safety

Design prescribing, drug dispensing,

and drug administration systems that

reduce the chance of errors.


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Clinical Pharmacist in Surgery Rounds with surgery team

Assist with antibiotic selection

Write policies for antibiotic use

Pharmacokinetic dosing

Design parenteral nutrition regimens

Pain assessment and analgesic recommendations

Provide drug information

Patient counseling


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Renal Transplant Service Assist in dosage adjustment

for immunosuppressants

(such as cyclosporine)

Manage other chronic

diseases (diabetes,

hypertension, hyperlipidemia)

Review drug regimens.

Patient counseling and

compliance monitoring.


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Oncology Assure safety of cancer

drug treatments.

Provide drug information tophysicians and nurses.

Provide information and

counseling to patients.

Assist with clinical studies.


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Anticoagulation Clinic See patients after referred by physician.

Monitor coagulation tests (such as prothrombin

time). Check for adverse effects (bleeding).

Provide education to patients.

Encourage compliance.


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Pediatrics

Assist with determining the

best dosage and route of

administration.

Create policies for drug use

in children.

Provide drug information tophysicians.


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Intensive Care Service

Trauma service and Medical Intensive Care

Rounds with intensive care teams.

Review drug regimens.

Pharmacokinetic dosing.


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New Clinical Pharmacy Areas

in Georgia

Wellness Clinic (disease screening)

Immunization programs

Disease management

Clinical drug study management

Medication Access Program


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Wellness Clinic

Disease screening (hypertension, diabetes,

osteoporosis, hyperlipidemia)


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Wellness Clinic

Medication counseling for patients

Immunizations

Smoking cessation


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Clinical Pharmacy ResearchPrinciple investigator or Co-investigator with

physicians

Pharmacokinetic studies

Clinical efficacy trials

Pharmaco-epidemiology

Pharmaco-economics

Post-marketing safety studies

Quality of life / patient satisfaction studies


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Trends in Pharmacy Automation of prescription dispensing

function

Increasing drug costs

Greater need for drug information and

assessment

New drugs based on biomedical discoveries

Patient concern for drug safety


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Other Important TrendsAging of the population.

Greater use of medications for chronicdisease.

Introduction of new, expensive medications

Shortage of physiciansIncreasing authority of nurses, physician

assistants, and psychologists.


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W

ho Hires Clinical Pharmacists?Hospitals

Community Pharmacies

Drug Companies

Physician groups

Federal government

Insurance companies


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Documented Benefit of

Clinical Pharmacists

Decrease drug costs

Decrease drug adverse effects

Reduce mortality in hospitalized

patients

Introduction to Clinical Pharmacy 2

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