Pharmaceutical Care Plan (PCP) Process

Pharmaceutical care plan (PCP) is a patient - centered systematic approach. Clinical pharmacists design a written format to ensure proper drug use, achieve a definite outcome and improve patient care through assuring the safety, effectiveness and cost-effectiveness. It was originally framed by Dr. Linda M. Strand and her colleagues at the University of Minnesota in the early 1990's.

Pharmaceutical care plan

Goals Of Pharmaceutical Care Plan

The pharmaceutical care plan is a written, individualised, comprehensive medication therapy plan based on clearly defined therapeutic goals. It is updated with every change in patients status and shared with the physician and patient. It is a systematic, comprehensive process with three primary functions or goals:

1. Identify a patient's actual and potential drug-related problems.

2. Resolve the patient's actual drug-related problems.

3. Prevent the patient's potential drug-related problems.

Development of Goals of Therapy

There is a standard for each of the activities in the care plan. The pharmacist identifies goals of therapy that are patient-centered. The first of these follows measurement criteria:

1. Goals of therapy are established for each indication managed with drug therapy.

Read Also: Patient Interview In Pharmaceutical Care (PC)

2. Desired goals of therapy are described in terms of the observable or measurable clinical and/or laboratory parameters to be used to evaluate effectiveness and safety of drug therapy.

4. Goals of therapy are mutually negotiated with the patient and other health care practitioners when appropriate.

5. Goals of therapy are realistic in relation to the patient's present and potential capabilities.

6. Goals of therapy include a time frame for achievement.

Expected Outcomes

- Cure of a specific disease

- Alleviation or minimization of a patient’s symptoms

- Arresting or slowing disease progression

- Preventing a disease or symptoms

Steps In Creating A Pharmaceutical Care Plan

A. Establishment of a comprehensive patient database:

1. Patient demographics (age, sex, height, weight,…..)

2. Diagnoses and past medical history

3. Present medications and medication history

4. Medication allergies/intolerances

5. Smoking/alcohol/caffeine/drug use history

6. Abnormal laboratory and physical exam results

7. Renal and liver function

Read Also: Definition Of Pharmaceutical Care (PC)

B. Determining the actual and potential drug-related problems: Assess the actual problem using SOAP format data:

S: Subjective: patient’s chief complaint or why came to hospital

O: Objective: traceable facts as vital signs, laboratory results, blood pressure

A: Assessment: the medical diagnosis on the given date

P: Plan: treatment plan including drugs, lab orders, referrals,…     

1. Assess the patient for drug-related problems. Drug related problems are untreated indication, improper drug selection, sub-therapeutic dosage, failure to receive medications, overdosage, adverse drug reaction, drug interaction and medication use without indication

2. Determine whether drug-related problems are being treated.

3. Determine whether current drug therapy is appropriate.

4. Determine whether additional drug therapy is needed.

5. Determine if any of the drug-related problems may have been caused by medication.

C. Development of therapeutic goals: Therapeutic goals must be developed for each problem. Goals should be definite, realistic, and measurable if possible. Therapeutic goals mostly related to:

1. Approach normal physiology (i.e., normalize blood pressure).

2. Slow progression of disease (i.e., slow progression of cancer).

3. Alleviate symptoms (i.e., optimize pain control).

4. Prevent adverse effects

5. Control medication costs.

6. Educate the patient about his or her medication.

D. Identifying monitoring parameters with end points and frequency: The monitoring parameters must be specified to determine if the patient is progressing. Also, potential adverse effects must be established. The goal of each parameter and the frequency must be established to estimate the therapeutic intervention.

Read Also: How Doctors Write Medical Prescription Of Drugs For Pharmacist

E. Evaluation and reassessment: Clinical pharmacists need to review the database and medical care plan on a regular basis, to re-prioritize patient’s problems and required intervention. Check the patient data and therapeutic goal to determine if the care plan is achieving its set objective. If yes, continue. If no, reevaluate the plan and set new plans and goals.

Documentation Of Pharmaceutical Care Plan

They said if the pharmaceutical care plan is not documented, it never happened. Documentation of the care plan shows the relationship between the goals of therapy and the interventions made to achieve the goals.