Principles Of Practice For Pharmaceutical Care (PC)

Pharmaceutical Care is a patient-centered, outcomes oriented pharmacy practice that requires the pharmacist to work in concert with the patient and the patient's other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. The goal of Pharmaceutical Care is to optimize the patient's health-related quality of life, and achieve positive clinical outcomes, within realistic economic expenditures.

Pharmaceutical care practice principles

Principles Of Pharmaceutical Care

To achieve this goal, the following must be accomplished:

A Professional Relationship Must Be Established And Maintained

A relationship based upon caring, trust, open communication, cooperation, and mutual decision making is established and maintained between pharmacist and patient. The pharmacist holds the patient's welfare paramount, maintains an appropriate attitude of caring for the patient's welfare, and uses all his/her professional knowledge and skills on the patient's behalf. On the other hand, the patient gives personal valuable health information and preferences and participates in the therapeutic intervention plan.

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Patient-specific Medical Information Must Be Collected, Organized, Recorded, And Maintained

Pharmacists must collect and/or generate subjective and objective information regarding the patient's general health and activity status, past medical history, medication history, social history, diet and exercise history, history of present illness, and economic situation (financial and insured status). Sources of information may include, but are not limited to, the patient, medical charts and reports, pharmacist-conducted health/physical assessment, the patient's family or caregiver, insurer, and other healthcare providers including physicians, nurses, mid-level practitioners and other pharmacists. Since this information will form the basis for decisions regarding the development and subsequent modification of the drug therapy plan, it must be timely, accurate, and complete, and it must be organized and recorded to assure that it is readily retrievable and updated as necessary and appropriate.

Patient information must be maintained in a confidential manner.

Patient-specific Medical Information Must Be Evaluated And A Drug Therapy Plan Developed Mutually With The Patient

Based upon a thorough understanding of the patient and his/her condition or disease and its treatment, the pharmacist must, with the patient and with the patient's other healthcare providers as necessary, develop an outcomes-oriented drug therapy plan. The plan may have various components which address each of the patient's diseases or conditions. In designing the plan, the pharmacist must carefully consider the psycho-social aspects of the disease as well as the potential relationship between the cost and/or complexity of therapy and patient adherence. As one of the patient's advocates, the pharmacist assures the coordination of drug therapy with the patient's other healthcare providers and the patient. In addition, the patient must be apprised of (1) various pros and cons (i.e., cost, side effects, different monitoring aspects, etc.) of the options relative to drug therapy and (2) instances where one option may be more beneficial based on the pharmacist's professional judgement. The essential elements of the plan, including the patient's responsibilities, must be carefully and completely explained to the patient. Information should be provided to the patient at a level the patient will understand. The drug therapy plan must be documented in the patient's pharmacy record and communicated to the patient's other healthcare providers as necessary.

The Pharmacist Assures That The Patient Has All Supplies, Information And Knowledge Necessary To Carry Out The Drug Therapy Plan

The pharmacist providing Pharmaceutical Care must assume ultimate responsibility for assuring that his/her patient has been able to obtain, and is appropriately using, any drugs and related products or equipment called for in the drug therapy plan. The pharmacist must also assure that the patient has a thorough understanding of the disease and the therapy/medications prescribed in the plan.

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The Pharmacist Reviews, Monitors, And Modifies The Therapeutic Plan As Necessary And Appropriate, In Concert With The Patient And Healthcare Team

The pharmacist is responsible for monitoring the patient's progress in achieving the specific outcomes according to strategy developed in the drug therapy plan. The pharmacist coordinates changes in the plan with the patient and the patient's other healthcare providers as necessary and appropriate in order to maintain or enhance the safety and/or effectiveness of drug therapy and to help minimize overall healthcare costs. Patient progress is accurately documented in the pharmacy record and communicated to the patient and to the patient's other healthcare providers as appropriate. The pharmacist shares information with other healthcare providers as the setting for care changes, thus helping assure continuity of care as the patient moves between the community setting, the institutional setting, and the long-term care setting.