Pharmaceutical Care Module

Part I
Direct Patient Care Practice:
An Overview
Lalitha Raman-Wilms, PharmD, FCSHP
Associate Professor
Leslie Dan Faculty of Pharmcacy,
University of Toronto

Section I Overview of Practice

Part I

Part II

Direct Patient Care

Practice:
An Overview

Practitioner
Requirements to
Practice, including
the Patient Care
Process

Part I - Learning Objectives

At the end of this session, students will be able to:
Demonstrate an understanding of the evolution
of pharmacy practice
List key elements of a patient care practice (for
any health profession)
List the primary focus and responsibility of a
pharmaceutical care practitioner
List the practitioner requirements for a patient
care practice

Evolution of Pharmacy Practice

1930s and 1940s: compounding;
preparing drugs
1950s: dispensing of medications
1960s: Patient Counselling; Clinical
Pharmacy in hospital setting
1990s: Pharmaceutical Care defined
direct patient care provided by
pharmacists
Ongoing practice and research in this area

Pharmaceutical Care Practice

Packaging
of product;
dispensing
mechanisms

Pharmacy Technician

Pharmacist
Ensure patients
drug therapy problems
are identified & resolved

Work with
other HCPs

Patient Education

Documentation
in medical record
Drug Product

GOOD DISPENSING
PRACTICES

PATIENT

DRUG INFORMATION
SYSTEMS,
THERAPEUTIC DRUG
MONITORING, etc

Develop new
Practices
Sustainable
Business
Model
KNOWLEDGE &
SKILLS

A Patient Care Service

Involves a patient and a qualified practitioner
Requires a face-to-face encounter
Practitioner takes responsibility for patients
needs, the specific interventions carried out
and the patients outcomes
Service provided must be consistent and
comprehensive
Practitioner assess each patients needs,
develops a care plan to meet these needs
and follows-up to evaluate the outcomes
Slide used with permission from Dr. L.Strand

Health Care Needs of a Patient

Nursing
Care
Geriatric
Care

Mental Health
Care

Medical
Care

PATIENT
SELFCARE

Pharmaceutical
Care

Dental
care

Eye
Care
Pediatric
Care

Medication Use System

SYSTEM LEVEL
What is best for society?
(Health Care Policy, Regulation, Legislation)
INSTITUTIONAL LEVEL
What is best for an organization, institution, disease
state?
(formulary, DUE, DUR, protocol)
PATIENT LEVEL
What is best for a patient?
Pharmaceutical Care
Slide used with permission from Dr. L.Strand

Knowledge and skills required to

practise Pharmaceutical Care
Primary Focus

Identifying and meeting a patients drug-related

needs
Knowledge Base - Pharmacotherapy
Skills patient care requires a lot of practise
Attitude a caring approach
Responsibility - Identification, prevention, and
resolution of drug therapy problems

Pharmaceutical Care
Pharmaceutical care is a patient-centered
practice in which the practitioner
assumes responsibility for a patients
drug-related needs and is held
accountable for this commitment.1

1Cipolle,

R.J., Strand, L.M., Morley, P.C. (2004).

Pharmaceutical Care Practice: The Clinicians Guide
New York: McGraw Hill.

Patient Care
Process

Patient

Experience

Medication
Responsibilities

Care Plan

Pharmacotherapy
Workup

Todays wants
and needs

Practitioner

Assessment

Follow-up
Evaluation

Philosophy of Practice
Social Obligation
Responsibilities
Patient-centered
approach

Therapeutic Relationship
This slide, used with permission, from Dr. L. Strand.

Caring

Practitioner Requirements
Philosophy of Practice
Professional / Therapeutic Relationship with
Patient
An understanding of the Patients Medication
Experience
Systematic Thought Process: Pharmacotherapy Workup and Patients Drug
Therapy Problems
Patient Care Process
Documentation System
Reimbursement System

Part I Overview
Evolution of pharmaceutical care practise
Key elements of a patient care practice
Role of the pharmacist in providing
pharmaceutical care
The three components of the Patient Care
Process
New Terminology