Outline • Define clinical pharmacy • Differentiate between pharmacy and clinical pharmacy. • Explain the qualification required for clinical pharmacists • List clinical pharmacists competencies
Definition of Clinical Pharmacy • Clinical pharmacy is defined as that area of pharmacy concerned with the science and practice of rational medication use. ACCP, Pharmacotherapy 2008;28(6):816–817
The Detailed DefinitionImportant Aspects • Clinical pharmacy is a health science discipline in which pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention. ACCP, Pharmacotherapy 2008;28(6):816–817
The Detailed DefinitionImportant Aspects • The practice of clinical pharmacy embraces the philosophy of pharmaceutical care • “Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve or maintain a patient’s quality of life”. • This calls attention to the fact that the primary object of practice and research is ultimately the patient
The Detailed DefinitionImportant Aspects • Clinical pharmacy also has an obligation to contribute to the generation of new knowledge that advances health and quality of life. • This means that in addition to optimizing therapy and promoting patient health, clinical pharmacy must also be engaged in research.
The Detailed DefinitionImportant Aspects • The clinical pharmacist cares for patients in all health care settings • This emphasizes two points: • that clinical pharmacists provide care to their patients (i.e., they don’t just provide clinical services), and • that this practice can occur in any practice setting • The term “clinical” does not necessarily imply an activity implemented in a hospital setting.
The Detailed DefinitionImportant Aspects • Clinical pharmacists assume responsibility & accountability for managing medication therapy in direct patient care settings, whether practicing independently or in consultation or collaboration with other health care professionals. • Clinical pharmacist researchers generate, disseminate, and apply new knowledge that contributes to improved health and quality of life.
The Detailed DefinitionImportant Aspects • Clinical pharmacists are experts in the therapeutic use of medications. • They routinely provide medication therapy evaluations and recommendations to patients and health care professionals. • Clinical pharmacists are a primary source of scientifically valid information and advice regarding the safe, appropriate, and cost-effective use of medications
How Does Clinical Pharmacy Differ from Pharmacy ? • The discipline of pharmacy embraces the knowledge of synthesis, chemistry and preparation of drugs • Clinical pharmacy is more oriented to the analysis of population needs with regards to medicines, ways of administration, patterns of use and drugs effects on the patients. • The focus of attention moves from the drug to the single patient or population receiving drugs.
Goal of Clinical Pharmacy to promote the correct and appropriate use of medicinal products and devices. This is achieved by: • maximising the clinical effect of medicines • minimising the risk of treatment-induced adverse events • minimising the expenditures for pharmacological treatments.
How to Pursue a Profession in Clinical Pharmacy in Saudi Arabia • Pharm D Degree • Master Degree in clinical pharmacy • Residency with 2 years of training
Clinical Pharmacist Competencies ACCP, Pharmacotherapy 2008;28(6):806–815
Level of Action of Clinical Pharmacists • Clinical pharmacy activities may influence the correct use of medicines at three different levels: • before, • during • and after the prescription is written.
A) Before the Prescription Is Written • Clinical trials • Formularies • Drug information • Drug-related policies
B) Process of Writing the Prescription • Clinical pharmacists can influence the attitudes and priorities of prescribers in their choice of correct treatments. • The clinical pharmacist monitors, detects and prevents Drug related problems • The clinical pharmacist pays special attention to the dosage of drugs which need therapeutic monitoring. • Community pharmacists can also make prescription decisions directly, when over the counter drugs are counselled.
Drug Related Problems • Untreated indications. • Improper drug selection. • Subtherapeutic dosage. • Failure to receive medication • Medication overdosage. • Adverse drug reactions. • Drug interactions. • Medication use without indication.
C) After Writing the Prescription • Counselling • Drug use evaluation • Outcome research • Pharmacoeconomic studies
Clinical Pharmacy Practice Areas • Ambulatory care • Critical care • Drug Information • Geriatrics and long –term care • Internal medicine and subspecialties • Cardiology • Endocrinology • Gastroenterology • Infectious disease • Neurology • Nephrology • Obstetrics and gynecology • Pulmonary disease • Psychiatry • Rheumatology • Nuclear pharmacy • Nutrition • Pediatrics • Pharmacokinetics • Surgery