Author: K Lalithendra, ASN PHARMACY COLLEGE TENALI
a) Need for clinical pharmacy in India ;
Clinical pharmacy practice is concerned with the promotion of effective, safe and economical drug therapy. these include dispensing and drug distribution, drug information, health promotion, patient counseling, pharmacovigilance, medication reviews, academic details and sterile and non sterile manufacturing.
India is a country with many drug use problems. thereby results of socioeconomic, medical and political factors. These drug-related problems occur in different strategies i.e prescribers, patients, pharmacists, nurses etc.
Pharmacy practice in India
b) Scope for clinical pharmacy practice in India:
Clinical pharmacy practice plays a crucial role in the level of pharmacy profession. This was done by the support of medical staff in well-developed institutions.
The medical staff includes:
c) Clinical pharmacy education:
The postgraduate education in pharmacy offered by many Indian pharmacy colleges are established to expand the role of pharmacist in the health care system.
The pharmacy practice program deals:
This is used to understand the student about significance of laboratory tests and other biological values.
Used to understand the role of different diseases and their conditions, safety, efficacy, and rational selection of drugs.
Understand the kinetics of drug, especially when used during renal and hepatic impairment.
Excellent relationship are established with the medical profession are needed to ensure the progress pf clinical pharmacy.
CLINICAL PHARMACY IN INTERNATIONAL PERSPECTIVE:
Clinical pharmacy has evolved in many countries around the world for similar reasons And those reasons are,
The evaluation of drugs varied and different in results. During practice among countries, and also within countries due to different hospitals and other related settings.
COMMUNICATION SKILLS FOR PHARMACIST:
Communication is the most basic thing that helps to sending and receiving of information in pharmacy practice sight, hearing, touch, are used for communication. communication style depends on language, culture, social status, personality, interests, abilities and disabilities.
Empathy is the heart of communication.
It is defined as the ability to see and feel the way of another person does.
If feelings are not shared and empathy does not develop then communication can be impaired. The significance of empathy is that a sympathetic relationship based on understanding.
Nonverbal messages begin to be received and interpreted as soon as something catches attention of ours.
Ex: when two people first meet, before spoken impressions are formed from their signal, sound, smell and sometimes touch during that time,
What expressions on their face? How are they dressed?
How old are these?
What perfume they wearing? They appear to be friendly or not?
These unconscious impressions to be good during the process of communication.
Verbal communication is about the meaning of words may be spoken or written. Ex:tone of voice pr the type face used
This should have mainly skills on Language
Interactive communication Listening skills.
STAGES IN VERBAL COMMUNICATION:
It includes different writing styles, appropriate for different purposes.
Providing information, providing information about medicine is the common role of clinical pharmacist.
COMMUNICATION IN PROFESSIONAL PRACTICE:
During the establishment of clinical pharmacy service , interprofessional communication can be challenging.
Once a service is accepted the pharmacist establish their communication and creditability with new staff members or ward area .
Spoken messages can occur in person or over the telephone.
These are used to gain information about patient or their treatment and to provide medicine information to a practitioner or clarify modifications in patients therapy.
Case note annotation:
Case note of patient is important convey of providing information for the purpose of caring and record patients health management details.
Communication with patients:
Checking labeling of the medicines
ROLES OF CLINICAL PHARMACIST:
Interventions by clinical pharmacist during outpatients
² PATIENT COUNSELLING :
Patient counseling is the process of providing information advice to help the patients in their use of medications approximately.
This information is given by the pharmacist directly to the patient or any patients representatives.
This may include about patient illness and recommended life style changes
Patient counseling at prescription center
Steps of patient counseling:
a) preparing for the session:
b) opening the session:
c) Counselling content:
d) Closing the session:
Pharmacists are in a unique position to improve medication adherence because pharmacist show the medication to the patient and related any information to the medication
The patient received both oral education and written instructions in the local language about the disease need for regular medication, and importance of each medication by pharmacist.
Pharmacists play a valuable role in screening of interactions and advising on management of such interactions when they occur
a) Pharmacokinetic interactions:
b) Pharmacodynamic interactions
GUIDANCE ON IDENTIFYING AN ADVERSE DRUG INTERACTION:
INTERPRETING THE LABORATORY DATA:
ESR – erythrocyte sedimentation rate CRP- C reactive protein
Medication review involves the review of patient’s information to ensure therapy is appropriate, safe, efficacious and fast effective
This can be achieved by pharmacist attending ward rounds.
Pharmacist medication recounselling procedure
SIGNIFICANCE OF MEDICATION REVIEW:
Desired therapeutic outcomes are being achieved Monitor drug related problems or toxicity Ensure rational and quality use of medicines Assess patient compliance
Assess the completeness of medication charts
STEPS INVOLVED IN MEDICATION ORDER REVIEW BY PHARMACIST:
WARD ROUND PARTICIPATION:
The pharmacist impact can be substantially greater if impact is provided at the time of prescribing
Clinical pharmacist are ideally placed to favorably influence prescribing and improve the quality and safety of medicine.
Ward round participation
OBJECTIVES OF CLINICAL PHARMACIST ON WARD ROUND:
Gain and understanding of the patients clinical status and progress,planned investigations and therapeutic goals
Provide information on various aspects such as:
Optimise therapeutic management by influencing drug therapy selection ,implementation and monitoring and its follow up
Detect adverse drug reactions and drug interactions Participate in patient discharge planning
THERAPEUTIC DRUG MONITORING(TDM):
Pharmacist can help ensure the appropriate use ,timing and interpretation of TDM Routine monitoring is not required for clinically stable patient
TDM results may influenced by:
FACTORS CONSIDERATION DURING TDM ARE:
Clinical pharmacists have an important role in advising on the appropriate use of TDM and in the interpretation of assay results
ETHICAL ISSUES IN CLINICAL RESEARCH
One of the primary legal and ethical obligations of researchers and their teams is to protect the human participants who take part in the research
DOCUMENTS AN ETHICS COMMITTEE MUST REVIEW:
Drug related problems in clinical area
For example: clinical pharmacist interventions on inappropriate prophylactic acid suppressant use in hepatobiliary surgical patients undergoing elective operations
A total of 500 patients were enrolled in this study, 250 patients in each group, Then, 52 patients who didn’t meet our criteria were excluded. At last, 448 patients in total were included for further research with 218 in the pre-intervention group and 230 in the post- intervention group. General characteristics of the patients in two groups. The 2 groups were similar with respect to demographics and clinical characteristics, such as sex, age, body mass, medical history, surgery type and operative duration (P > 0.05). There was no significant difference in post-operative bleeding between the two groups (P > 0.05). Three cases received therapeutic acid suppressant after surgery, so they were excluded when analyzing the rationality of prescriptions and the cost-benefit results
Clinical pharmacist interventions significantly decreased the rate of the use of no indications for prophylactic acid suppressant and of the cases of inappropriate drug selection, dose, route, replacement and prolonged duration of prophylaxis (P < 0.05 or P < 0.001), resulting in significant increase by 10.65% in the percentage of cases adhering to all the criteria (P < 0.001). Moreover, significant reductions were found in the average usage quantity (P<0.001), mean cost (P = 0.03) and mean duration (P < 0.001) of prophylaxis acid suppressant. The ratio of the mean cost savings for acid suppressants to the mean cost of pharmacist time.
FINAL REPORT: This review concluded by, the clinical pharmacist’s real-time interventions facilitated the rational use of prophylactic acid suppressant and resulted in favorable economic outcomes in hepatobiliary surgery.
Here we concluded that pharmacist activities and interventions on patient who suffering from prophylactic acid suppressants on surgical patients
A clinical pharmacist plays a vital role in the development of patient health management in all aspects.
And he is the main lead for the performing different types of therapies which was conducted by highly health care professionals by checking, interpreting all the details of patient who are admitted in the hospital he should responsible for all the information such as patient demographics, medication history, past allergic conditions , and patient counseling during admission and discharge .
In this article we can get some of the aspects of the pharmacist that related to his profession and the pharmacy practice or clinical pharmacy growth in India by comparing with other countries.
How useful was this post?
Tasks handled by our staff, updated in real-time.