Pharmacy Preceptors Guild of the Philippines

HOSPITAL PHARMACY VIRTUAL INTERNSHIP PROGRAM (MAJOR)

CLINICAL PHARMACY – DRUG THERAPY ASSESSMENT
ACTIVITY ASSIGNMENT – 27

Name of Student: Chua, Ma. Victoria P.

School: Fellowship Baptist College
Batch Number: 03

Objective:

● Able to use strategies that develop effective and efficient data gathering and able to obtain
accurate, comprehensive medication-related histories despite of potential barriers in
communication.
● To effectively communicate medication-related information and drug-related problems to other
healthcare professionals.

Instruction:

❖ Using the patient’s medication list created in activity assignment – 26 MEDICATION

RECONCILIATION INTERVIEW:
o Analyze and assess the list using Drug Therapy Assessment
▪ Reference: American Society of Health-System Pharmacists. (2012). ASHP Clinical Skills
Competition LOCAL COMPETITION CASE. Retrieved August 24, 2020, from
https://www.ashp.org/-/media/assets/about-ashp/docs/awards-clinical-skills-
competition-2012-local-case.ashx?
la=en&hash=32490D786F0E27A4A1305786EFD4F7F75063642F
o Identify any drug related problem(s) from the list.
o Write your analysis and assessment based on SBAR (Situation, Background, Assessment,
Recommendation) Format
▪ Reference:
Quality Insights of Pennsylvania, the Medicare Quality Improvement Organization
Support Center for Home Health. (2012). Safety - Communication with Physicians SBAR.
Retrieved October 14, 2020, from http://www.hhvna.com/Safety_-
_Communication_with_Physicians_SBAR.pdf
o One drug therapy problem = one SBAR
o On the last column of SBAR, please indicate the target respondent to whom you will
refer the drug-related problem you identified. (e.g., plan to discuss with the Prescribing
Physician, Nurse-in-charge or to the patient).

Patient’s name: Mrs. Smith

Age: __________________________________
Gender: Female
Allergies: None

Patient’s Medication List

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 Pharmacy Preceptors Guild of the Philippines
HOSPITAL PHARMACY VIRTUAL INTERNSHIP PROGRAM (MAJOR)
CLINICAL PHARMACY – DRUG THERAPY ASSESSMENT
ACTIVITY ASSIGNMENT – 27

Name of Medication* Dose and Frequency Last Taken Indication

Hydrochlorothiazide 12.5 mg in the morning Still Taking High Blood Pressure

Lisinopril Dose Check at Pharmacy Long time ago since High Blood Pressure

she had taken the

medicine.

Clopidogrel 75 mg in the morning Still Taking Blood Thinner

Metformin 500 mg (2pills evening and Still Taking Diabetes

2pills morning)

Atorvastatin 10 mg at Night Still Taking Cholesterol

Steroid Inhaler Twice a day Still Taking but as Asthma

needed

Albuterol Doesn’t take very Asthma

often

Ciprofloxacin twice a day for 3 days Still Taking Bladder

Ibuprofen 800 mg two or three times as needed Back Problems

a day
Nitroglycerin Doesn’t need to take

anymore

Fish Oil Everyday Still Taking Supplement

Drug Therapy Assessment

Situation Background Assessment Recommendation Target

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 Pharmacy Preceptors Guild of the Philippines
HOSPITAL PHARMACY VIRTUAL INTERNSHIP PROGRAM (MAJOR)
CLINICAL PHARMACY – DRUG THERAPY ASSESSMENT
ACTIVITY ASSIGNMENT – 27

Respondent

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