Pharmaceutical Care

2
Needs, Skills & Obstacles
 Pharmaceutical Care
What should pharmacists do?
Re-engineer their practice to create the capacity for patient
care
◦ Many duties including the mechanics of the dispensing
process, must be delegated to Pharmacy Technicians
◦ This does NOT include tasks that involve clinical
decision making
◦ Pharmacist serves a supervisory role in the drug
dispensing process.
 Pharmaceutical Care
What do pharmacists expect to gain?
Professional satisfaction and increased patient loyalty
◦ Patients are unlikely to accept a lower standard of practice
Increased job satisfaction amongst pharmacy staff
Potential for increased business profitability
◦ 20% increase in total sales in 6 months
◦ Doubled traffic in pharmacy
◦ 15% increase in prescription orders
What does pharmaceutical care look like when implemented? (1)

 Spending time with a patient to make sure they

really understand how to use their medication.

 Make a connection with the doctor/prescriber

to discuss the appropriateness of a drug or
dose

 Working with a patient (and/or carer) to

develop a system to ensure that they actually
receive the agreed-upon medication regimen
What does pharmaceutical care look like when implemented? (2)

 Following-up on the patient to make sure that intended

outcomes are achieved, and search for answers to questions left
to others. For example:
 Did the dispensed meds actually help the patient?
 Have therapy goals that were set actually been
attained?
 Is the medication regimen causing new problems?
 Success?

Providing pharmaceutical care means that,

at the end of the day, pharmacists
measure their success by how many people
they have helped, NOT by how many
prescriptions they have filled.
Knowledge and Skills Needed for Pharmaceutical Care (1)

 Knowledge and understanding of drugs and drug

therapy and disease

 Clinical skills
 Patient assessment
 Diagnostic tests interpretation

 Communication skills (speaking, listening and presentation skills)

 Gathering information
 Talking to other health care providers
 Interacting with the patient
 Skills Needed for Pharmaceutical Care (2)

 Problem solving skills

 Practical relevance versus theoretical relevance
 Ability to find relevant information

 Organizational skills
 “Organized, Systematic Process or approach”
 Time management
Skills Needed for Pharmaceutical Care (3)

 Critical Thinking
 Using logic and reasoning to identify the strengths and
weaknesses of alternative solutions, conclusions or
approaches to problems.
 Judgment and Decision Making
 Considering the benefits of potential actions to choose the
most appropriate one.
 Active Learning
 Understanding the implications of new information for
both current and future problem-solving and decision-
making.
 Obstacles to Pharmaceutical Care

1. Pharmacists’ attitudes
 Lack of comprehension
 Misconceptions
 Fear of change
 Lack of motivation
 Obstacles to Pharmaceutical Care
2. Lack of advanced practice skills
 Therapeutics
Θ Fear that knowledge is inadequate
 Clinical problem solving
Θ Clinical problem solving skills are learnable, but only by practice
 Communication skills
Θ The most important skill to master
 Documentation
Θ Without consistent & efficient documentation, it is difficult to
provide optimal care to patients & prove the value of PC to the
health care system
 Obstacles to Pharmaceutical Care
3. Resource-related constraints
 Time
 In reality, pharmacists lack time because they concentrate on the wrong activity: dispensing
 Delegate tasks that could be done more efficiently / quickly / cheaply by someone else

 Finances
 Pharmacists can carefully plan for making changes at a minimal cost as they become necessary

 Space
 A patient care area does not require expensive pharmacy redesigns

 Management
 Support from managers is essential
 Obstacles to Pharmaceutical Care
4. System-Related Constraints
 Reimbursement
 The most real & difficult to overcome of all obstacles
 Only when pharmacists start billing consistently for services rendered &
documenting the care they have provided will the health care system
start recognising the contributions of pharmacists
 Patient demand
 A key reason why patients do not demand pharmaceutical care is that
they do not understand the concept
 The profession needs public relations & education campaigns
 By identifying needs & explaining to patients how they will benefit from
PC, pharmacists can win over reluctant patients
 Obstacles to Pharmaceutical Care

4. System-Related Constraints … cont.

 Acceptance by health care providers (HCP’s)
 Realistically not all HCP’s will appreciate pharmacists taking
on the role of a patient care provider.
 This is a temporary obstacle that can be overcome as
pharmacists demonstrate their skill at making rational drug
therapy decisions & collaborate with others on the health
care team.
 Obstacles to Pharmaceutical Care

5. Intraprofessional Obstacles
 Professional relationships
 In the past, pharmacy organizations have not worked
together efficiently for the common good of pharmacy
 Pharmacists from all practice settings & all pharmacy
organizations must cooperate closely to make PC a
reality
 Obstacles to Pharmaceutical Care
6.Academic & Educational Obstacles
 Colleges of Pharmacy
 Not all pharmacy colleges view themselves as having a
role in creating the capacity for PC
 Lack of mentors & role models as pharmacists learn by
watching & emulating the behaviours of role models
 In implementing PC, most pharmacists have to figure
things out for themselves
 As more practitioners convert their practices, the number
of mentors & role models will increase