Pharmaceutical Care Practice

[Gearhead-Rx]

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I am a PD1 at UMN and we have a class called Pharmaceutical Care Practice. Its whole premise is to develop a pharmacist practioner who reviews, identifies and seeks to correct drug therapy problems a patient may have. I know you are thinking, "isn't that the physicians job?"

The pharmaceutical care practioner has a practice location independent of the hospital or retail pharmacy. Patients come in and the pharmacist reviews all their current medication as well as medication history. If there are any problems identified, the pharmacist would then develop a care plan towards fixing the problem. Of course the prescribing physician would be involved to.

Obviously such a pharmacist does not fall in the retail or hospital niche......it involves alittle bit of both

my question is, do you guys have a similar class in your program? also what do you think of the Pharmaceutical practioner idea?
pharmacists please pitch in as well.

 

[trx]

I had a shadowing experience where my preceptor was working in the Family Medicine Clinic. What you described sounds like what she did: pull patient profile, analyzed certain points she wanted to focus on, and meet with the patient. Anyway, I found this interesting.. apparently, next year, we have a class in "Physical Assessment" that covers basic assessment skills required in the delivery of pharmaceutical care.

 

[KARM12]

I am a PD1 at UMN and we have a class called Pharmaceutical Care Practice. Its whole premise is to develop a pharmacist practioner who reviews, identifies and seeks to correct drug therapy problems a patient may have. I know you are thinking, "isn't that the physicians job?"

The pharmaceutical care practioner has a practice location independent of the hospital or retail pharmacy. Patients come in and the pharmacist reviews all their current medication as well as medication history. If there are any problems identified, the pharmacist would then develop a care plan towards fixing the problem. Of course the prescribing physician would be involved to.

Obviously such a pharmacist does not fall in the retail or hospital niche......it involves alittle bit of both

my question is, do you guys have a similar class in your program? also what do you think of the Pharmaceutical practioner idea?
pharmacists please pitch in as well.

We have a similar class called Applied Pharmaceutical Care. We take two quarters of it.

 

[Gearhead-Rx]

We have a similar class called Applied Pharmaceutical Care. We take two quarters of it.

How do you like it and whats your opnion on Pharmaceutical care? thanks

 

[sdn1977]

This whole concept of "pharmaceutical care practice" came out of the limits the profession of pharmacy itself put on the concept of "clinical" pharmacy.

The method you have described - a separate individual - apart from the prescriber & dispenser who evaluates & makes recommendations for change to the prescriber is far-fetched, IMO. It does not exist in that manner right now anyway & won't ever, IMO....for a number of reasons.

It does exist, however, in many different areas within large healthcare delivery systems - like Kaiser, VA & large medical clinics. These pharmacists are assigned to a variety of services - everything from peds to endocrine, snfs to cardiology. They do review medications & labwork, adjust doses in warfarin clinics, start folks on insuin pumps if they're diabetic educators, advise medication changes, and many other tasks.

But...the key here....the practice location cannot be separate from the pts chart! The acute hospital chart has all that happened during the pts stay, with an admission summary & a discharge summary which gets sent to the pts physician. That goes in that chart - whether its in a clinic or a physicians private office. That chart has everything else - all outpt labwork, xrays, diagnostic imaging, etc....Ideally...that chart will ultimately be computerized so it can be accessed many places at the same time.

That is the limitation MTM will have in a retail, outpt setting - the inability to fully have all the information available.

I think this is where students become frustrated. They feel that without this actual practice setting...they aren't clinical. However, these classes fail to explain that altho you may not work in this exact practice setting - nor choose to work for a huge operation like the VA, Kaiser or large medical clinics...in community pharmacy...you do see many, many physical ailments which will require your ability to decide if you can suggest an otc product or if they need to seek medical advice; if a side effect they're complaining of is one which will resolve or can be treated with an otc or should be referred back to the prescriber. One of our big purposes is to keep those folks out of ERs who can be treated at home safely & to get those people to the ER or their medical provider who cannot. Also...many community pharmacists are now working with specific pts....diabetics for example...who are well known for having difficulty following their regimens & focusing on them to try to improve compliance & therefore outcome. This (MTM) is just beginning & only being reimbursed by Medicare currently. So - reimbursement of your time is a factor. Historically, we have no mechanism to bill for a visit - our billing is tied to a product.

My advice - learn what they are teaching you. Learn all of it so you have the skills to adapt to what will be there in 3 years when you graduate & 30 years later when you're still working. It won't be the same....so don't dismiss what you're being offered just because it may not exist in that format universally now - it may later or in a different format.

Good luck!

 

[All4MyDaughter]

Well, they won't let us call it pharmaceutical care at Kentucky. It's patient care, and it's very similar to what you describe. We will enjoy 6 glorious semesters of patient care lab!

 

[KARM12]

How do you like it and whats your opnion on Pharmaceutical care? thanks

I think ours is more of implementing pharmaceutical care into various practice settings. I think ours is more our learning the skills that you can apply across the board. It really isn't as learning it as a separate practice, but more of something you should be doing every day as part of your profession.

 

[twester]

I think we call ours Professional Skills Development for four semesters then Comprehensive Patient Care for two. It has to be one of my more applicable classes, so far.