Pharmacy Services

Pharmacy The art and science of preparing, compounding, stabilizing, preserving and dispensing medications and the provision of drug and related information. Also a place where drugs are stored, compounded and dispensed. A Pharmacist is a health care professional who Compounds and dispenses medications and other pharmaceutical supplies, using standard physical and chemical procedures to fill written prescriptions issued by physicians. Maintains records on all unit dose for each nursing unit and also IV additive program. Maintains inventory of supplies. A graduate from accredited school of pharmacy and licensed in the state of practice.

Responsibilities of Pharmacists Compounding drugs Dispensing drugs Medication profile review Patient education Provider of drug information Clinical pharmacy Pharmaceutical care Patient care provider

Compounding Drugs Pharmacists compounded drugs used to treat patients in the 1940s and 50s. Then pharmaceutical manufacturers began to take over this role. Hospital pharmacists assumed responsibility for compounding parenteral admixtures in the 1960s and 70s. Today more pharmacists are compounding specialty products that are not commercially available and more compounding is predicted in the future.

Dispensing Drugs In the 1960s hospital pharmacists implemented unit-dose drug distribution systems to reduce medication dispensing and administration errors. In unit dose system medication distribution, medications are contained in single unit packages; they are dispensed in as ready-to-administer form as possible; and for most medications, not more than a 24-hour supply of doses is delivered to or available at the patient-care area at any time. Most hospitals and long term care facilities now use a unit-dose system. In the 80s automated dispensing devices became available for use in hospital and community settings.

Dispensing Drugs – Automation Webster’s Ninth New Collegiate Dictionary Automatically controlled operation of an apparatus, process, or system by mechanical or electronic devices that take the place of human organs of observation, effort, or decision. Pharmacy Automation a collection of apparatus, process, and systems (mechanical and/or electronic) to enhance drug distribution and clinical drug therapy management. Robots: Automated mechanical equipment specifically designed to fill medication vials with tablets or capsules, apply a lid to the vial, and place a prescription label on the vial.

Dispensing Drugs – Automation Benefits Automation of the dispensing process offers the potential for improved service delivery in four key areas: Efficiency. Faster speed of operation than humans Staff can then be utilized in more patient-centered activities Safety According to the US National Academy of Science, > 78% of dispensing errors could be avoided by the use of automated dispensing systems. Stock management. Improve stock rotation Improve overall stock control Environment. Less space requirements Less staff movements

Medication Profile Review In the 1970s pharmacists began maintaining medication profiles to review patient medications for drug related problems. Computerized systems for automatically reviewing prescriptions for allergies, drug interactions, appropriateness of the dosage, and other common drug related problems have since evolved.

Patient Education In the 1980s most states required pharmacists to provide patient medication counseling to outpatients on new prescriptions. Verbal, written and computerized printed education materials to supplement verbal patient counseling has since evolved.

Provider of Drug Information In the 1960s drug information centers were created in hospitals to provide drug information to physicians and other health care providers. The role of pharmacists as drug information providers led to decentralization of pharmacists to provide drug information.

Clinical Pharmacy In the 70s and 80s most hospitals began to develop clinical pharmacy services. Pharmacists were decentralized to patient care units to provide clinical services. Ambulatory clinical services also began in clinics and a few community pharmacies. Early Clinical Pharmacy Patient focused, drug focused, interdisciplinary, and data driven Provider of drug information to patients and health professionals Individualizing doses: clinical pharmacokinetics Monitoring drug therapy: Order review and feedback Nutritional support

Pharmaceutical Care A fairly new concept in providing health care; 1990s - these terms became very popular Involves direct involvement of the pharmacist in the design, implementation, and monitoring of a therapeutic drug plan to produce a specific therapeutic outcome. A strategy that attempts to utilize drug therapy more efficiently to achieve definite outcomes that improve a patient’s quality of life. Requires a reorientation of physicians, pharmacists, and nurses toward effective drug therapy outcomes. It is a set of relationships and decisions through which pharmacists, physicians, nurses, and patients work together to design, implement, and monitor a therapeutic plan that will produce specific therapeutic outcomes.

Community Pharmacy Practice Community pharmacists counsel patients, answer questions about prescription and over-the-counter drugs, such as possible adverse reactions and interactions, and give patients health care advice. They also give advice about durable medical equipment, home care and preventive care. Some community pharmacists offer disease management services for conditions such as diabetes, asthma, hypertension, etc. Some community pharmacists offer preventive health programs: smoking cessation, immunizations, screening for lipid disorders, etc.

Hospital Pharmacy Practice Unit-dose and parenteral admixture programs Clinical services. Computerized drug distribution systems and use some automated dispensing devices. Some hospitals have comprehensive inpatient pharmaceutical care programs. Few hospitals have extensive ambulatory pharmaceutical care programs.

Pharmacy Trends Increased emphasis on patient care services as well as drug distribution Increased emphasis on continuity of care (home-office practice-hospital-long term care, etc.) Increased emphasis on preventive care (use of OTCs, alternative medicines, self-diagnostic kits, diet, screening procedures, immunizations, etc.) Increased use of automation for pharmacy dispensing Increased use of information technology