Humanistic therapies

This optimistic view emphasizes the essential goodness of humans and the belief that we all have choices. To realize our full potential we need to get in touch with our inner selves and true feelings, and be able to express them freely. The attitude of the therapist in conveying understanding from a position of equality is critical (Thomas, 1997 and General References). 

Most therapists who work in this way have a humanistic orientation but also use elements of other therapeutic disciplines. Its ruling principle is the integration of mind, body, and soul to create a whole and aware person (Thomas, 1997 and General References). 

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Many have proposed that evaluation of drug therapy and pharmacists value-added services should include assessments of economic, clinical, and humanistic outcomes. The economic, clinical, and humanistic outcomes (ECHO) model assumes that the outcomes of medical care can be classified along the three dimensions of economic, clinical, and humanistic outcomes (Kozma, Reeder, and Schultz, 1993). Clinical outcomes are defined as medical events that occur as a result of disease or treatment. Economic outcomes are defined as the direct, indirect, and intangible costs compared with the consequences of medical treatment alternatives. Humanistic outcomes are defined as the consequences of disease or treatment on patient functional status or quality of life. All three of these outcomes need to be balanced simultaneously to assess value. 

Patient satisfaction and quality of life are the two most common methods of measuring the humanistic outcomes of care. Improvements in patients quality of life have not been consistently demonstrated however, there is evidence that many of these studies purporting to provide pharmaceutical care were in fact disease state management or specific drug-focused programs in which pharmacists did not assume responsibility for all of the patients drug therapy treatment goals. 

Unlike asthma, hypertension is a largely asymptomatic disease. As with other asymptomatic diseases, patients with hypertension are often noncom-pliant with their therapy. This presents a challenge for health care practitioners, because chronic uncontrolled hypertension can lead to serious sequelae such as stroke, coronary disease, and cardiac failure. Pharmacists have been shown to have an impact in improving the clinical and humanistic outcomes among patients with hypertension. 

Quality is evaluated by measuring relevant indicators. Outcomes indicators (economic, clinical, and humanistic) will be the major importance in the future for clinical pharmacist services. Clinical pharmacist services must relocate themselves strategically as a proactive agent and lead drug therapy in the healthcare team. 

One of the primary applications of pharmacoeconomics in clinical practice today is to aid clinical and policy decision making. Through the appropriate application of pharmacoeconomics, practitioners and administrators can make better, more-informed decisions regarding the products and services they provide. Complete pharmacotherapy decisions should contain assessments of three basic outcome areas whenever appropriate clinical, economic, and humanistic outcomes. Traditionally, most drug therapy decisions were based solely on the cfinical outcomes (e.g., safety and efficacy) associated with a treatment alternative. Over the past lOto 15 years, it has become quite popular also to include an assessment of the economic outcomes associated with a treatment alternative. The current trend is also to... 

As with many therapeutic decisions, economic cost both to the individual and to society mnst be considered. Currently, the annual cost of the new potentially disease-modifying therapies is considerable. The cost to the pharmacist of glatiramer and both currently available interferons is between 10,000 and 17,000 per patient per year. Given this expense, it must be remembered that these therapies are not curative and that individual patients may experience variable results. Future investigations evaluating these therapeutic modahties clearly will need to address not only chnical but also economic and humanistic outcomes. 

In recent years pharmacoeconomics has been used as a term to describe the identification, measurement and comparison of the costs and consequences of pharmaceutical products and services (Bootman et al 1996). As such, pharmacoeconomics focuses primarily on pharmaceuticals, and attempts to evaluate the economic and humanistic impact of drug therapy. Pharmacoeconomic tools are derived from a variety of sources, including the fields of economics and outcomes research. Quite often the pharmacoeconomist will bring to the development team skills and experience in quality of life, patient satisfaction and other patient-centered measures. Health economists and a pharmacoeco-nomists differ (while the terms are sometimes used interchangeably), in having stronger backgrounds in the theoretical and applied aspects of health economics, respectively. A researcher with solid... 

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