Pharmaceutical care philosophy

This philosophy of practice is very imporfanf, particularly when hard decisions have to be made in practice, determining what is important, setting priorities in the care of patienfs, and managing efhical dilemmas. Although pharmacists might have their own philosophy of life, there can only be one philosophy of practice thaf practitioners uphold. This xmiformity of practice philosophy resulfs in sfandardization of practice behaviors applied to all patients. Each component of fhe pharmaceutical care philosophy of practice is briefly described next. 

All health care professions have a specific philosophy of care. The four componenfs of fhe philosophy for pharmaceutical care are (1) the statement of social need, (2) a patienf-cenfered need for meeting the social need, (3) the development of a fherapeutic relationship to care for another human being, and (4) a description of fhe practitioner s specific responsibilities. A philosophy of practice is a sef of values thaf guide behaviors. This philosophy defines the rules, roles, relationships, and responsibilities of the practitioner. 

The patient care process clearly describes how a pharmaceutical care practitioner fulfills responsibilities outlined in the philosophy of care. The fhree sfeps in the patient care process are assessment, care plan, and evaluation. These three steps are continuous, or may be viewed as being cyclical in nature. The initial assessment helps the practitioner formulate a care plan in concert with the patient, and follow-up evaluation includes documenfation of acfual patienf oufcomes, leading back to assessment of new drug-relafed needs. 

There has been extensive professional discourse on the roles and responsibilities of pharmacists. Experiences of early clinical pharmacists paved the way for expanded professional responsibility. Pharmaceutical care emerged as a call for the responsible provision of drug therapy for achieving definite outcomes that improve a patient s quality of life. The experiences of pharmacists seeking to incorporate this philosophy into everyday practice have led to the definition of a pharmaceutical care practice as one in which the practitioner takes responsibility for all of a patient s drug-related needs and is held accormtable for this commitment. 

Pharmaceutical care has become the philosophy of pharmacy practice in recent years, as well as a mission or purpose for the profession, ffowever, another term that has come into use to simultaneously describe pharmaceutical care and the system for the medication use proces.s— CDTM. As the healthcare system grows in complexity, pharmaceutical care becomes increasingly important. It becomes more and more necessary for pharmacists, physicians, and other health professionals to work together in collaboration to assure safe use of medication. CDTM is an innovative approach in which pharmaceutical care services can be provided by a pharmacist in a supportive healthcare environment after a process of credential-ing, privileging, and approval of a Collaborative Practice Agreement. 

In the time that has passed since the original ACCP prospectus, the literature has continued to grow in both depth and breadth of evidence supportive of the financial justification of clinical pharmacy services. New service models and philosophies of practice have developed in the past 6 years, the most notable being that of pharmaceutical care. " In addition, our ability to evaluate scientifically and measure the impact of clinical services on costs and outcomes has matured with the increased understanding and use of analytical techniques in health economics and pharmacoeconomics. " The effect of these advances on the quality and quantity of literature is unknown. The ACCP Board of Regents thus asked the ACCP Publications Committee to update this prospectus. 

Pharmaceutical care is very different from other cognitive patient care services such as clinical pharmacy and disease state management programs. It is not a separate service that is superimposed on an existing practice but a comprehensive professional practice much like medicine and nursing. Consequently, it has a clearly defined philosophy of practice, patient care process, and practice management system. The remainder of this article describes the essential principles and processes involved in the practice of pharmaceutical care. 

The practice of pharmaceutical care has a clearly articulated philosophy that defines values and explains what all practitioners must do. According to this philosophy, the practitioner performs the following 1) takes responsibility for meeting society s need to reduce drug-related morbidity and mortality 2) employs a patient-centered approach that addresses all the patient s drug-related needs 3) establishes a caring therapeutic relationship with individual patients and 4) assumes a clearly defined set of responsibilities that directs patient care activities. These responsibilities are to ensure that patients receive the most appropriate, effective, safe, convenient, and economical therapy to identify, resolve, and prevent drug therapy problems and to ensure that optimal patient outcomes are achieved. 

The patient care process (Fig. 1) describes how an individual practitioner fulfills the responsibilities delineated in the philosophy of practice. This process includes three distinct elements that must be completed for each patient 1) patient assessment 2) creation of a pharmaceutical care plan and 3) follow-up evaluation. The success of the process depends on the quality of the therapeutic relationship established with the patient. 

To date, actual and perceived barriers have impeded widespread acceptance and implementation of pharmaceutical care practice. Some factors affecting individual pharmacists include inadequate education and training in the required skills, absence of suitable role models and mentors, lack of time due to dispensing pressures, unwillingness to change to an entirely new philosophy of practice, fears of legal liability, fear of failure, and the... 

However, the concept and philosophy of clinical pharmacy is not yet implemented in all hospitals and is found even less among community pharmacists. Most community pharmacists saw clinical pharmacy linked to hospital practice and hardly adapted to the needs of the community practice setting. That is probably the reason why the pharmaceutical care concept was formulated by Hepler and Strand. But with the concept of pharmaceutical care, we carry the same risk as with clinical pharmacy. Many people are talking about the concept, but few are putting in the effort and means required to put it into practice. 

Objective and Scope. The objective and scope of the SOP need to be carefully thought through and described. A limited objective could be to validate only those computer systems directly related to the production of pharmaceuticals the broadest one would be to validate all computer systems regardless of their application. Usually it is somewhere between the two. The scope will be determined by the company philosophy, organizational structure and the number of divisions, plants or departments involved. The scope should be limited to as small a unit as possible for the initial validation effort in order to achieve at least one successful computer system validation quickly. 

Boerhaave s circumscribed emphasis on the performance of specific operations, with an eye to practical (usually pharmaceutical) results, was echoed by most chemical lecturers in this period. Chemistry s practical, largely medical orientation set it apart from natural philosophy, which embraced theory as well as practice. Theory in chemistry remained largely speculative one could not demonstrate, either mathematically or by experiment, the existence of the atoms and pores required by the mechanical philosophy. Boerhaave carefully noted that he studied only bodies discernible by the senses. ... 

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