Pharmacists clinically educated

Pharmacists Available educational materials and understanding clinical topics... 

The staff pharmacist may or may not have an advanced degree (i.e.. Doctor of Pharmacy degree). Although a PharmD degree is not required, it does ensure that the pharmacist has a good, sound clinical education. More important is the person s ability to think quickly when asked difficult questions or when in difficult situations to interact professionally with a wide range of individuals (both clinical and nonclinical) and to be able to work with little supervision in an often unstructured environment. 

The limited efficacy and potential toxicity of many of today s medications, coupled with the rapidly expanding portfolio of medications for disease treatment and prevention, creates enormous complexity in selecting optimal medications for individual patients. Thus, the expertise of clinically educated and trained pharmacists is increasingly important if we are to ensure patients receive the most effective medications in the doses and combinations that are optimal for them and their illnesses. 

Pharmaceutical medicine is a medical specialty in which both physicians and non-physicians take part. This is not unusual. For example, various medical specialties require specialist nurses, nuclear medicine requires physicists, pathology requires histologists, and venereology requires contact tracers. In our case, pharmaceutical medicine requires pharmacists, clinical research associates, statisticians, administrators, and financiers. Interaction with a diverse set of other types of professional can be one of the most rewarding (and educational) aspects of a career in pharmaceutical medicine. 

A cancer patient may encounter many different health care professionals phlebotomists, pathologists, surgeons, medical and radiation oncologists, physician assistants, pharmacists, nurses, counselors, dieticians, social workers, and chaplains all may be involved with a single patient. Each one plays an important role in care of the cancer patient. The pharmacist s role may include education of patients and family members, education of staff about new agents and safety issues, preparation of therapies, resolution of reimbursement issues, development of order sets, and participation in clinical trials. Each patient should have access to an interdisciplinary team to assist him or her during treatment. 

The Drug Information Centre provides a unique learning environment for the education of clinical pharmacologists, other medical doctors, information pharmacists or information technicians, and for any other health care personnel that need training in clinical pharmacology, drug evaluation and the rational use of drugs. 

Consistent with these findings was another study that described the impact of strategic planning conducted in the Department of Veterans Affairs Medical Center pharmacies. Strategic planning resulted in more Veterans Affairs Medical Centers with increased pharmacist involvement in patient care, increased involvement in specific types of clinical services, more efficient drug distribution systems, and increased involvement in pharmacy education (Portner et al., 1996). 

Once it is determined which service is to be implemented, it is important to put some thought into what the service will look like and how it will be delivered at the practice. As discussed previously, regardless of the type of service (i.e., diabetes, lipids, asthma, etc.), the medication management processes used by pharmacists remain relatively the same. Some component of the service will require the pharmacist to collect patient clinical information, including laboratory data. The pharmacist also needs to assess the patient information that has been collected and make a clinical decision regarding the appropriateness of the therapy. Patient education is a component of each type of service but may be emphasized more so with certain services (e.g.,... 

Medication and/or dosage changes will be made, if necessary, based on the pharmacists assessment, and patients will be counseled on these changes. The physician communication form will be used to communicate clinical recommendations regarding drug therapy. Also, patient education will be reinforced and documented. Patients will be instructed on when to return to the clinic, and referrals to physicians will occur as needed. The referrals are based on patient complications of therapy or condition and patient resistance to therapy. 

Carol had hired a local clinical pharmacist who had expertise in ambulatory care as a consultant to assist with the pharmacists education and skills development. The clinical consultant facilitated the case discussions. The cases that were developed for this program required pharmacists to assess and modify patients dietary habits and activity levels. Also, they needed to identify and develop plans for resolving drug therapy problems. They practiced writing recommendations to physicians on the physician communication form. 

About the Author Dr. Snella is the Assistant Dean of the University of Missouri— Kansas City School of Pharmacy and Vice Chair and Associate Professor for the Division of Pharmacy Practice in Columbia, Missouri. Her pharmacy education includes a B.S. in pharmacy from the University of Iowa and a Pharm.D. from the University of Texas— Austin/University of Texas Health Sciences Center, San Antonio. She also completed a specialty residency inprimary care at the WilliamS. Middleton Aeterans Hospital in Madison, Wisconsin. Dr. Snella has been working in the area of compensation for pharmacist services for over 10 years. She has provided value-added services in both private physician offices and hospital outpatient clinics. She is invited frequendy to speak regarding pharmacist service compensation and has authored several articles and book chapters on this topic. 

Organizational structure. It is necessary to develop an internal organization structure that allows pharmacists to focus on the individual patient, exercise clinical judgment, and be supported in a manner consistent with their work. Training and education of pharmacy technicians must be provided to make possible the development of clinical services. Financial resources must be directed toward clinical functions with as much enthusiasm as that shown for distributive functions. 

The National Institute for Clinical Excellence published a guideline on diabetic footcare in 2004 which recommends regular (at least annual) visual inspection of patients feet with assessment of foot sensation and palpation of foot pulses by trained personnel (NICE, 2004). Pharmacists can play an important role in patient education around self-care and self-monitoring of the feet. 

It is also important to educate and counsel Mrs CR on the chemotherapy treatment she is receiving and the possible side-effects, as well as how to manage them. It is imperative, however, to ensure that any communication from the clinical pharmacist is in line with that already provided by other health professionals, especially clinicians and nurses. Briefly, this advice should include ... 

The emergence of clinical services during this phase of pharmacy practice is exemplified by the development of clinical pharmacy services in the U.S. Indian Health Service (IHS). The IHS provides health care services for 1.4 million American Indians and Alaska Natives. The IHS s health care facilities are in rural areas near or on Indian reservations in 34 states, mainly in the western part of the U.S. and Alaska. In the 1960s, pharmacists within the IHS began to provide services that were the predecessors for current models of patient care. Pharmacists working within the IHS provided primary care to patients with minor conditions, monitored them for adverse drug reactions, provided patient education, and developed disease prevention programs.il... 

Traineeship A short, intensive, clinical and didactic postgraduate educational program intended to provide the pharmacist with knowledge and skills needed to provide a high level of care to patients with specific diseases or conditions. 

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