Physician communication with pharmacist

Incorrect drug use occurs because essential information is not properly communicated -or is incompletely or incorrectly understood. Two results of not properly educating patients about their medicahons are mismedicahon and noncompliance, both of which cause unnecessary illness and health costs. Because patients usually interact more frequently with pharmacists than with their physicians, pharmacists are well positioned to monitor pahents for mismedicahon and noncompliance. Pharmacists can ensure that a pahent is taking their medication correctly and can help reduce unnecessary human suffering and increasing healthcare costs. 

The Millis Commission s report in 1975, Pharmacists for the Future The Report of the Study Commission on Pharmacy (Millis, 1975), suggested that pharmacists were inadequately prepared in systems analysis and management skills and had particular deficiencies in communicating with patients, physicians, and other health care professionals. A subsequent report suggested including more of the behavioral and social sciences in pharmacy curricula and encouraged more faculty participation and research in real problems of practice (Millis, 1976). 

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. 

In various settings such as the VA outpatient clinics, Kaiser Permanente outpatient services, hospital-based outpatient clinics, physician offices, and community pharmacies, pharmacists have been successfully managing patients warfarin therapy. " Research demonstrates the positive outcomes associated with and the cost-effectiveness of pharmacist-run warfarin clin-iCs.50/51... 

This article has summarized critical legal and ethical issues associated with the evolving function of the pharmacist prescriber. The purpose of this chapter is not to discourage pharmacists interested in prescribing, but to review critical issues associated with a new role. With proper training, communication with the patient and the patient s physician, adherence to the appropriate standard of care, avoidance of ethical and criminal breaches, the modern pharmacist will be able to contribute even more to the health care team. 

Preparations for cutaneous (or dermal) application may be used for local treatment as well as for transdermal administration with a systemic effect. The chapter focuses on preparations with a local effect and on design of formulation and method of preparation of those prepared in pharmacies. The interaction between skin, active substance and base, the anatomy of the skin and biopharmaceutical aspects of cutaneous preparations are discussed as well as the therapeutic effect of the base. Because of the important role of the pharmacist in prescription assessment some recommendations for the communication with the physician are given. One aspect is how to proceed with a request for the mixing of two licensed medicines or for the addition of an active substance or an excipient to a licensed product. The formulation design is generally following the several phases of the multicomponent preparations. Based on the... 

A pharmacist also is likely to make use of interpersonal communication skills when interacting with patients and other practitioners such as physicians. Training in these skills is essential. For example, pharmacists may need practice and critical feedback in writing effective SOAP (subjective, objective, assessment plan) notes to be sent to physicians. It is important that pharmacy personnel develop confidence in their ability not only to provide new pharmacy services but also to market their services to all groups of consumers (i.e., patients, health care providers, and payers). 

The physician will communicate via fax with their response to the pharmacists recommendations within 24 hours. 

Pharmacists are uniquely positioned to become involved in DM activities for several reasons. First, within the community, pharmacists practice at the interface of care and therefore have the ability to interact directly with patients. In addition, public opinion polls reveal that pharmacists are consistently ranked among the most trusted professionals. Figure 17.1 illustrates how the drug prescribing process places pharmacists at the interface of patient care. Because pharmacists, like physicians, have the ability to directly deliver DM services, they can serve as conduits for implementing DM programs developed by health insurance providers, PBMs, pharmaceutical companies, wholesalers and distributors, and employers. 

Given their broad range of community activities, MRC units recruit volunteers with varied backgrounds, including practicing and retired physicians, nurses, pharmacists, dentists, veterinarians, mental health professionals, paramedics, and epidemiologists (18,19). Nonmedical volunteers, such as interpreters, chaplains, office workers, legal advisors, and others offer support services. 

But, perhaps the greatest difference between this specialty and all other specialties is the value placed on versatility, adaptability, communication skills and teamwork. Physicians and pharmacists must learn that in pharmaceutical medicine, they are unlikely to be as predominant as decision makers as they were in clinical practice. Those who can become an expert in some subject and be respected for it by people both inside and outside the company, even though they may never have heard of that particular disease or drug before three months ago, will do well if they can match such knowledge with superior inter-personal skills. Knowing when to lead, when to follow and when to get out of the way, rather than presuming a leadership role in all situations, will always be valued in this specialty. 

Pharmacists should also consider how an elderly patient s relationship with other health care providers might influence adherence. For example, research shows that the elderly tend to favor partnership-type relationships with their physicians and that satisfying patient-provider relationships contribute to better adherence. However, with the growing number of managed care and group practices, these relationships are often more difficult to develop. A good pharmaceutical care plan can help elderly patients relate more effectively with primary care providers by helping these patients understand the nature of their diseases and how to better communicate their needs to physicians. 

In this way, a combination of experts and end-users review AMH content. At present, a team of about 150 external reviewers assist in the Review Panel process. They include general practitioners and specialist physicians and surgeons, academics and researchers, hospital and community pharmacists, specialist nurses, and educators from organizations that support consumers with chronic illnesses. Each Review Panel contains expert specialist clinicians, a clinical pharmacologist with an interest in the specific area, hospital-based clinical pharmacists, community pharmacists, general practi-... 

For supervisory positions, three to five years of practice experience is often required. During the practice experience, the pharmacist should demonstrate the ability to achieve results, complete objectives on a timely basis, possess good communication skills, and demonstrate good working relationships with coworkers, physicians, and nurses. 

Fig. 1 The hospice interdisciplinary team. The patient, primary caregiver, and family are the focus of the hospice team s efforts in collaboration with the patient s primary physician. The core team is represented by the next circle away from the center. The support team is indicated by the outer circle. Community resources that support hospice care are listed outside that circle. Pharmacists serve on both the core team (second circle from the center) by providing direct pharmaceutical care to patients and families, and on the support level (next circle out from the center) by providing professional and public education about drug therapy in the care of terminally ill patients. (From Lipman AG, Berry JI. Pharmaceutical care of terminally ill patients. Journal of Pharmaceutical Care Pain and Symptom Control 1996 3(2) 31-56.)...

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