WHAT IS CLINICAL PHARMACY ?

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Below you will find a brief outline explaining the profession of Clinical Pharmacy and the important role of a Clinical Pharmacist. The profession requires a complex and developed set of competencies discussed in the following four sections. Clinical Pharmacy - a Definition Clinical Pharmacy - Overall Goal Level of Action of Clinical Pharmacists How to Pursue a Profession in Clinical Pharmacy ?

Clinical Pharmacy - a Definition

Clinical Pharmacy is a commonly used term in pharmacy practice and in pharmacy literature. It is a health specialty, which describes the activities and services of the clinical pharmacist to develop and promote the rational and appropriate use of medicinal products and devices. Clinical Pharmacy includes all the services performed by pharmacists practising in hospitals, community pharmacies, nursing homes, home-based care services, clinics and any other setting where medicines are prescribed and used. The term "clinical" does not necessarily imply an activity implemented in a hospital setting. It describes that the type of activity is related to the health of the patient(s). This implies that community pharmacists and hospital pharmacists both can perform clinical pharmacy activities. How does clinical pharmacy differ from pharmacy?

the discipline of pharmacy embraces the knowledge on synthesis, chemistry and preparation of drugs clinical pharmacy is more oriented to the analysis of population needs with regards to medicines, ways of administration, patterns of use and drugs effects on the patients.

The focus of attention moves from the drug to the single patient or population receiving drugs.

Clinical Pharmacy - Overall Goal

The overall goal of clinical pharmacy activities is to promote the correct and appropriate use of medicinal products and devices. These activities aim at:

maximising the clinical effect of medicines, i.e., using the most effective treatment for each type of patient minimising the risk of treatment-induced adverse events, i.e., monitoring the therapy course and the patient's compliance with therapy minimising the expenditures for pharmacological treatments born by the national health systems and by the patients, i.e., trying to provide the best treatment alternative for the greatest number of patients.

Level of Action of Clinical Pharmacists

Clinical pharmacy activities may influence the correct use of medicines at three different levels: before, during and after the prescription is written.

1. Before the prescription

Clinical trials Formularies Drug information Clinical pharmacists have the potential to implement and influence drug-related policies, i.e., making decisions on which drugs deserve to be marketed, which drugs should be included in national and local formularies, which prescribing policies and treatment guidelines should be implemented. Clinical pharmacists are also actively involved in clinical trials at different levels: participating in ethical committees; study monitoring; dispensation and preparation of investigational drugs.

2. During the prescription

Counselling activity Clinical pharmacists can influence the attitudes and priorities of prescribers in their choice of correct treatments. The clinical pharmacist monitors, detects and prevents harmful drug interaction, adverse reactions ad medication errors through evaluation of prescriptions' profiles. The clinical pharmacist pays special attention to the dosage of drugs which need therapeutic monitoring. Community pharmacists can also make prescription decisions directly, when over the counter drugs are counselled.

3. After the prescription

Counselling Preparation of personalised formulation Drug use evaluation Outcome research Pharmacoeconomic studies After the prescription is written, clinical pharmacists play a key role in communicating and counselling patients. Pharmacists can improve patients' awareness of their treatments, monitor treatment response, check and improve patients' compliance with their medications.

As members of a multidisciplinary team, clinical pharmacists also provide integrated care from 'hospital to community' and vice versa, assuring a continuity of information on risks and benefits of drug therapy.

How to Pursue a Profession in Clinical Pharmacy

At present Schools of Pharmacy in Europe do not satisfy the minimal requirements for an appropriate education in clinical pharmacy. They are still largely focused an old model of pharmacy activity, e.g., based on chemistry and basic sciences knowledge. A few universities have modified and broadened their curriculum including topics as epidemiology, pharmacoeconomics, clinical medicine, communication skills, the latter being particularly important for community pharmacists. The majority of new graduates in pharmacy will therefore work either in the community or the hospital setting to learn the skills unique to a Clinical Pharmacist. Membership in ESCP and participation in ESCP courses, conferences and symposia provide important learning platforms for pharmacy graduates wishing to specialise in Clinical Pharmacy. Johnny Beney (12.11.2010)

What is a clinical pharmacist?

Clinical pharmacists work directly with doctors, other health professionals, and patients to ensure that the medications prescribed for patients contribute to the best possible health outcomes. Clinical pharmacists practice in health care settings where they have frequent and regular interactions with doctors and other health professionals, contributing to better coordination of care. The clinical pharmacist is educated and trained in direct patient care environments, including medical centers, clinics, and a variety of other health care settings. Clinical pharmacists are frequently granted patient care privileges by collaborating doctors and/or health systems that allow them to perform a full range of medication decision-making functions as part of the patients health care team. These privileges are granted on the basis of the clinical pharmacists demonstrated knowledge of medication therapy and record of clinical experience. This specialized knowledge and clinical experience is usually gained through residency training and specialist board certification.

What do clinical pharmacists do?

Clinical pharmacists: Assess the status of the patients health problems and determine whether the prescribed medications are optimally meeting the patients needs and goals of care. Evaluate the appropriateness and effectiveness of the patients medications. Recognize untreated health problems that could be improved or resolved with appropriate medication therapy. Follow the patients progress to determine the effects of the patients medications on his or her health. Consult with the patients doctors and other health care providers in selecting the me dication therapy that best meets the patients needs and contributes effectively to the overall therapy goals. Advise the patient on how to best take his or her medications. Support the health care teams efforts to educate the patient on other important s teps to improve or maintain health, such as exercise, diet, and preventive steps like immunization. Refer the patient to his or her doctor or other health professionals to address specific health, wellness, or social services concerns as they arise.

How do clinical pharmacists care for patients?

Clinical pharmacists: Provide a consistent process of patient care that ensures the appropriateness, effectiveness, and safety of the patients medication use. Consult with the patients doctor(s) and other health c are provider(s) to develop and implement a medication plan that can meet the overall goals of patient care established by the health care team. Apply specialized knowledge of the scientific and clinical use of medications, including medication action, dosing, adverse effects, and drug interactions, in performing their patient care activities in collaboration with other members of the health care team. Call on their clinical experience to solve health problems through the rational use of medications. Rely on their professional relationships with patients to tailor their advice to best meet individual patient needs and desires.

How do you find a clinical pharmacist?

Clinical pharmacists practice in many different health care environments: hospitals and their affiliated outpatient clinics, emergency departments, community pharmacies, doctors offices, communitybased clinics, nursing homes, and managed care organizations. Beginning in 2014, health care providers will be able to request a clinical pharmacy consult from a member of The Panel of Volunteer Clinical Pharmacists.