Transcript 04 present OEF

04 Organization of non- prescription
drugs sales
Pharmaceutical care
In the last quarter century, pharmacy has
expanded its role within the health are delivery
system from a profession focusing on
preparation and dispensing of medications to
patients to one in which pharmacists provide a
range of patient- services to maximize the
medicine's effectiveness.
Is this the right medicine, doc?" In 1948, patients
asked their pharmacists that question every day,
and physicians didn't seem to mind at all. Fifty
years later, patients don't refer to their pharmacists
as "doc," but they still ask the same question. Now,
however, physicians seem concerned about
pharmacists intruding on their turf s providers of
medical care and advice.
The worry comes as pharmacists seek an increased
role in providing counseling and clinical services to
patients as well as greater payment for their
services. Pharmacists see themselves as health
care professionals licensed to apply their special
knowledge, and they're telling health care systems,
patients and insurers they are an integral part of the
managed care solution or pharmaceutical care.
Statement On Pharmaceutical Care
Pharmaceutical care is the responsible
provision of drug therapy for the purpose
of achieving definite outcomes that
improve a patient's quality of life. These
outcomes are: cure of a disease,
elimination or reduction of a patient's
sympatology, arresting or slowing of a
disease process, or preventing a disease
or sympatology.
Pharmaceutical care involves
the process through which a
pharmacist, іn cooperation with a
patient and other health
professionals, designs, implements,
monitors a pharmaceutical care plan
that will produce specific therapeutic
outcomes for the patient. This in turn
involves three major functions
performed by the pharmacist:
identifying potential and actual dragrelated problems, 'resolving actual
drug-related problems, and
preventing potential drug-related
problems.
Pharmaceutical care is a necessary
element of health care that should
integrated with other elements.
Pharmaceutical care is, however,
provided for the direct benefit of the
patient, and the pharmacist is responsible
directly to the patient for the quality of that
care. The fundamental relationship in
pharmaceutical care і mutually beneficial
exchange in which the patient grants
authority to the provider and the provider
gives competence and commitment
(accepts responsibility) to the patient.
The fundamental goals, processes, and
relationships of pharmaceutical care exist
regardless of practice settings.
The basis of pharmaceutical care is
responsibility and accountability to patient for
the outcome of their drug therapy.
 The overall goal of pharmaceutical care is
to maintain patients at the highest possible
level of functional and psychosocial wellbeing through optimal management of drug
therapy.
 Pharmaceutical care requires continuity
of care between different practice settings.
Drug-Related Problems
Pharmaceutical care involves the pharmacist in
three major functions on behalf of the patient:
identifying potential and actual drug-related
problems, resolving actual drug related
problems, and preventing potential drug-related
problems. A drug-related problem is an event or
situation involving drug therapy that actually or
potential interferes with an optimum outcome for
a specific patient.
•Untreated indications. The patient has a
medical problem that requires drag therapy but
is not receiving a drag for that indication.
•Improper drag selection. The patient has a drug
indication but is taking the wrong drug, or is
taking a drug that is not the most appropriate for
the special needs of the patient.
• Subtherapeutic dosage. The patient has a
medical problem that is being treated with too
little of the correct medication.
• Failure to receive medication. The patient
has a medical problem that is the result of
not receiving a medication due to
economic, psychological, sociological, or
pharmaceutical reasons.
• Overdosage. The patient has a medical
problem that is being treated with too
•much of the correct medication.
• Adverse drug reactions. The patient has a
medical problem that is the result of an
adverse drug reaction or adverse effect.
• Drug
interactions. The patient has a medical problem that is
the result of a drug-drug, drug-food, or drug-laboratory test
interaction.
• Drag use without indication. The patient is taking a
medication for no medically valid indication.
• Treatment failures. The patient has a medical problem that
is being treated with a medication that is generally
considered appropriate for the indication, but the desired
therapeutic outcome is not achieved.
Its main aim is to work in partnership both with other
healthcare professionals and with patients, to ensure they
make the best and safest use of medicines.
Pharmaceutical care reflects a systematic
approach that makes sure that the patient
gets the right medicines, in the right dose, at
the right time and for the right reasons. it is
about a patient-centred partnership approach
with the team accepting responsibility for
ensuring that the patient's medicines are as
effective as possible and
As safe as possible. This is done by
identifying, resolving and preventing
medicine-related problems so the patient
understands and gets the desired therapeutic
goal for each medical condition being treated.
Pharmacists can and do make a unique
contribution to improving patient care. Medicines
are the most common of all the steps taken by
clinicians to help patients. And of all the
healthcare professions, pharmacists have the
widest knowledge in the science and use of
medicines.
Whether in the community, in hospitals or
specialist units, pharmacy focuses on
empowering and protectin patients. Pharmacists
have a key role to play in ensuring health gain
wherever medicines are used.
Pharmacists provide care not just to
patients but to the wider general
publik. The 'pharmaceutical health' of
the nation depends on good access to
medicine advice and to tailoring
therapy to the needs of individuals.
Principles of Practice for Pharmaceutical Care
Pharmaceutical Care is a patient-centered,
outcomes oriented pharmacy practice that
requires the pharmacist to work in concert with
the patient and the patient's other healthcare
providers to promote health, to prevent disease,
and assess, monitor, initiate, and modify
medication use to assure that drug therapy
regimens are safe and effective. The goal of
Pharmaceutical Care is to optimize the patient's
health-related quality of life, and achieve positive
clinical outcomes, within realistic economic
expenditures. To achieve this goal, the following
must accomplished:
A. A professional relationship must be
established and maintained.
Interaction between the pharmacist and the patient must
occur to assure that a relationship based upon caring,
trust, open communication, cooperation, and mutual
decision making is established and maintained. In this
relationship, the pharmacist holds the patient's welfare
paramount, maintains an appropriate attitude of caring for
the patient's welfare, and uses all his/her professional
knowledge and skills on patient's behalf. In exchange, the
patient agrees to supply personal information
preferences, and participate in the therapeutic plan.
The pharmacist develop mechanisms to assure the
patient has access to pharmaceutical care at all times.
В Patient-specific medical information must be
collected, organized, recorded, and maintained.
Pharmacists must collect and/or generate subjective and objective
information rearding the patient's general health and activity
status, past medical history, medication history, social history, diet
and exercise history, history of present illness, and economic
situation (financial and insured status). Sources of information
may include, but are not limited to, the patient, medical charts and
reports, pharmacist-conducted health/physical assessment, the
patient's family or caregiver, insurer, and other healthcare
providers including physicians, nurses, mid-level practitioners and
other pharmacists.
Since this information will form the basis for decisions regarding the development and
subsequent modification of the drug therapy plan, it must be timely, accurate, and
complete, and it must be organized and recorded to assure that it is readily retrievable
and updated as necessary and appropriate. Patient information must be maintained in a
confidential manner.
C. Patient-specific medical information must be evaluated
and a drugtherapy plan developed mutually with the
patient
Based upon a thorough understanding of the patient and
his/her condition or
disease and its treatment, the pharmacist must, with the
patient and with the patient's other healthcare providers as
necessary, develop an outcomes-oriented drug therapy
plan. The plan may have various components which
address each of the patient's diseases or conditions. In
designing the plan, the pharmacist must carefully consider
the psycho-social aspects of the disease as well as the
potential relationship between the cost and/or complexity
of therapy and patient adherence.
As one of the patient's advocates, the pharmacist
assures the coordination of drug therapy with the
patient's other healthcare providers and the patient.
In addition, the patient must be apprised of U)
various pros and cons (i.e., cost, side effects,
different monitoring aspects, etc.) of e options
relative to drug therapy and (2) instances where
one option may be more beneficial based on the
pharmacist's professional judgment.
D. The pharmacist assures that the patient has all
supplies, informatioi and knowledge necessary to
carry out the drug therapy plan.
The pharmacist providing Pharmaceutical Care must
assume ultimat responsibility for assuring that his/her
patient has been able to obtain, and і appropriately using,
any drugs and related products or equipment called for in
th drug therapy plan. The pharmacist must also assure
that the patient has a thorough understanding of the
disease and the therapy/medications prescribed in the
plan. ,
E. The pharmacist reviews, monitors, and modifies
the therapeutic plan as necessary and appropriate, in
concert with the patient and healthcare team.
The pharmacist is responsible for monitoring the patient's
progress in achieving the specific outcomes according to
strategy developed in the drug therapy plan. The pharmacist
coordinates changes in the plan with the patient and the
patient's other healthcare providers as necessary and
appropriate in order to maintain or enhance thi safety and/or
effectiveness of drug therapy and to help minimize overall
healthcare costs.
Pharmacy items (point) are placed in
separate premises with or without selection
by highlighting the room service population
in the capital medical institutions. Area
drugstore can be not less than 18 sq.m.
Pharmacy items ready to traders
medications, prescription and non
prescription doctor.
Pharmacy kiosks are placed in separate
premises (at least 8 meters) without
extracting trading hall only in capital
structures: for plants, factories, railway
stations, airports.
Pharmacy booth can be placed on the first
floor residential and public buildings if there
is a separate entrance, supply of utilities
(water, sewerage, heating), availability of
space and ventilation premises not less than
21 square meters, including 8 m - Download
Zone equipment jobs personnel, 10 sq.m Service Area population, 3 m wardrobe.
For booth located in areas
where there is no Communication (water,
sewerage), may be placed in Drink biotoilet
and resettlement places for treatment of
hands.
For booth located in the village are allowed
Download the lavatory outside pharmacy,
while in pharmacy must be equipped with a
separate for sanitization of hands.
Pharmacy booth must be equipped
shelves, cabinets, refrigerator and place for
sanitization hand, a case for separate
storage of personal clothing and special
clothes and a closet for storage of business
inventory separately for the
purpose.
Pharmaceutical booth ready
to traders only drugs, dispensing
without prescription.