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Questions and Answers
What is the estimated annual number of deaths in hospitals due to preventable errors?
Which of the following is NOT one of the six aims for improvement outlined in 'Crossing the Quality Chasm'?
What was one of the recommendations provided in the IOM report 'To Err is Human'?
What is a potential cause of medical errors mentioned in 'To Err is Human'?
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How much financial loss is attributed to preventable errors in hospitals annually?
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What structures are often responsible for coordinating care across different services and providers?
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Which step in the Evidence-Based Practice (EBP) process involves evaluating the validity and applicability of the information?
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What is a primary focus of public health programs?
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How are healthcare providers often incentivized?
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In the EBP process, what step follows the acquisition of evidence?
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What type of organizations are commonly associated with offering a continuum of care?
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What is one of the primary purposes of health information technology systems?
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In Evidence-Based Practice, which step involves discussing findings with the patient to integrate preferences into care decisions?
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What is one of the key issues with healthcare in America?
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Which organization is mentioned as proposing ideas for quality improvement in healthcare?
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What is a primary focus of new healthcare models like Patient Centered Medical Home?
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When did Hippocrates, a significant figure in ancient medicine, live?
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What belief did Galen have regarding drugs in ancient practice?
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How long has pharmacy existed in some form according to the content?
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What aspect of pharmacy practice has evolved significantly over time?
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What is one proposed model that aims to improve healthcare delivery?
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What was the primary purpose of founding the United States Pharmacopoeia in 1820?
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What significant development occurred with the establishment of the Philadelphia College of Pharmacy in 1821?
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How did the relationship between physicians and pharmacists evolve in the 1840s?
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What was a key factor in the blurred boundaries between pharmaceutical and medical practice during the 1850s?
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Who is recognized as the founder of the American Pharmaceutical Association?
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What was a significant shift in the role of pharmacists during the clinical pharmacy era (1965-1990)?
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What was one of the main challenges faced by pharmacy graduates in the 1970s?
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What did the Millis Commission report (1975) advocate for?
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How did the perception of the individual receiving pharmacy services change during the clinical pharmacy era?
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What new responsibilities did hospital pharmacists take on during this era?
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What technological advancement improved pharmacy workflows during the clinical pharmacy era?
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What impact did changes in health insurance during the 1960s have on pharmacy services?
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What was one consequence of the thriving drug industry during the 1960s for pharmacists?
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What change in pharmacy education occurred during the clinical pharmacy era?
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What was a perception of community pharmacy towards clinical pharmacy during the clinical pharmacy era?
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Study Notes
Ancient Pharmacy
- ‘Medicinals’ are used for the mediation of disease and suffering since the dawn of humanity.
- Pharmacy existed for thousands of years before it developed into a specialized occupation.
- Hippocrates (circa 425 BCE)
- Used dietary regimens and environmental changes to produce health.
- Medicines were sometimes used.
- Galen (second century CE)
- Believed that drugs could restore humoral balance within patients.
- Used polypharmaceutical compounds.
Pharmacy in Early US
- The United States Pharmacopoeia was founded in 1820.
- This book of standards was created to help prevent trouble or uncertainty in the relationship between physicians and apothecaries.
- The Philadelphia College of Pharmacy was established in 1821.
- This was a model for occupational development that was emulated in other large cities in the US.
- The first pharmacy journal, the American Journal of Pharmacy, was created.
- The first code of ethics for pharmacists was composed.
Relationships with Physicians
- Physicians supported the appearance of pharmacists near their practices and welcomed them as subordinate colleagues.
- Pharmacists and apothecaries did not compete directly with physicians for business.
- The relationship between physicians and pharmacists varied over the next few decades.
- Medical schools increased their output of physicians during the 1840s.
- Physicians reverted to setting up shop and selling drugs as well as advice, competing with pharmacists.
- The borders between pharmaceutical and medical practice became unclear again during the 1850s.
- Pharmacists began “counter prescribing” - recommending favorite preparations “over the counter” for customers.
- Pharmacists solidified their position as the prime sellers of patent medicines.
- Medical schools increased their output of physicians during the 1840s.
Founding of the American Pharmaceutical Association
- The American Pharmaceutical Association was founded in 1852.
- Initiated by pharmacists wanting to advance the profession and establish its practice.
- This organization provided a forum for professional development through meetings, journals, publications, and networking.
Clinical Pharmacy Era
- This era (1965 – 1990) was a transitional period for professional development, primarily in hospitals.
- Pharmacists transitioned from “count and pour” roles to “drug information experts”.
- P&T committees and hospital formularies brought pharmacists into the therapeutic side of practice.
- The pharmacist’s clinical role was expanding.
Other Important Transitions in Health Care
- Health insurance developments (1950s) and the passage of Medicare and Medicaid legislation (1965) created a system of third-party payment for pharmacy services.
- Drug companies shifted some medicines from prescription-only to nonprescription status.
- Hospital pharmacists established advanced drug distribution systems and assumed primary responsibility for the preparation of intravenous products.
- Computer systems allowed pharmacists to track patient profiles, check for drug interactions, and improve record keeping.
- Technology applied to dispensing improved workflow for pharmacy practitioners.
Managed Care
- Managed care plans began to shift from traditional fee-for-service arrangements to managed care arrangements.
- This created pressure for pharmacists in community settings to reduce dispensing costs, and this required pharmacists to provide more efficient services.
- The rise of managed care brought new pressures for pharmacists to demonstrate their clinical value.
- The managed care era promoted a renewed emphasis on cost containment and health outcomes.
Outcomes-Based Pharmacy Practice
- Outcomes-based pharmacy practice evolved as a response to the increasing focus on patient outcomes and cost containment in health care.
- This practice emphasized pharmacists’ contributions to patient care, not only by dispensing medications but also by providing clinical services and monitoring patient outcomes.
- The pharmaceutical profession started to establish a clear link between pharmacist services and patient care outcomes.
Pharmacy Practice Today
- The current practice of pharmacy has been shaped by a multitude of forces, including the increasing complexity of medications and the growing need for patient education.
- Today’s pharmacists are expected to have a deep understanding of pharmacotherapy, disease management, and patient counseling.
- They are often involved in medication therapy management, disease state management, and the development of health care programs.
Key Points
- Pharmacists are valuable members of the health care team.
- Pharmacy practice can be challenging, with constant changes and requirements to adapt.
- Today’s pharmacists require a high level of knowledge and skills to provide optimal patient care.
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Description
Explore the rich history of pharmacy from ancient medicinal practices to the establishment of the first pharmaceutical standards in the United States. Learn about key figures like Hippocrates and Galen and the evolution of pharmacy as a profession with the founding of the United States Pharmacopoeia and the Philadelphia College of Pharmacy.
