Introduction to Clinical Patient Management Past Paper PDF 2024-2025

Integrated Sequence 1 (PHIDG 1501), 12/17/2024 Introduction to Clinical Patient Management: Pharmacists’ Patient Care Process Melinda J. Burnworth, PharmD, FASHP, FAzPA, BCPS Professor of Pharmacy Practice, Adult Internal Medicine...

Integrated Sequence 1 (PHIDG 1501), 12/17/2024 Introduction to Clinical Patient Management: Pharmacists’ Patient Care Process Melinda J. Burnworth, PharmD, FASHP, FAzPA, BCPS Professor of Pharmacy Practice, Adult Internal Medicine Midwestern University College of Pharmacy – Glendale Chapter 1: Patient Care Process. DiPiro’s Pharmacotherapy: A Pathophysiologic Approach, 12e. McGraw Hill; 2023. The Patient Care Process. DiPiro’s Pharmacotherapy Handbook, 12e. McGraw Hill; 2023. Cholla 211-13 (623) 572-3546 [email protected] Thurs, 12-1 Copyright © Burnworth, Midwestern University, 2024. All rights reserved.  Learning Objectives After attending the lecture and completing self-study, the learner will be able to: LO1. State the THREE essential elements that are required for a professional patient care practice [RememberingBT] [1 TQ] LO2. Identify the FIVE sequential steps in the Pharmacists’ Patient Care Process (PPCP) described by the Joint Commission of Pharmacy Practitioners (JCPP) [UnderstandingBT] [1 TQ] LO3. Identify the FOUR most common medication-related needs [UnderstandingBT] [1 TQ] LO4. Illustrate how ONE reliable pharmacy resource (UpToDate® Lexidrug ) can assist with resolving medication-related problems [ApplyingBT] [1 TQ] LO5. Illustrate how the modernized QUADruple Aim in Healthcare can transform the healthcare system [ApplyingBT] [1 TQ] Higher order thinking Lower order thinking BT=Bloom’s Taxonomy LO1. State the essential elements that are required for a professional patient care practice [1 TQ] A professional patient care practice is not a physical location; rather, is built on 3 essential elements: Philosophy of practice Patient care process Practice management system LO2. Identify the steps in the Pharmacists’ Patient Care Process described by the Joint Commission of Pharmacy Practitioners [1 TQ] Patient Care Process Across Disciplines ADPIE SOAP PPCP [Nurse] [Doctor] [Pharmacist] circa 1960s circa 1970s circa 2014* Problem Oriented Medical Record (POMR) Abbreviations: ADPIE=Assessment, Diagnosis, Planning, Implementation, Evaluation; SOAP=Subjective, Objective, Assessment, Plan; PPCP=Pharmacists’ Patient Care Process 2024 revisions pending JCPP-Patient-Care-Process-Update-and-Decision-Background-Materials.pdf. LO2. Identify the steps in the Pharmacists’ Patient Care Process described by the Joint Commission of Pharmacy Practitioners [1 TQ] Pharmacists’ Patient Care Process Pharmacists use a patient-centered approach in collaboration with other providers on the health care team to optimize patient health and medication outcomes. Using principles of evidence-based practice, pharmacists progress through 5 steps: Collect subjective & objective information about the pt Assess the collected data to identify problems & set priorities Create an individualized care plan that is evidence-based & cost-effective Implement the care plan Monitor pt over time during follow-up encounters to evaluate the effectiveness of the plan & modify it as needed Joint Commission of Pharmacy Practitioners. Pharmacists’ Patient Care Process. May 29, 2014. Available at: https://jcpp.net/wp-content/uploads/2016/03/PatientCareProcess-with-supporting-organizations.pdf.  [Disease State] and the “Inspired” PPCP Burnworth MJ. “Inspired” Pharmacists’ Patient Care Process. February 4, 2019. Available at: Intellectual property of Burnworth B a c k g r o u n d Medication Pearls Joint Commission of Pharmacy Practitioners. Pharmacists’ Patient Care Process. May 29, 2014. Available at: https://jcpp.net/wp-content/uploads/2016/03/PatientCareProcess-with-supporting-organizations.pdf. 2024 revisions pending JCPP-Patient-Care-Process-Update-and-Decision-Background-Materials.pdf. LO3. Identify the most common medication-related needs [1 TQ] The 4 most common medication-related needs: Indication Effectiveness Safety Adherence LO3. Identify the most common medication-related needs [1 TQ] The 4 medication related needs represent ten medication therapy problem categories. When this assessment approach is applied, a relatively consistent pattern of medication therapy problems emerges. Pharmacy Quality Alliance https://www.pqaalliance.org/ LO3. Identify the most common medication-related needs [1 TQ] It is critical that the pharmacist completes their assessment and defines a problem list considering indication, effectiveness, safety, and adherence in this order. This order of assessment ensures that the most relevant issue affecting the patient is identified. Safety? Indication? Efficacy? Adherence? LO3. Identify the most common medication-related needs [1 TQ] Indication? Every medication must have an appropriate indication & appropriate SIG. Medication Reconciliation Indication / SIG metformin [GLUMETZA] 500 mg po bid Diabetes aspirin [BAYER LOW DOSE] 81 mg po daily Heart health lisinopril [ZESTRIL] 10 mg po daily Hypertension hydrochlorothiazide [GENERIC] 25 mg po daily Hypertension simvastatin [ZOCOR] 10 mg po at bedtime Cholesterol levofloxacin [LEVAQUIN] 750 mg po daily LO3. Identify the most common medication-related needs [1 TQ] Are therapeutic goals being met? Efficacy? Justify therapeutic goals with evidence. Medication (Indication) Therapeutic Goal* Justification Metformin (DM) A1C 7 ADA, AACE Aspirin (CV) Stop CV problems ADA, KDOQI, NCEP Lisinopril (HTN) BP 130/80 ADA, AACE, KDOQI Hydrochlorothiazide (HTN) BP 130/80 JNC-8 Simvastatin (Cholesterol) LDL 100 NCEP high intensity statin AHA Levofloxacin (Infection) Resolve infection IDSA *Therapeutic goals change based on current guidelines. Refer to most current guidelines as related to: ADA=American Diabetes Association, AACE=American Association of Clinical Endocrinologists, NCEP=National Cholesterol Education Program, AHA=American Heart Association, KDOQI=Kidney Disease Outcomes Quality Initiative, JNC=Joint National Committee, IDSA=Infectious Diseases Society of America LO3. Identify the most common medication-related needs [1 TQ] Safety? Is it a true allergy or common side effect? “How was the allergy manifested?” “What happened when you took the medication?” “What medication caused this effect?” OTC / herbal / food products using “body” systems approach “What do you take for headache?” “What do you take for upset stomach?” Is the patient pregnant / lactating? LO3. Identify the most common medication-related needs [1 TQ] How many doses have you missed in the last 3 days? Last week? Adherence? www.azahcccs.gov/ Nonformulary Formulary LO4. Illustrate how UpToDate® Lexidrug can reliably assist with resolving medication-related problems [1 TQ] Various references are available to assist in resolving medication-related problems. Let us review the 1 most common drug reference: UpToDate® Lexidrug LO4. Illustrate how UpToDate® Lexidrug can reliably assist with resolving medication-related problems [1 TQ] Medication Pearls Step 1. Medication Reconciliation Step 2. Appropriate? Match Medication to Indication & SIG Yes Step 3. Identify at least: Efficacy Safety 2 Efficacy Endpoints Parameters Parameters 2 Safety Endpoints Step 4. Adherence Monitor Adherence LO4. Illustrate how UpToDate® Lexidrug can reliably assist with resolving medication-related problems [1 TQ] UpToDate® Lexidrug Adverse Reactions Patient & Therapy Management LO4. Illustrate how UpToDate® Lexidrug can reliably assist with resolving medication-related problems [1 TQ] Safety Parameters LO4. Illustrate how UpToDate® Lexidrug can reliably assist with resolving medication-related problems [1 TQ] Efficacy Safety Parameters Parameters Blood Pressure Creatinine Kidney Function Potassium LO4. Illustrate how UpToDate® Lexidrug can reliably assist with resolving medication-related problems [1 TQ] LO4. Illustrate how UpToDate® Lexidrug can reliably assist with resolving medication-related problems [1 TQ] Google, Bing Wikipedia Facebook, Tik Tok, Snapchat National Institutes of Health www.nlm.nih.gov/medlineplus/encyclopedia.html LO5. Illustrate how the quadruple Aim in Healthcare transforms the healthcare system [1 TQ] Historical Modern Improved Provider Well-being Improved Population Health Furthermore, "quintuple aim" that includes advancing health equity is the future.  Learning Objectives After attending the lecture and completing self-study, the learner will be able to: LO1. State the THREE essential elements that are required for a professional patient care practice [RememberingBT] [1 TQ] LO2. Identify the FIVE sequential steps in the Pharmacists’ Patient Care Process (PPCP) described by the Joint Commission of Pharmacy Practitioners (JCPP) [UnderstandingBT] [1 TQ] LO3. Identify the FOUR most common medication-related needs [UnderstandingBT] [1 TQ] LO4. Illustrate how ONE reliable pharmacy resource (UpToDate® Lexidrug ) can assist with resolving medication-related problems [ApplyingBT] [1 TQ] LO5. Illustrate how the modernized QUADruple Aim in Healthcare can transform the healthcare system [ApplyingBT] [1 TQ] Higher order thinking Lower order thinking BT=Bloom’s Taxonomy  Integrated Sequence 1 (PHIDG 1501), 12/17/2024 Introduction to Clinical Patient Management: Pharmacists’ Patient Care Process Melinda J. Burnworth, PharmD, FASHP, FAzPA, BCPS Professor of Pharmacy Practice, Adult Internal Medicine Midwestern University College of Pharmacy – Glendale Chapter 1: Patient Care Process. DiPiro’s Pharmacotherapy: A Pathophysiologic Approach, 12e. McGraw Hill; 2023. The Patient Care Process. DiPiro’s Pharmacotherapy Handbook, 12e. McGraw Hill; 2023. Cholla 211-13 (623) 572-3546 [email protected] Thurs, 12-1 Copyright © Burnworth, Midwestern University, 2024. All rights reserved.