Pharmaceutical Care Plan PDF

PHARMACEUTICAL CARE PLAN: THE CARE PLAN THE CARE PLAN DEVELOPMENTAL GOALS OF THERAPY CARE PLANNING ACTIVITIES AND MEASUREMENTS CRITERIA...

PHARMACEUTICAL CARE PLAN: THE CARE PLAN THE CARE PLAN DEVELOPMENTAL GOALS OF THERAPY CARE PLANNING ACTIVITIES AND MEASUREMENTS CRITERIA RESPONSIBILITIES 1. Goals of therapy are established for each indication Establish goals of therapy managed with drug therapy. ➔ It should always be with the px ➔ Focus in drug therapy problems, all the diseases of the px should have at least drug and all of the goals of the Practitioner and patient negotiate and agree upon therapy should be based on the indications desired endpoints and time frame for pharmacotherapeutics. 2. Desired goals of therapy are described in terms of the ➔ You’re not going to impose your time frame w/ the px, observable or measurable clinical and/or laboratory you’re not going to impose the goals therapy of the px. parameters to be used to evaluate effectiveness and Px is the most important person in the healthcare team. safety of drug therapy. ➔ If you would want to provide your goals for therapy Determine appropriate interventions ensure it is measurable & quantifiable. Qualitative data ➔ Everytime you plan for the activities & responsibilities should always be followed up by quantitative data you have to determine the appropriate intervention for your px. 3. Goals of therapy are mutually negotiated with the patient and other HCPs when appropriate. Consider therapeutic alternatives and select patient- ➔ It is a collaborative effort specific pharmacotherapy, patient education, and non-drug interventions 4. Goals of therapy are realistic in relation to the ➔ Not all medicines are applicable to your px, in one patient’s present and potential capabilities. pharmaceutical class not everything can be use by your ➔ You have to be careful for the terms or the words px there are specific molecules that cannot be used by whenever you’re talking to your px. It should be realistic. the px. Instead of saying “gagaling po kayo” even px has ➔ Provide px education, if the px would be knowledgeable incurable dx say “mapapababa po natin yung value neto enough w/ their medications they would be willing in a normal level in 6 months” enough to participate in their interventions 5. Goals of therapy include a time frame for ➔ Non-drug interventions, some dx can be treated by achievement. lifestyle changes alone, problem is people are resistant ➔ Therapy is dependent on the disease for those. Reiterate this to them. Resolve DTP, achieve goals of therapy, prevent new MAJOR QUESTIONS THAT MUST problems BE CONSIDERED Schedule follow-up evaluations What goals of therapy are you and your patient trying ➔ It could be a laboratory test, which we would have to to achieve with pharmacotherapy? coordinate with px in order for us to do so. Make sure that this is convenient to the px. What are you going to do, or how are you going to intervene, to resolve any drug therapy problems Establish a schedule for follow-up evaluation that is identified during the assessment? clinically appropriate and convenient to the patient ➔ It should be possible that the goal will always be What interventions (drug therapies, devices, patient achievable. education) are you going to provide to ensure that your patient education) are you going to provide to ensure that your patient achieve the desired goals of therapy? 1 MATOS, MARY LOUISE T.  When are you going to follow up with your patient to II. Removal of barriers to obtain medication determine the actual outcomes of drug therapies and ➔ Barrier would be the price; provide them possible other interventions? discount ➔ EX. HIV Tx- Access by HIV medication GOALS OF DRUG THERAPY ➔ In some cases px not able to obtain medication under experiment phase provide them under clinical trial. Cure a disease III. Initiation of new drug regimen ➔ EX. Px can be cured in bacterial infection within 7 days ➔ RX Only - OTC’s (prescription only) as long as you by means of a clear chest x-ray perfectly know that this new drug therapy would not Reduce or eliminate signs and symptoms cause an significant impact on the prescription drug of ➔ EX. Px has BP in normal range in 6 months (BP is px. quantifiable w/ a time frame of 6 months) IV. Change in dosage regimen Slow or halt the progression of a disease ➔ If the px doesn’t go to the physician yet and go to pharmacy just symptomatic. If you ever going to provide Prevent a disease a new regimen drug for the patient always remember to ➔ EX. Px would not have an infection after a surgical advise to go to the physician. If they feel like drug does procedure for the next 3 days (during surgery provide px not have effect pls refer them to their doctors. prophylactic dose of antibiotic to prevent infection) V. Initiation of a monitoring plan Normalize lab values ➔ EX. Uric acid of the px would be in the normal ranges Change in drug product based on excretion in two weeks ➔ in some cases the drug product that they normally used wouldn’t be available you would provide them with Assist in the diagnostic process another drug product ➔ It should be realistic, measurable and should have a ➔ EX. Generic Counterparts- generic substitution must time frame be involved in the SAME DOSAGE FORM. INTERVENTIONS REQUIRING DIRECT Discontinue any therapy COMMUNICATION WITH THE PATIENT’S PHYSICIANS ➔ You can advise them to discontinue OTC’s drug that has negative impacts on their health 1. Initiate new drug therapy ➔ Ask the px physician’s for new prescription Drug administration device provided ➔ Px difficult to administer drug to them 2. Change the dosage regimen ➔ If you’re going to change time it doesn’t have any Other problem but when you change the number of doses per day you have to have a prescription for that. MEDICATION MANAGEMENT REFERRALS 3. Discontinue the drug regimen I. PHYSICIAN’S OFFICE ➔ Always start w/ GPS (General Practitioner) from them 4. Institute a monitoring plan (labs) they would refer to specialist practitioner ➔ It would be the physician’s order in order for the px to be ➔ Always go to them first, since they have low fee, they’re given a lab exam more knowledgeable for simple diseases, if they can’t do it, that is the only one they would refer to a INTERVENTIONS IMPLEMENTED DIRECTLY BY specialist. PATIENT AND/ OR PRACTITIONER II. SPECIALIST OFFICE I. Patient-specific instructions on proper use of III. EMERGENCY DEPARTMENT/HOSPITAL medication ➔ If severe condition refer them directly to emergency ➔ Teach your px how to properly take their medications department ➔ EX. Px has asthma attacks because px use the inhaler as a breath freshener. Or the capsule for inhalation purposes is taken by mouth. ➔ EX. Albuterol (Ventolin Rotacaps) - Px take this by mouth which is wrong 2 MATOS, MARY LOUISE T.  STATEMENT OF INTERVENTIONS MEASUREMENT CRITERIA MEASUREMENT CRITERIA The clinical and laboratory parameters to evaluate effectiveness are established, and a time frame for Each intervention is individualized to the patient’s collecting the relevant information selected. conditions, drug-related needs, and drug-therapy ➔ Make sure the lab parameter that you’re going to ask problems would be based on or appropriate in px condition ➔ Always provide personalized care for px although this is The clinical and laboratory parameters to evaluate the ideal especially in ph setting but if it is feasible why not safety of the patient’s medication are selected and a All appropriate therapeutic alternatives to resolve time frame for collecting the relevant info is desired. drug therapy problems are considered and the best are selected prior to dispensing. A schedule for the follow-up evaluation visit is ➔ You have to check all of the best therapeutic alternative established with the patient. The plan is developed in collaborations with the The schedule and plan for follow-up evaluation is patient, his family and/or caregivers, and HCPs. documentation. ➔ Sometimes it is possible - Px is okay but caregivers are not PLANNING FOR FOLLOW-UP EVALUATION ➔ When will the caregiver's decision be heavier compared to their patient? When px is not capable to decide on When should the follow-up evaluation occur? their own, px is minor, px has psychiatric disorders, px ➔ When is the nearest possible time wherein you could who are delusional stages. When px does not have have the result? capability to provide rational decisions, it would always be the family member who will give consent. How will you determine if positive outcomes have ➔ Between the parent of the px and the spouse who will occurred? (effectiveness) have the power? It’s the spouse legally, but if not ➔ What are the laboratory parameters that you have to married it’s the parents consider? What is the clinical parameter that you have to consider? All interventions are documented. ➔ Picture is not alone enough How will you determine if negative outcomes have ➔ You have to provide a narrative and follow up evaluation occurred? (safety) ➔ Presence of ADRs. The px should provide you a The plan provides for continuity of care by including complete description on how they feel whenever they a schedule for continuous follow-up evaluation. take their medication. INTERVENTIONS PURPOSE Resolve Drug Therapy Problem ➔ Existing in px all u have to do is resolve them, provide interventions in order to discuss DTP Achieve Goals of Therapy Prevent Problems Therapeutic Alternatives ➔ This could be non pharmacologic therapy Cost Considerations ➔ Maybe your px has drug therapy problems coz you not able to avail to take their medications ESTABLISH A SCHEDULE FOR FOLLOW-UP EVALUATION 3 MATOS, MARY LOUISE T.