Quality Education for a Healthier Scotland

Pharmacy

Creating a Pharmaceutical Care Plan for the Chronic Medication Service

NES Core Event

Quality Education for a Healthier Scotland

PharmacyObjective

• To outline each of the sections of the Pharmacy Care Record within the context of the Chronic Medication Service (CMS) explaining:-

• the purpose of the patient profile• the purpose of the medication profile • how to document pharmaceutical care issues,

outcomes and actions

Quality Education for a Healthier Scotland

Pharmacy

Chronic Medication Service (CMS)

Description

A system of ‘personalised’ pharmaceutical care to patients with long term medical conditions

Purpose

To ensure patients obtain optimal therapeutic benefit from their medicines and minimise any predictable undesirable effects

Quality Education for a Healthier Scotland

Pharmacy

Pharmacy Care Record (PCR)

Web based

– a secure system

– username and password protected

– integrates with the PMR system

Supports CMS by hosting the:-

– pharmaceutical assessment

• patient profile

• medication profile

– pharmaceutical care plan

Quality Education for a Healthier Scotland

PharmacyPharmaceutical Assessment

• Completed within 3 months of registration

• Determines the necessity and priority for a personalised pharmaceutical care plan

Quality Education for a Healthier Scotland

Pharmacy

Patient Profile

Named Pharmacist: Contact DetailsGeneral HealthMedical ConditionsAllergies and SensitivitiesDispositionsOrgan FunctionMaternal Status

Pharmaceutical Care Plan Priority:-Not Required; Low; Medium; HighInitial Assessment: DateModified Date

Quality Education for a Healthier Scotland

Pharmacy

Patient Profile

Quality Education for a Healthier Scotland

Pharmacy

Medication Profile

Care issues with the appropriateness of the medicine/s?

Care issue with the formulation of the medicine/s?

Care issue with the dosage and frequency of the medicine/s?

Care issue in relation to contraindications?

Drug interaction with one or more medicines?

Side effects with one or more medicines?

Problems with concordance?

Care issue in relation to polypharmacy?

Pharmacokinetic risk factors?

Pharmacodynamic risk factors?

Disease risk factor?

Taking one or more medicines with a narrow therapeutic range?

Taking one or more black triangle medicines?

Duplication of medication ?

Are there any pharmaceutical care issues of note?

Quality Education for a Healthier Scotland

Pharmacy

Medication Profile

Quality Education for a Healthier Scotland

PharmacyWhat is Pharmaceutical Care?

Hepler and Strand’s definition –

‘The responsible provision of drug therapy for the purpose of achieving definite outcomes which improve a patient’s quality of life’

Quality Education for a Healthier Scotland

Pharmacy

A Systematic Approach

• Collate patient data (patient profile) - pharmacist and patient

• Assess pharmaceutical care needs (medication profile) - pharmacist and patient

• Prioritise patient for a pharmaceutical care plan (patient and medication profile) - pharmacist

• Identify pharmaceutical care issues (patient and medication profile) - pharmacist and patient

• Formulate a care plan - pharmacist• Implement the actions - pharmacist, patient and others• Document outputs - pharmacist• Monitor and review - pharmacist and patient

Quality Education for a Healthier Scotland

Pharmacy

How do we formulate a care plan?

Care issue Desired outcome

Action Action by (Pharmacist, GP, patient)

Response

Education re medication

Patient understands what medicines are for and what to do if a dose is missed

Provide explanation of different medicines and rationale for use

Pharmacist Patient has better understanding of medicines and what to do if a dose is missed

Quality Education for a Healthier Scotland

Pharmacy

PCR Care Issue Summary

Quality Education for a Healthier Scotland

Pharmacy

PCR Care Issue Outcome/s

Quality Education for a Healthier Scotland

Pharmacy

Now it is your turn!

We now have 3 workshops where you can try care planning for patients

1. Hypertension

2. Parkinson’s Disease

3. Osteoporosis

At the end of each workshop, you will receive completed care plans. There is no right or wrong way to care plan for a patient and everybody will do this in a slightly different way, but with practise you will become confident in identifying and documenting care issues, outcomes and actions.