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Introduction to pharmacist clinics

Hello, everyone It’s been honor to be here to share the topics of pharmacist clinics with you today. I am Ju-Chieh Wung, the clinical pharmacist working in Taipei Veterans General Hospital. I’m also currently the coordinator of anticoagulation clinics in this hospital. Before we go to our main topic, there is three core concepts you have to know before you go to the topic. One is the updated today is the out-of-date tomorrow, medication advance with time. If you have the chance to set up a pharmacy clinics, the first thing you have to do is try to keep up with the most updated medication situation.
So, you have to do the literature research, you can talk with your work colleague, the physician, the nurse, try to keep yourself the most updated situation. The second thing is think globally and act locally. Once you review the literature, you will know some successful models. However, all the successful case need to grow up in a certain culture, certain insurance policy, and a certain situation. For example, the anticipation of the pharmacy in this culture system. So, if you want to set up a pharmacist clinic, you must to know that you have a custom to the local culture.
Then, once you know the top two core concepts, then we can go to our main topic, that is how to develop, and run a pharmacy clinics. This is the outline today. First, we will have the literature review of the successful model currently, and then once we see all these successful case, we will go to start a clinic, step one, two, three, which is Needs Assessment, Clinic set-up, and Assessment. After we finish set up the clinics, then we need to know the future of the clinics. We need to imagine the clinics by times.
Then, we go to the literature review. Here is several models for pharmacy clinics. There is one drug model, one class of drug model, one health condition models, and we go to the more complicated model, which is numerous conditions. It means you have to deal with several types of disease condition and several types of our drug class. And you cannot go to the detail, you probably have to go to the comprehensive evaluation. Then the latest model is the electronic communication. Because the communicated technology, it improved a lot recently. People have telephone, people can communicate with e-mail, with smart phones, with apps. So recently it develops the telepharmacy.
And it shows that it have positive effecs to the patients’ disease control and it is a growing service model recently.
Then we go to our cases. This is a one drug model, and pharmacy clinics focus only on amiodarone drugs. And, because the amiodarone has a notable adverse effects need close monitoring. And, the second thing is most of patients are fear of the potential adverse drug effect. So, the medication adherence are usually poor if you don’t give a proper education to the patient. So, in this paper, it demonstrates a successful model that if the pharmacists have a proper education and proper monitoring of the amiodarone rapid adverse effect, the patient will improve their medication adherence and their treatment efficacy will improve through times. Here is another case of one drug model, which is a new drug.
It’s PCSK9 inhibitor, for the treatment of patient with hypercholesterolemia condition. It’s a newly marketing drug. And physicians, the nurse and other medication staffs are not very worry about this drug potential side effects, so, the pharmacists will have the chance to join the treatment team and have a good education to the patient, and how the treatment to have a better outcome.
Then, we go to the one class of drug model. It has been the most successful model, and it has national certification. In United State, it also have Certified Anticoagulation Care Provider. And, if you go to the website here, you will know more about the national certification. And, it is also related to the payment of the service if you got the certification.
This is a systemic review. It’s talking about anticoagulation therapy. It’s talking about one class of drug which is an anticoagulation and there is numerous paper already showed that a pharmacist-managed clinic in anticoagulation management will have the better quality of anticoagulation control and lower bleeding and thromboembolic events, and less frequent of hospitalization. So, it already demonstrated that the pharmacists have a positive impact on our patient care. And, it is already enrolled in official payment in the insurance policy in United State.

Last session, we have gone through various examples of clinical pharmacy services (CPS). We welcome Ju-Chieh Wung, a clinical pharmacist working at TVGH as our educator this week. She will introduce the ins and outs of pharmacist clinics.

There are three core concepts you have to know before you build up pharmacist clinics. One is to keep medication in advance with time. If you have the chance to set up a pharmacy clinic, the first thing you have to do is try to keep up with the most updated medication situation. The second is localized pharmacy clinics. Literature research would help you find success models. You would need to think globally and act locally. Customizing pharmacist clinics to fit in the local culture is required. The final core concept is to develop and run your pharmacist clinic.

Setting up pharmacy clinics is a 3-step process consisting of needs assessment, set-up, and assessment. We will go through each step one by one.

There are several models for pharmacy clinics: one drug model, one class of drug model, one health condition model, numerous conditions model, and electronic communications model and etc. We will give examples to explain each model.

Share and learn:

  • Do you know of other drugs that are managed by one drug model pharmacist clinic?

  • Are pharmacist clinics certified in your country?

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Good Pharmacy Practice: Introduction to Clinical Pharmacy Services

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