Total Pharmacy Care
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I am not here for the money,…
really
If you don’t believe it
come and see for yourself

My dispensary,
and my mini masjed
at the end of the of the shop

Lake Rd Pharmacy provides the following services


A) Dispensing prescription medicines. Just bring in your prescription provided by your doctor, dentist or midwife.
B) We provide professional advice about the medicines you have been prescribed.
C) We maintain a medication profile, keeping a list of medicines you are taking in our files.
D) For your safety, we have an obligation to report any significant findings about your medicine to your prescriber - your doctor, dentist or midwife who wrote the prescription. This will be in a confidential manner.



Total Pharmacy Care (TPC)


What Total Pharmacy Care Offers

:

A concept:


Total Pharmacy Care (TPC) the concept is an added value comprehensive patient management programme which operates at all service levels and interfaces between doctors, pharmacists and primary and secondary care.



Why do we need this type of patient management programme

:

-poly pharmacy has been established as a major component of treatment failure and hospitalisation- re-admission as well.
This patient management programme has been designed to improve patient compliance, reduce budget spending and improve quality of life, as a result there will be improvements in the economy of the social group subject to this treatment and better usage of public resources, ie. redirection of resources for other needed areas.

From the patient perspective their will be:
A greater easing of their disease
better management,
early return to the workforce, where applicable
less spending on sickness benefit, and other social expenditure.
improved quality of life.

From a prescriber perspective

:
Better disease management outcomes ie. pharmaceutical problems solved.
Improved job satisfaction through better management of patient problems
Resource optimisation especially in respect to budgets and personnel.

From a purchaser perspective

:
Less wastage of pharmaceutical
Savings on admission and readmission (/day/patient)
Better usage of resources in Primary and secondary health care
Achievement of better access, quality, communication between health professionals and services

From a pharmacy provider perspective

:
Integrated systems that cover all levels and allow for greater accountability and transparency to purchaser and prescriber stakeholders.
Ease of systems management
Defined roles allowing a complimentary team approach
Cost savings for the pharmacy in education, time and resources
Opportunity to be able to gain the skills and knowledge necessary to carry out some functions of level three.
Support for those patients who require intensive interventi
beyond the pharmacists present capabilities, and re-establishment of these patients at a level within the pharmacists capabilities. Increased remuneration and the opportunity to provide a service to all their present client base.

Increased job satisfaction


Why do we need to put this within a management framework and its attendant systems:
The process of the health reforms required a more cooperative approach to health which can only occur when roles are defined and complimentary. With the funder/ provider split came the need to quantify outcomes and document how effective our service is. The management process allows us to satisfy these criteria and usually expresses itself in the form of a business plan which can then be used to develop and implement our service. An integrated service plan for pharmacy which is cognisant of all stakeholders expectations allows for seamless health provision and its attendant benefits.

Unfortunately although businessman, pharmacists in general have difficulty applying management processes to their professional roles and services. Local environmental factors such as the capabilities of the pharmacist, relationships with other health providers, and roles and resources limit traditional professional bodies, organisations, and institutions to providing broad outlines. It therefore requires any service such as ours to not only provide appropriate clinical support services but also to facilitate our client pharmacies towards developing clearly defined roles which compliment their local Doctors, and provide service outputs and quality measures which can be documented and satisfy service purchases, users, generators and other health providers expectations.

Implementation of Total Pharmacy Care Clinical Support Services

.

How is the service performed.
For each Disease State
Socioeconomic Sector
Age Group & Gender
Ethnicity
Will be determined by Statistical analysis of patient data bases, using computer data (off Pharmacy(s) data bases .
Identification of pharmaceutical complex with disease state
High cost medicines identified and the use of cheaper alternative dosage regime resulting in: immediate savings ( reducing poly pharmacy)
reducing poly pharmacy with better patient compliance
less drug interactions ........ultimately removing drug interactions
improved patient health resulting in decreased use of services
Notification to prescriber if consistant patterns emerge across disease state.
Documentation:
Patient profiles and Demographic charts have been constructed.
On each the following data is recorded.
Age, Name, Address
Patient History
Present Medication
Past Medication History
Dosage
Dosage Form and Suitability
Biochemistry data if available
Communication with prescriber
Communication with dispenser (if not on our site)
Patient knowledge of their disease and medication
Appropriate administration of medicines
Past history of hospital admission
liaising with ward pharmacist...(interface)
Sharing information and liasing with client community pharmacist

Patient Counselling File:


On Initial contact

History taking along above guidelines carried out by onsite pharmacist:
- Clinical pharmacist reviews when required:
Current medication
Creation of a Follow up plan to suit individual
to cooperate with family members
to compliment the prescribers treatment plan

Follow up plan will contain:



Computerisation of documentation


Review of medication on a cyclical basis
Encourage patient to communicate with the pharmacist of any observation of changes
Address any issues arising from prior consultations
Problem solving
- obtaining medicine
-using medicine
-timing of medications
-cost of medicine
-over the counter and lay advice
-concurrent use of alternative medicines.
Recommendations to client community pharmacist with proposed individual action plan for implementation by them.

Monitoring Programme:


-Analysis of medicines pickup for deviation from the expected, through analysis of repeat data base.
-Interviewing for adverse effects and deviations from treatment as part of the clinical process through regular appointments.
-Update patient medication from all sources
-Dissemination of updated information to the appropriate people.
- Advise prescriber of changes that need to be made if any.
-Quantify prn medication with the aim of reducing overuse and reducing complications.
-Set consulting line for patient with appropriate documentation of questions and answers... feed back to appropriate person
-Establish close control protocols for certain high risk patients








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