Clinical Pharmacy is a commonly used term in pharmacy practice and in pharmacy literature. It is a health specialty, which describes the activities and services of the clinical pharmacist to develop and promote the rational and appropriate use of medicinal products and devices.
Clinical Pharmacy includes all the services performed by pharmacists practising in hospitals, community pharmacies, nursing homes, home-based care services, clinics and any other setting where medicines are prescribed and used.
The focus of Clinical Pharmacy
- The discipline of pharmacy embraces the knowledge on the synthesis, chemistry, and preparation of drugs
- Clinical pharmacy is more oriented to the analysis of population needs with regards to medicines, ways of administration, patterns of use, and drug effects on the patients.
The focus of attention moves from the drug to a single patient or population receiving drugs.
The goal of Clinical Pharmacy
The overall goal of clinical pharmacy activities is to promote the correct and appropriate use of medicinal products and devices. These activities aim at:
- Maximizing the clinical effect of medicines, i.e., using the most effective treatment for each type of patient
- Minimizing the risk of treatment-induced adverse events, i.e., monitoring the therapy course and the patient’s compliance with therapy
- Minimizing the expenditures for pharmacological treatments born by the national health systems and by the patients, i.e., trying to provide the best treatment alternative for the greatest number of patients.
Level of Action of Clinical Pharmacists
Clinical pharmacy activities may influence the correct use of medicines at three different levels: before, during, and after the prescription is written.
1. Before the Prescription
- Clinical trials
- Drug information
- Clinical pharmacists have the potential to implement and influence drug-related policies, i.e., making decisions on which drugs deserve to be marketed, which drugs should be included in national and local formularies, which prescribing policies and treatment guidelines should be implemented.
- Clinical pharmacists are also actively involved in clinical trials at different levels: participating in ethical committees; study monitoring; dispensation and preparation of investigational drugs.
2. During the Prescription
- Counseling activity
- Clinical pharmacists can influence the attitudes and priorities of prescribers in their choice of correct treatments.
- The clinical pharmacist monitors detect and prevent harmful drug interaction, adverse reactions ad medication errors through evaluation of prescriptions’ profiles.
- The clinical pharmacist pays special attention to the dosage of drugs that need therapeutic monitoring.
- Community pharmacists can also make prescription decisions directly when over the counter drugs are counseled.
3. After the Prescription
- Preparation of personalized formulation
- Drug use evaluation
- Outcome research
- Pharmacoeconomic studies
- After the prescription is written, clinical pharmacists play a key role in communicating and counseling patients.
- Pharmacists can improve patients’ awareness of their treatments, monitor treatment response, check and improve patients’ compliance with their medications.
- As members of a multidisciplinary team, clinical pharmacists also provide integrated care from ‘hospital to the community’ and vice versa, assuring continuity of information on risks and benefits of drug therapy.
Direct Patients Care
In Clinical Pharmacy, patients are provided with direct care services optimizing the use of medication for health promotion and disease prevention. Clinical Pharmacy initially began in hospitals and clinics but now, clinical pharmacists administer care for patients in whatever health care setting. The clinical pharmacist’s work is in collaboration with physicians, nurses, and other healthcare personnel in various medical and surgical areas, making their profession an integral part of patient care
Clinical Pharmacy Care is direct health care and consultation provided by clinically trained pharmacists to patients and consumers about prescription and nonprescription drugs, and related products. Clinical Pharmacy Residents post-PharmD professionals training in general pharmacy practice and/or specialty areas, such as oncology and pediatrics. In the system of health care, clinical pharmacists are experts in the therapeutic use of medications.