Clinical pharmacy is the branch of pharmacy in which doctor of pharmacy provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often work in collaboration with physicians, nurse practitioners, and other healthcare professionals.
Education and credentialing
Clinical pharmacists have extensive education in the biomedical, pharmaceutical, socio-behavioural and clinical sciences. Most clinical pharmacists have a Doctor of Pharmacy (Pharm.D.) degree and many have completed one or more years of post-graduate training (for example, a general and/or specialty pharmacy residency). In the United States, clinical pharmacists can choose to become Board-certified through the Board of Pharmacy Specialties (BPS), which was organized in 1976 as an independent certification agency of the American Pharmacists Association. The BPS certifies pharmacists in the following specialities: ambulatory care pharmacy, critical care pharmacy, nuclear pharmacy, nutrition support pharmacy, oncology pharmacy, pediatric pharmacy, geriatric pharmacy, pharmacotherapy, and psychiatric pharmacy.
Role in the health care system
Within the system of health care, clinical pharmacists are experts in the therapeutic use of medications. They routinely provide medication therapy evaluations and recommendations to patients and other health care professionals. Clinical pharmacists are a primary source of scientifically valid information and advice regarding the safe, appropriate, and cost-effective use of medications. Clinical pharmacists are also making themselves more readily available to the public. In the past, access to a clinical pharmacist was limited to hospitals, clinics, or educational institutions. However, clinical pharmacists are making themselves available through a medication information hotline, and reviewing medication lists, all in an effort to prevent medication errors in the foreseeable future. In the United Kingdom, clinical pharmacists are routinely involved in the direct care of patients within hospitals, and increasingly, in doctors surgeries. They also develop post registration professional education, professional curricula for workforce development, provide expertise on the use of medicines to national organizations such as NICE, the Department of Health, and the MHRA, and develop medicines guidelines for use in therapeutic areas.
Clinical pharmacists interact directly with patients in several different ways. They use their knowledge of medication (including dosage, drug interactions, side effects, expense, effectiveness, etc.) to determine if a medication plan is appropriate for their patient. If it is not, the pharmacist will consult the primary physician to ensure that the patient is on the proper medication plan. The pharmacist also works to educate their patients on the importance of taking and finishing their medications. Studies conducted into Pharmacist-led Chronic Disease Management show that it was associated with effects similar to usual care and might improve physiological goal attainment.
In some states, clinical pharmacists are given prescriptive authority under protocol with a medical provider, and their scope of practice is constantly evolving. In the United Kingdom clinical pharmacists are given independent prescriptive authority.
- "The definition of clinical pharmacy" (PDF). Pharmacotherapy. 28 (6): 816–7. June 2008. doi:10.1592/phco.28.6.816. PMID 18503408.
- "Economic Evaluations of Clinical Pharmacy Services: 2001–2005" (PDF). Pharmacotherapy. ACCP. Retrieved 28 April 2016.
- "About Clinical Pharmacists". American College of Clinical Pharmacy. Retrieved 2015-10-20.
- Greer N, Bolduc J, Geurkink E, Rector T, Olson K, Koeller E, MacDonald R, Wilt TJ (April 2016). "Pharmacist-led Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared With Usual Care". Annals of Internal Medicine. doi:10.7326/M15-3058. PMID 27111098.
- "Collaborative drug therapy management (CDTM)". Pharmacist's Letter/Prescriber's Letter. 25: 250801. 2009.
- "Collaborative Practice Agreements". AMCP. 17 September 2010. Archived from the original on September 17, 2010. Retrieved 28 April 2016.
- Hoti K, Hughes J, Sunderland B (2011-04-30). "An expanded prescribing role for pharmacists - an Australian perspective". The Australasian Medical Journal. 4 (4): 236–42. doi:10.4066/AMJ.2011.694. PMC 3562903
. PMID 23393515.
- "An Overview of the Clinical Pharmacist Practitioner in NC". North Carolina Association of Pharmacists. 23 May 2005. Archived from the original on May 23, 2005. Retrieved 28 April 2016.