Clinical pharmacy should adopt a consistent process of direct patient care

Abstract

Although the application of a consistent process of care serves as a foundational principle for most health care professions, this is not true for the discipline of clinical pharmacy. Without an explicit, reproducible process of care, it is not possible to demonstrate to patients, caregivers, or health professionals the ways in which the clinical pharmacist can reliably contribute to improved medication-related outcomes. A consistent patient care process should describe the key steps that all clinical pharmacists will follow when they encounter a patient, regardless of the type of practice, the clinical setting, or the medical conditions or medications involved. Four essential elements serve as the cornerstones of the clinical pharmacist's patient care process: assess the patient and his or her medication therapy, develop a plan of care, implement the plan, and evaluate the outcomes of the plan. Despite the fact that several processes of care have been advocated for clinical pharmacists, none has been adopted by the clinical pharmacy discipline. In addition, numerous publications evaluate outcomes related to clinical pharmacy services, but it is difficult to determine what process of patient care was used in most of these studies. In our view, a consistent process of direct patient care that includes the four essential elements should be adopted by the clinical pharmacy discipline. This process should be clear, straightforward and intuitive, readily documentable, and applicable to all practice settings. Once adopted, the process should be implemented across practice settings, taught in professional degree programs, integrated into students' clinical rotations, refined during residency training, and used as a foundation for future large-scale studies to rigorously study the effects of the clinical pharmacist on patients' medication-related outcomes.

Keywords: clinical pharmacist; clinical pharmacy; direct patient care; process of care.