The Pharmacists’ Patient Care Process contributes to safety

Pharmacists’ Patient Care Process

According to CDC, nearly 50% of adults in the United States use at least one prescription drug each month. As a growing number of patients are exposed to the potential benefits and risks associated with medication therapy, there is a huge opportunity for pharmacists and student pharmacists to contribute to the prevention of adverse drug events (ADEs). Pharmacists can help keep people healthy and reduce the amount of money spent treating patients with ADEs. 


Medication safety can be improved through the use of the Pharmacists’ Patient Care Process (PPCP). The PPCP is a five-step process that can be used as a framework for delivering pharmacists’ patient care services in any practice setting. In the PPCP, pharmacists use a patient-centered approach in collaboration with other health care providers to optimize patient health and medication outcomes. Patient safety is inherent in every step of the PPCP.


Step 1: Collect


As you learn throughout pharmacy school, collecting the appropriate subjective and objective information is key to understanding the clinical status of a patient. The first step in the PPCP is to collect information about the patient’s lifestyle habits and beliefs. Health literacy status is also critical. According to the National Assessment of Adult Literacy, nearly 9 out of 10 adults may lack the skills needed to manage their health. An ADE is more likely to occur if a patient does not understand their disease state, how their medications treat their disease state, or how to take their medications properly. 


As noted in the U.S. Department of Health and Human Services Office of Minority Health’s National Standards for Culturally and Linguistically Appropriate Services in Health Care, cultural competency is the ability of practitioners to recognize the cultural beliefs, values, attitudes, traditions, language preferences, and health practices of diverse populations, and to apply that knowledge to produce a positive health outcome. Considering health literacy and cultural beliefs during the initial patient–pharmacist interaction will help to establish a relationship of trust, inform the pharmacist’s interaction with the patient, and ultimately contribute to the patient’s safe use of medication(s).


Step 2: Assess


The second step of the PPCP is to review each of the patient’s medications for appropriateness, effectiveness, safety, and patient adherence. In regards to medication safety, the pharmacist should verify that each medication and dose is appropriate for the specific indication. The pharmacist should also assess whether the medication is working for the patient in the way it is intended. 


As potential medication-related problems are identified, the pharmacist should investigate the patient’s medications and medication regimens for drug–drug interactions, drug–food interactions, drug–condition interactions, and signs and symptoms of possible adverse effects. The pharmacist must consider the risks and potential benefits associated with each medication used in the patient’s plan of care. 


Steps 3 and 4: Plan and 
implement


The next two steps in the PPCP encompass the creation and implementation of a patient-specific care plan that sets clinical goals for the patient to address medication-related problems and optimize medication therapy. 


For effective and safe coordination of the patient’s care, the pharmacist should consult and communicate with appropriate members of the patient’s care team. This includes informing prescribers of any medication-related issues the patient is having, providing an updated medication list, sharing goals of therapy, and referring the patient if necessary. 


Step 5: Follow up


The fifth and final step of the PPCP is the ongoing monitoring and evaluation of medication appropriateness, effectiveness, safety, and patient adherence. From a patient safety perspective, this step should include the documentation and reporting of any ADEs to MedWatch, followed by appropriate adjustments to therapy to avoid additional ADEs. Patients should be provided with an appropriate follow-up plan including timing and triggers, which would warrant a pharmacist or clinician visit. Documenting changes to the patient care plan and communicating those changes to the patient’s entire health care team are central to patient safety. 


Pharmacists and student pharmacists already contribute to patient safety in many ways. Consistent use of the PPCP throughout the profession will help to further improve patient safety across the continuum of care.