1. Ambulatory care Prepared by: Nehad Ahmed

2. Ambulatory care is Primary care-based services and services provided from office-based specialists and hospital visits on an outpatient basis. Examples: - clinics - general (primary care); specialty (day surgery, chemotherapy) - ER - private offices - community pharmacies

3. Why ambulatory care? decrease hospitalization rates. drug cost savings improve quality of care - more thorough work-up - address adherence issues - better treatment outcomes - fewer adverse drug reactions

4. Ambulatory Care could be Primary Care or Specialty Care Primary Care “first contact” continuity of care comprehensive care individualized care health promotion, disease prevention, early detection

5. Specialty Care Particular organ system or disease type health promotion and prevention specialized training

6. Pharmacist’s activities Assists with designing therapeutic regimen Identifying untreated conditions Proccessing narcotic prescripton Assesing nonformulary prescription Designing long-term follow-up and monitoring plans

7. Identifying therapeutic duplication Establish relationships with patients Educate and counsel patients to enhance compliance Teaching pharmacy students

8. Pharmacist: Roles & Responsibilities Screening and early detection - dyslipidemia - hypertension - diabetes - osteoporosis

9. Health promotion and disease prevention - immunization - smoking cessation - general wellness

10. Medication history and assessment - disease specific - efficacy, toxicity, adherence - medication management - herbal products

11. Pharmacotherapeutic interventions - identification/prevention of drug-related problems - establishing goals and outcomes - initiate - modify - discontinue - monitor drug therapy

12. ASHP Standards Minimum standards for pharmaceutical care services in ambulatory care – Leadership and Practice management – Medication therapy and pharmaceutical care – Drug distribution and control – Facilities, equipment and other resources

13. Ambulatory Care Pharmacy good opportunity for growth Multidisciplinary team resources available enough time for direct patient care and follow-up Taking the lead in care Opportunity to try new ideas!