1. Clinical Pharmacy
Basma Y. Kentab MSc.

2. Outline Define clinical pharmacy
Differentiate between pharmacy and clinical pharmacy.
Explain the qualification required for clinical pharmacists
List clinical pharmacists competencies

3. Definition of Clinical Pharmacy
Clinical pharmacy is defined as that area of pharmacy concerned with the science and practice of rational medication use.
ACCP, Pharmacotherapy 2008;28(6):816–817

4. The Detailed Definition Important Aspects
Clinical pharmacy is a health science discipline in which pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention.
ACCP, Pharmacotherapy 2008;28(6):816–817

5. The Detailed Definition Important Aspects
The practice of clinical pharmacy embraces the philosophy of pharmaceutical care
“Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve or maintain a patient’s quality of life”.
This calls attention to the fact that the primary object of practice and research is ultimately the patient

6. The Detailed Definition Important Aspects
Clinical pharmacy also has an obligation to contribute to the generation of new knowledge that advances health and quality of life.
This means that in addition to optimizing therapy and promoting patient health, clinical pharmacy must also be engaged in research.

7. The Detailed Definition Important Aspects
The clinical pharmacist cares for patients in all health care settings
This emphasizes two points:
that clinical pharmacists provide care to their patients (i.e., they don’t just provide clinical services), and
that this practice can occur in any practice setting
The term “clinical” does not necessarily imply an activity implemented in a hospital setting. 

8. The Detailed Definition Important Aspects
Clinical pharmacists assume responsibility & accountability for managing medication therapy in direct patient care settings, whether practicing independently or in consultation or collaboration with other health care professionals.
Clinical pharmacist researchers generate, disseminate, and apply new knowledge that contributes to improved health and quality of life.

9. The Detailed Definition Important Aspects
Clinical pharmacists are experts in the therapeutic use of medications.
They routinely provide medication therapy evaluations and recommendations to patients and 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

10. How Does Clinical Pharmacy Differ from Pharmacy ?
The discipline of pharmacy embraces the knowledge of 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 drugs effects on the patients.
The focus of attention moves from the drug to the single patient or population receiving drugs.

11. Goal of Clinical Pharmacy
to promote the correct and appropriate use of medicinal products and devices.
This is achieved by:
maximising the clinical effect of medicines
minimising the risk of treatment-induced adverse events
minimising the expenditures for pharmacological treatments.

12. How to Pursue a Profession in Clinical Pharmacy in Saudi Arabia
Pharm D Degree
Master Degree in clinical pharmacy
Residency with 2 years of training

13. Clinical Pharmacist Competencies
Clinical problem solving, judgment, & decision making
Monitor patients in the health care setting
Assess patient-specific medical problems
Evaluate patient-specific drug therapy and therapeutic problems.
Design a comprehensive drug therapy plan for patient specific problems
Collaborate with patients, caregivers, and other healthcare professionals.
ACCP, Pharmacotherapy 2008;28(6):806–815

14. Clinical Pharmacist Competencies
Communication and education
Educate patients
Educate other health care professionals
Communicate effectively.
Document interventions in the patient medical record.

15. Clinical Pharmacist Competencies
Medical information evaluation & management
Demonstrate the motivation and commitment to become a lifelong learner.
Retrieve biomedical literature using appropriate search strategies.
Interpret biomedical literature with regard to study design, methodology, statistical analysis, significance of reported data, and conclusions.
Integrate data obtained from multiple sources to derive an overall conclusion or answer.

16. Clinical Pharmacist Competencies
Management of patient populations
Patient safety and drug therapy evaluation
Critical pathways

17. Clinical Pharmacist Competencies
Therapeutic knowledge areas
Apply disease-oriented knowledge of the following areas (anatomy, physiology, epidemiology, etc….)
Demonstrate competence in the pharmacotherapy of medical problems
Apply the following principles (pharmacokinetics, pharmacodynamics, pharmacoeconomics…etc) in the setting of each disease state, patient population, and/or therapeutic category

18. 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.

19. A) Before the Prescription Is Written
Clinical trials
Formularies
Drug information
Drug-related policies

20. B) Process of Writing the Prescription
Clinical pharmacists can influence the attitudes and priorities of prescribers in their choice of correct treatments.
The clinical pharmacist monitors, detects and prevents
Drug related problems
The clinical pharmacist pays special attention to the dosage of drugs which need therapeutic monitoring.
Community pharmacists can also make prescription decisions directly, when over the counter drugs are counselled.

21. Drug Related Problems Untreated indications. Improper drug selection.
Subtherapeutic dosage.
Failure to receive medication
Medication overdosage.
Adverse drug reactions.
Drug interactions.
Medication use without indication.

22. C) After Writing the Prescription
Counselling
Drug use evaluation
Outcome research
Pharmacoeconomic studies

23. Clinical Pharmacy Practice Areas
Ambulatory care
Critical care
Drug Information
Geriatrics and long –term care
Internal medicine and subspecialties
Cardiology
Endocrinology
Gastroenterology
Infectious disease
Neurology
Nephrology
Obstetrics and gynecology
Pulmonary disease
Psychiatry
Rheumatology
Nuclear pharmacy
Nutrition
Pediatrics
Pharmacokinetics
Surgery