1. Pharmaceutical Care
Akram Ahmad
2nd Pharm.D(P.B.)
Department of Pharmacy
Practice.
Annamalai University

2. Pharmaceutical care
 The pharmaceutical care is defined as “The
responsible provision of drug therapy for the
purpose of achieving definite therapeutic
outcomes that improve the patients quality of
life”
 These outcomes are :
 Cure of the disease
 Elimination or reduction of patient`s
symptomology
 Arresting or slowing of a disease process

3. Basic Elements of Pharmaceutical
Care
 Patient oriented
 Both acute and chronic problems addressed
 Stress on prevention of drug related problems
 Documented system on patients record need
and care.
 Offering continuous care in systematic way.
 Taking help of other health care providers in
integrating the care provided.
 Highly accuntable and responsible
 Emphasis on optimizing patients health quality
of life.

4. Basic Elements of Pharmaceutical
Care(conti..)
 Emphasis on patient`s health education and
health promotion.
 Pharmaceutical care involves the process
through which a pharmacist cooperates with a
patient and other professionals in
designing,implementing and monitoring a
therapeutic plan that will produce specific
therapeutic outcomes for the patients.
 Three major functions

5. Conti…
 1-Identifying potential and actual drug-
related problems.
 2-Pesolving actual drug-related
problems and
 3-Preventing potential drug-related
problems.
 The pharmacist ,who is the central
figure of pharmaceutical care,then he
has the following functions to perform

6. Function of Pharmacist To
Perform
 1-Collection of patient data.
 2-Identification of problems.
 3-Establishing outcome goals through
a good therapeutic plan
 4-Evaluating treatment alternatives,by
monitoring and modifying therapeutic
plan.
 5-Individualising drug regimens.
 6-Monitoring outcomes.

7. Types of Pharmaceutical Care
 SOAP Analysis
 CORE Pharmacotherapy plan
 FARM Analysis.
 PRIME Pharmacotherapy plan
 P-Pharmaceutical based problems’
 1-pt not receving a prescribed drug
 2-routine monitoring ( lab data)
 R-risks ,to patients- ADR

8. Format of a SOAP note:
 The SOAP format is the one used most
often by medical practitioners; however,
when used within the pharmaceutical
care context, the content of the sections
must be revised to match the
pharmacist’s legal scope of practice.
 S=subjective findings
Exp-chief complaints and duration or
severity of symptoms.

9. O=objective findings
Exp-laboratory data, weight, height, blood
pressure, and pulse.
A=assesment
Diagnogsis or possible explanations for the
patients medical problems.
P=Plan
Drug regimen or surgical procedure

10. CORE
 C=Condition or patient need, it may
include nonmedical conditions or need
and is thus not a reiteration of the
current medical problem.
 O=outcome, desired for the condition or
needs.
1. Patient outcomes (POEMS: patient-
oriented evidence that matters)

11.  There are generally five category of
patient outcome:
1. Mortality
2. Morbidity
A)-related to disease process,
B)-related to medication/ treatment plan
3. Behavior
4. Economic
5. Quality of life

12.  Therapeutic end point (surrogate markers;
DOES: disease oriented evidence)
 A) a therapeutic end point represents the
pharmacological or therapeutic effects that is
expected, ultimately, to achieve the desired
outcome.
 B)more than one end point is usually needed
to achieve an outcome-for example, both
near normal glycemic control and
normalization of blood pressure are
necessary to significant reduce the risk of

13.  R=regimen to achieve desired outcome
1. Therapeutic regimens
Existing therapy
Initial therapy
2. Goal setting and behavior regimens
a. Identify the type of goal being set, such
as the following
Start a new positive action-exercise
program
Increase the frequency or intensity of a
positive action- drink 2 more cup of

14. CORE-Analysis
 Stop or decrease- stop smoking
 Continue an action that is perfect-
continue to exercise 30 min a day, every
day.
b)State the behavior goal in terms that are
clear, specific and reasonable.
E=Evaluation parameter to assess
outcome achievement.
1. Efficacy parameters
2. Toxicity parameters- ADRs, allergic
reactions, or toxicity is not occuring.

15. FARM NOTE
 Formulate a FARM note or SOAP note to
describe and document the interventions
intented or provided by the pharmacist.
Some healthcare facility may specific one
format over the other;
 F= findings
The patient-specific information that gives a
basis for, or leads to, the recognition of a
pharmacotherapy problem or indication for
pharmacist intervention, finding include
subjective and objective information about
the patient.

16.  A=assessment
 a.) any additional information that is needed
to best access the problem to make
recommendations
 B) the severity, priority or urgency of the
problem
 C) the short-term and long term goals of the
problam
 Short term goals: eliminate symptoms,
lower BP to 140/90 mm Hg within 6 weeks,
manage acute asthma flareup without
requiring hospitalization.

17.  R= resolution (including prevention)
The intervention plan includes actual or
proposed action by pharmacist
1. observing, reassessing
2. Counseling
3. Making recommendations to the patients
4. Informing the prescriber
5. Making recommendations to the
prescriber
6. Withholding medication or advising
against use

18.  M=monitoring and follow up.
1. The parameter to be followed
(pain, depressed mood, serum potassium
level)
2. The intent of the monitoring
(efficacy, toxicity, adverse event)
3. How the parameter will be monitored
(patient interview, serum drug
level, physical examination)
4. Frequency of monitoring (weekly, monthly)
5. Duration of monitoring (weekly, monthly)
6. Duration of monitoring (until resolved, while
on antibiotic, until resolved them monthly
for 1 year)

19.  Anticipated or desired finding (no pain,
euglycemia, healing of lesion)
 Decision point to alter therapy when or
if outcome is not achieved (pain still
present after 3 days, mild
hypoglycemia more than two times a
week)

20. PRIME Pharmacotherapy
Plan
 I-Interactions -Drug-drug interaction,
food drug interaction
 M-Mismatch between medication and
condition or pt needs.
 E-Efficacy, efficacy issues
 Too much of the correct drug
 Too much little of the correct drug
 Wrong drug, device, intervention, or
regimen prescribed ; more efficacious
choice possible)

21. THANK YOU