Developing Pharmacy Practice - FIP

1 Developing Pharmacy Practice A focus on patient careHANDBOOK 2006 EDITIONK arin WiedenmayerSwiss Tropical Institute, Basel, SwitzerlandRob S. SummersSchool of Pharmacy , University of Limpopo, MEDUNSA Campus, South AfricaClare A. MackieMedway School of Pharmacy , The Universities of Greenwich and Kent, Chatham Maritime, United KingdomAndries G. S. GousSchool of Pharmacy , University of Limpopo, MEDUNSA Campus, South AfricaMarthe EverardDepartment of Medicines Policy and Standards, World Health Organization, Geneva, SwitzerlandWith contributions from Dick Tromp (Chairman of the Board of Pharmaceutical Practice of the International Pharmaceutical Federation, The Hague, The Netherlands)

2 World Health OrganizationDepartment of Medicines Policy and StandardsGeneva, SwitzerlandIn collaboration withInternational Pharmaceutical Federation The Hague, The NetherlandsWHO/PSM/ World Health Organization and International Pharmaceutical Federation 2006 All rights designation employed and the presentation of the material in this report including tables and maps, do not imply the expression of any opinion whatsoever on the part of the World Health Organization and the International Pharmaceutical Federation concerning the legal status of any country, territory, city or area or of authorities or concerning the delimitation of its frontiers or boundaries.

3 Dotted lines on maps represent border lines for which there may not yet be full mention of specific companies or suppliers or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization and the International Pharmaceutical Federation in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital World Health Organization and the International Pharmaceutical Federation do not warrant that the information con-tained in this publication is complete and correct and shall not be liable for any damages incurred as a results of its views expressed in documents by named authors are solely the responsibility of those design by Quim MartellDesigned by minimum graphicsPrinted in The NetherlandsContentsAcknowledgements vForeword viiIntroduction ix Part I.

4 Pharmacists in the health care team: a policy perspective 11 New paradigm for Pharmacy Practice 3 Introduction 3 Main learning objectives 5 What is health? 5 The Pharmacy profession 5 New dimensions of Pharmacy Practice 7 Pharmaceutical care 7 Evidence-based Pharmacy 8 Meeting patients needs 8 Chronic patient care HIV/AIDS 8 Self-medication 10 Quality assurance of pharmaceutical care services 10 Clinical Pharmacy 11 Pharmacovigilance 12 the value of professional pharmacist services 12 The Pharmacy Practice Activity Classification 13 The pharmacist as a member of the health care team 14 Pharmacy Practice settings 14 Levels of Practice and decision-making 15

5 The seven-star pharmacist 15 Pharmacy Practice : a commitment to implement change 17 Policy changes 17 A change in Pharmacy education and a new learning approach 19 Summary 19 Further reading 20 Part II. Pharmacists in patient care: a Practice perspective 232 Pharmaceutical care 25 Introduction 25 Main learning objectives 26 The pharmaceutical care process 27iiiDEVELOPING Pharmacy Practice A FOCUS ON PATIENT CARE Pharmaceutical services 34 Referral 34 Summary 38 Further reading 383 Information Management and the Use of Evidence 40 Introduction 40 Main learning objective 41 Continuing professional development and life-long learning 41 Critical appraisal in Pharmacy Practice 43 Sources of medicines information 43 How to retrieve (and evaluate)

6 Medicines information online 46 How to obtain relevant information from a pharmaceutical representative 47 How to evaluate the medical literature 48 Pharmacoeconomic analysis 56 Using evidence to develop Standard Treatment Guidelines and an Essential Medicines List 59 Limitations of and misperceptions about evidence-based Practice 61 The patient s viewpoint 61 Summary 64 Further reading 65 Glossary 67 Appendices 73 Appendix 1: Systematic review (Wilkinson D et al.) 75 Appendix 2: Example of pharmacoeconomic analysis: Thrombolytics for acute myocardial infarction (a hypothetical exercise) 83 Appendix 3: Answers to self-assessment questions, exercises and learning activities 85ivDEVELOPING Pharmacy Practice A FOCUS ON PATIENT CAREA cknowledgementsThe authors are grateful to the following persons who reviewed previous drafts of this docu-ment.

7 Their comments were invaluable. Ms Christal Albert, Cologne, GermanyDr Rosario d Alessio, WHO/PAHO, Washington DC, USAMs Teresa Alves, FIP Secretariat, The Hague, The NetherlandsDr Douglas Ball, Department of Pharmacy Practice , Faculty of Pharmacy , Health Sciences Center, University of Kuwait, KuwaitDr Shalom Charlie Benrimoj, Assistant Pro-Vice-Chancellor (Health Sciences), University of Sydney, Australia Dr Jan-Olof Br nstad, Sweden Dr Perla M. De Buschiazzo, Pharmacology Department, School of Medicine, National University of La Plata, La Plata, ArgentinaDr Mhina Chambuso, School of Pharmacy , Muhimbili University College of Health Sciences (MUCHS)

8 , The University of Dar es Salaam, United Republic of TanzaniaDr Greg Duncan, Department of Pharmacy Practice , Monash University, Parkville, AustraliaMs Sonia Mota Faria, International Pharmaceutical Students Federation, PortugalMs Bente Frokjaer, Vice President of FIP, DenmarkProfessor William Futter, Division of Pharmacy Practice , Rhodes University, Grahamstown, South AfricaProfessor Abdul Ghani, Directorate of Drugs Administration, Ministry of Health and Family Welfare, Dhaka, BangladeshMs Ida Gustafsen, EUROP harm Forum, Copenhagen, DenmarkProfessor Ebba Holme Hansen, The Danish University of Pharmaceutical Science, Copenhagen, DenmarkProfessor Abraham Hartezema, Perry A.

9 Foote Eminent Scholar, Chair in Health Outcomes and Pharmacoeconomics, College of Pharmacy , University of Florida, Gainesville, USADr Kurt Hersberger, Pharmaceutical Care Research Group, University of Basel, Basel, SwitzerlandMr Ton Hoek, General Secretary and Chief Executice Officer of FIP, The Hague, The NetherlandsDr Ross Holland, Bowie MD, USADr Adriana Mitsue Ivama, Pan American Health Organization/WHO, BrazilDr Nelly Marin Jaramillo, Pan American Health Organization/WHO, BrazilDr Richard Thuo Kamau, Nairobi, Kenya Mr Balkrishna Khakurel, WHO, Kathmandu, NepalDr Rosalyn King, Howard University Continuing Education, Silver Spring MD, USAMs Mirjam Kokenberg, Quality Institute for Pharmaceutical Care, Kampen, The NetherlandsDr Hlonelikhaya Masiza, South Africa Pharmacy Council, Pretoria, South AfricaDEVELOPING Pharmacy Practice A FOCUS ON PATIENT CAREvMs Lindsay McClure, Pharmaceutical Services Negotiating Committee, Aylesbury, UKProfessor Guru Prasad Mohanta, Division of Pharmacy Practice , Department of Pharmacy , Annamalai University, Annamalai Nagar, Tamil Nadu, IndiaDr Nagavi, JSS College of Pharmacy , Karnataka, IndiaProfessor Lars Nilsson, Sweden Dr Christine Nimmo, Bowie MD.

10 USADr Atieno Ojoo, Gertrude s Children s Hospital, Nairobi, KenyaDr Jos Maria Parisi, Pan American Health Organization, Washington , USADr Rose Marie Parr, Scottish Centre for Post Qualification Pharmaceutical Education, University of Strathclyde, Glasgow, Scotland, UKDr Susan Putter, South Africa Pharmacy Council, Pretoria, South AfricaProfessor Ralph Raasch, Associate Professor of Pharmacy and Clinical Associate Professor of Medicine, UNC School of Pharmacy , Chapel Hill, USADr Feroza Sircar-Ramsewak, College of Pharmacy , Nova Southeastern University, Palm Beach Gardens, USAMr Howard Rice, Vice President of FIP, IsraelDr Philip Schneider, The Ohio State University, Columbus, USAMr Karl Friedrich Steinhausen, Berlin, GermanyMs Linda Stone, Vice President of FIP, London, UKProfessor Linda Strand, Department of Pharmaceutical Care & Health Systems, College of Pharmacy , University of Minnesota, Minneapolis, USADr Nippe Strandqvist, Honorary President of FIP, SwedenDr Sri Suryawati, Faculty of Medicine, Gadjah Mada University, Yogyakarta, IndonesiaMs Satu Tainio, FIP Secretariat, The Hague, The NetherlandsMs Karin Timmermans, WHO, Jakarta, IndonesiaDr Birna Trap, Euro Health Group, Soborg.