pharmacy
Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medication, medicines. It is a miscellaneous science as it ...
in which clinical pharmacists provide direct
patient
A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The patient is most often Disease, ill or Major trauma, injured and in need of therapy, treatment by a physician, nurse, op ...
care
Care may refer to:
Organizations and projects
* CARE (New Zealand), Citizens Association for Racial Equality, a former New Zealand organisation
* CARE (England) West Midlands, Central Accident Resuscitation Emergency team, a team of doctors & ...
that optimizes the use of
medication
Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...
and promotes
health
Health has a variety of definitions, which have been used for different purposes over time. In general, it refers to physical and emotional well-being, especially that associated with normal functioning of the human body, absent of disease, p ...
disease
A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
pharmacist
A pharmacist, also known as a chemist in English in the Commonwealth of Nations, Commonwealth English, is a healthcare professional who is knowledgeable about preparation, mechanism of action, clinical usage and legislation of medications in ...
s care for patients in all health care settings but the clinical pharmacy movement initially began inside
hospital
A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...
s and clinics. Clinical pharmacists often work in collaboration with
physician
A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
s, physician assistants,
nurse practitioner
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications an ...
collaborative practice agreement
A collaborative practice agreement (CPA) is a legal document in the United States that establishes a legal relationship between Clinical pharmacy, clinical pharmacists and collaborating physicians that allows for pharmacists to participate in co ...
with another healthcare provider, generally one or more physicians, that allows pharmacists to prescribe medications and order laboratory tests.
Education and credentialing
Clinical pharmacists have extensive
education
Education is the transmission of knowledge and skills and the development of character traits. Formal education occurs within a structured institutional framework, such as public schools, following a curriculum. Non-formal education als ...
in the biomedical,
pharmaceutical
Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the ...
, socio-behavioural and clinical sciences. Most clinical pharmacists have a
Doctor of Pharmacy
A Doctor of Pharmacy (PharmD; Neo-Latin: ''Pharmaciae Doctor'') is a professional doctorate in pharmacy. In some countries, it is a proficient graduate degree to practice the profession of pharmacy or to become a clinical pharmacist. In many co ...
(Pharm.D.) degree and many have completed one or more years of
post-graduate
Postgraduate education, graduate education, or graduate school consists of academic or professional degrees, certificates, diplomas, or other qualifications usually pursued by post-secondary students who have earned an undergraduate (bachelor' ...
training (for example, a general and/or specialty pharmacy residency). In the
United States
The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, clinical pharmacists can choose to become Board-certified through the Board of Pharmacy Specialties (BPS), which was organized in 1976 as an independent certification agency of the
American Pharmacists Association
The American Pharmacists Association (APhA, previously known as the American Pharmaceutical Association), founded in 1852, is the first-established professional society of pharmacists in the United States. The association consists of more tha ...
. The BPS certifies pharmacists in the following specialties:
*Ambulatory care pharmacy (BCACP)
*Critical care pharmacy (BCCCP)
*Nuclear pharmacy (BCNP)
*Nutrition support pharmacy (BCNSP)
*Oncology pharmacy (BCOP)
*Pediatric pharmacy (BCPPS)
*Geriatric pharmacy (BCGP)
*Pharmacotherapy (BCPS)
*Infectious disease pharmacy (BCIDP)
*Compounded sterile preparations pharmacy (BCSCP)
*Cardiology pharmacy (BCCP)
*Emergency medicine pharmacy (BCEMP)
*Transplant Pharmacist (BCTXP)
* Psychiatric pharmacy (BCPP)
There are several types of clinical pharmacists in the United States. In California they are called advanced practice pharmacists (APh). In New Mexico, they are known as Pharmacist Clinicians (PhC) and lastly in Montana and North Carolina they are known as Clinical Pharmacist Practitioners (CPP). Clinical pharmacists in the Veteran Administration are known as Clinical Pharmacy Specialists (CPS).
Role in the health care system
Within the system of
health care
Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...
, clinical pharmacists are
expert
An expert is somebody who has a broad and deep understanding and competence in terms of knowledge, skill and experience through practice and education in a particular field or area of study. Informally, an expert is someone widely recognized ...
s in the therapeutic use of medications. They routinely provide medication
therapy
A therapy or medical treatment is the attempted remediation of a health problem, usually following a medical diagnosis. Both words, ''treatment'' and ''therapy'', are often abbreviated tx, Tx, or Tx.
As a rule, each therapy has indications a ...
evaluations and recommendations to patients and other health care professionals. Clinical pharmacists are a primary source of scientifically valid
information
Information is an Abstraction, abstract concept that refers to something which has the power Communication, to inform. At the most fundamental level, it pertains to the Interpretation (philosophy), interpretation (perhaps Interpretation (log ...
and advice regarding the safe, appropriate, and cost-effective use of medications. Clinical pharmacists are also making themselves more readily available to the public. In the past, access to a clinical pharmacist was limited to hospitals, clinics, or educational institutions. However, clinical pharmacists are making themselves available through a medication information hotline, and reviewing medication lists, all in an effort to prevent medication errors in the foreseeable future. In the United Kingdom, clinical pharmacists are routinely involved in the direct care of patients within hospitals, and increasingly, in doctors surgeries. They also develop post registration professional education, professional curricula for workforce development, provide expertise on the use of medicines to national organizations such as
NICE
Nice ( ; ) is a city in and the prefecture of the Alpes-Maritimes department in France. The Nice agglomeration extends far beyond the administrative city limits, with a population of nearly one millionDepartment of Health, and the MHRA, and develop medicines guidelines for use in therapeutic areas.
Clinical pharmacists interact directly with patients in several different ways. They use their knowledge of medication (including dosage, drug interactions, side effects, expense, effectiveness, etc.) to determine if a medication plan is appropriate for their patient. If it is not, the pharmacist will consult the primary physician to ensure that the patient is on the proper medication plan. The pharmacist also works to educate their patients on the importance of taking and finishing their medications. Studies conducted into Pharmacist-led Chronic Disease Management show that it was associated with effects similar to usual care and might improve physiological goal attainment.
In some states in the USA, clinical pharmacists are given prescriptive authority under protocol with a medical provider, and their scope of practice is constantly evolving. In the United Kingdom clinical pharmacists are given independent prescriptive authority.
Basic components of clinical pharmacy practice include prescribing drugs, administering drugs, monitoring prescriptions, managing drug use, and counselling patients.
Hospital pharmacy
A hospital pharmacy is a
department within a hospital that prepares, compounds, stocks and dispenses inpatient medications. Hospital pharmacies usually stock a larger range of medications, including more specialized and investigational medicatio ...