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Keywords
Health care, Pharmaceuticals, Management
Abstract
Institutional pharmaceutical services have widely evolved over the past 20-30 years. Hospital pharmacy practice has changed from a profession concerned chiefly with the bulk preparation and distribution of drug products to one centred on ensuring optimal drug therapy. Whereas hospital pharmacists were charged with maintaining large drug stock on nursing units, many of them now provide individualised patient therapies. The practice of hospital pharmacy has therefore become one encompassing all aspects of drug therapy, from the procurement of drugs and drug delivery devices, their preparation and distribution, to their most appropriate selection and use for each patient. Hospital pharmacy services have traditionally had little involvement at the key stages in patients' hospital care. This leads to the conclusion that the model of clinical pharmacy practice adopted by many pharmacy department hospitals is no longer appropriate for the demands of today's health-care services. Reviews many new models proposed for clinical pharmacy practice including an integrated model for providing a pharmaceutical care management approach in the health-care system. This model is a response to the failures of traditional drug therapy. It is primarily an idea about how health professionals and patient should integrate their work to obtain outcomes important to patients and clinicians.
Pharmacy practice evolution
Pharmacy's history falls into three stages, compounding and dispensing, clinical pharmacy, and pharmaceutical care. For hundreds of years, people relied on pharmacists to prepare and dispense medications; thus, pharmacists were required to be skilled in compounding. As technical knowledge of drug components grew, and the drugs which were discovered became more potent and more dangerous, large manufacturers took over the role of preparing medications, leaving pharmacists only to dispense these drugs. The new medications, that are extremely effective and precise therapeutic and diagnostic tools, carry much greater risk and higher cost than those they are replacing. Evidence shows that, despite the cost-effective value of medications to society, the traditional method of prescribing and dispensing drug products is no longer enough to ensure the safety and effectiveness of drug therapy. Too much has gone wrong and can go wrong and the consequences are costly in terms of increased hospitalisations, physician visits, laboratory tests and remedial drug therapy (Manasse, 1989).
About 25 years ago, there...