Clinical Pharmacists in Chronic Care [Part 2]

Pharmacy practice has changed significantly lately. The professionals have the chance to contribute straightforwardly to patient consideration so as to lessen morbimortality identified with medication use, promoting wellbeing and preventing diseases. Healthcare organizations worldwide are under substantial pressure from increasing patient demand. Unfortunately, a cure is not always possible particularly in this era of chronic complications, and the role of physicians has become limited to controlling and palliating symptoms. The increasing population of patients with long-term conditions are associated with high levels of morbidity, healthcare costs and GP workloads. Clinical pharmacy took over an aspect of medical care that had been partially abandoned by physicians. Overburdened by patient loads and the explosion of new drugs, physicians turned to pharmacists more and more for drug information, especially within institutional settings. Once relegated to counting and pouring, pharmacists headed institutional reviews of drug utilization and served as consultants to all types of health-care facilities. In addition, when clinical pharmacists are active members of the care team, they enhance proficiency by: Providing critical input on medicine use and dosing. Working with patients to solve problems with their medications and improve compliance.

Keywords: Chronic care; Pharmacy intervention; Diabetes care; CVD prevention; Inflammatory bowel disease

Abbreviations: AACP: American Association of Colleges of Pharmacy; ACPE: Accreditation Council for Pharmacy Education; IDF: International Diabetes Federation; HbA1c: Hemoglobin A1c; IHD: Ischemic Heart Disease; MI: Myocardial Infarction; CHD: Coronary Heart Disease; DALY: Disability- Adjusted Life Year; QoL: Quality of Life; DRPs: Drug Related Problems; IBD: Inflammatory bowel disease; HRT: Hormone replacement therapy; BMD: Bone-Mineral Density; COPD: Chronic Obstructive Pulmonary Disease; LDL-C: LDL cholesterol; GERD: Gastroesophageal Reflux Disease; OSA: Obstructive Sleep Apnea; SCH: Subclinical Hypothyroidism; NAMI: National Alliance on Mental Illness; MDD: Major Depressive Disorder; NMHS: National Mental Health Survey; ABS: Australian Bureau of Statistics; NSMHWB: National Survey of Mental Health and Wellbeing; CHD: Coronary Heart Disease; MH: Mental Health; ADT: Antidepressant Drug Treatment; CANMAT: Canadian Network for Mood and Anxiety Treatments; PES: Psychiatric Emergency Services; DALY: Disability-Adjusted Life Year; DRPs: Drug-Related Problems; VLW: Value of Lost Economic Welfare; ALS: Amyotrophic Lateral Sclerosis; SNRIs: Serotonin and Norepinephrine Reuptake Inhibitors; TCAs: Tricyclic Antidepressants; ASPs: Antimicrobial Stewardship Programs; ESRD: End-Stage Renal Disease; CKD: Chronic Kidney Disease; MSM: Men who have Sex with Men; NSCLC: Non-small-cell lung cancer; ELISA: Enzyme-Linked Immunosorbent Assay; LLS: Leukemia & Lymphoma Society; ALL: Acute Lymphoblastic Leukemia; AML: Acute Myeloid Leukemia; CML: Chronic Myeloid Leukemia; NRT: Nicotine Replacement Therapy; ADT: Androgen Deprivation Therapy; PSA: Prostate Specific Antigen; DRE: Digital Rectal Examination; PSA: Prostate Specific Antigen; FOBT: Fecal Occult Blood Testing; GLOBOCAN: Global Cancer Incidence, Mortality and Prevalence