Richard Herrier - Patient Assessment in Pharmacy

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This textbook is dedicated to those Indian Health Service (IHS) pharmacists and other health professionals who from the 1960s through the 1970s pioneered the development of the first pharmacy practice model that focused on the PATIENT rather than on the dispensing process. These patient-centered practice innovations included (1) verifying patient understanding on proper use of prescription medications through patient counseling in private consultation rooms; (2) review of prescription orders for appropriateness; and (3) rectifying problems prior to dispensing; and (4) using pharmacists as primary care providers with prescriptive authority. This pharmacist-based management of patients with common chronic diseases and the diagnosis and treatment of common minor acute illnesses was supported by the IHS Pharmacist Practitioner Training Program (IHS PPTP). This program, initiated as an HRSA grant-funded program in 1973, expanded to an IHS-wide program in 1976. The principles of the training for the IHS PPTP serve as the foundation for this textbook. Successor to the IHS PPTP, the IHS Clinical Pharmacy Training Program (IHS CPTP) provided postgraduate training to enable pharmacists to practice in this unique patient-centered pharmacy practice model. All of these patient-centered pharmacy practice innovations were made possible by the farsighted leadership of Admiral Allen J Brands, who directed the pharmacy programs of the Indian Health Service and the U.S. Public Health Service. His dedication and persistence in developing and sharing these innovations with the pharmacy profession eventually became the basis for todays ambulatory clinical pharmacy practice.

PART ONE
PRINCIPLES OF PATIENT ASSESSMENT

Approach to Differential
Diagnosis

PART TWO
ASSESSMENT OF SYMPTOMS

Heartburn and
Abdominal Pain

PART THREE
ASSESSMENT IN THE DIAGNOSIS AND MANAGEMENT OF CHRONIC DISEASES AND THEIR COMPLICATIONS

PART FOUR
ASSESSMENT OF POTENTIAL DRUG-RELATED PROBLEMS

This textbook is intended to fill the significant resource gaps in patient assessment needed by pharmacists to provide optimal patient-centered pharmacy services including primary care. Existing pharmacy materials do not include the necessary breadth and depth in these areas. This textbook is intended to help pharmacists integrate the pathophysiology, findings from history taking, physical examination, and laboratory test interpretation to make accurate assessments in two areas. The first helps the pharmacist make a more accurate diagnosis and thus enables them to better advise patients regarding appropriate use of products intended for self-care or accurately refer patients to higher levels of care if indicated. The second area is to enhance the pharmacists ability to assist patients in the management of their chronic diseases, outlining monitoring parameters for disease control, early detection of disease-based complications, and drug therapybased adverse effects. In addition, the textbook will enhance pharmacists ability to counsel patients about both prescription and nonprescription medications, enhance their ability to communicate with other health care professionals, and assist in identification of potential drug-related problems.