Hepler Charles D
Department of Pharmacy Health Care Administration, College of Pharmacy, University of Florida, Gainesville, FL 32610-0496, USA.
Pharmacotherapy. 2004 Nov;24(11):1491-8. doi: 10.1592/phco.24.16.1491.50950.
Because of concerns about patient safety and the quality of health care in America, in particular about drug therapy, pharmacists have unprecedented opportunities to increase their value and significance. When defining clinical pharmacy and pharmaceutical care, pharmacists long ago recognized the need to improve the safety and effectiveness of drug therapy.
To describe how clinical pharmacy and pharmaceutical care, closely related concepts, can contribute to a strategy for improving the quality of drug therapy.
Commentary and review of selected publications.
Pharmacists can improve the quality of drug therapy by improving the organizational structures through which drug therapy is provided, specifically by creating medications use systems and by regularly evaluating their performance. As envisaged by the Institute of Medicine, these systems must be patient centered, cooperative, and interprofessional. To maximize pharmacists' participation in such systems, pharmaceutical education should include courses in medications use systems as necessary counterparts to courses in pharmacotherapeutics. Clinical functions must be organized around patient need and directed at outcomes. Clinical practice should constitute the mainstream practice of pharmacy rather than an "optional" specialty. Pharmaceutical care describes the original purpose of clinical pharmacy, when it was understood as a professional practice rather than a health science. It describes a way that clinical pharmacy, especially specialists and subspecialists, could coordinate their work more effectively. The concept of clinical pharmacy adds essential clarity about the process component of pharmacists' participation in, and strengthens the academic basis of, pharmaceutical care. The clinical, humanitarian, and economic case for preventing drug-related morbidity is strong, and pharmacy has much to offer. It is, again, time to work together as a profession to plan our common future.
由于对美国患者安全和医疗质量的担忧，尤其是对药物治疗的担忧，药剂师拥有前所未有的机会来提升自身价值和重要性。在界定临床药学和药学服务时，药剂师早就认识到需要提高药物治疗的安全性和有效性。
描述临床药学和药学服务这两个密切相关的概念如何有助于制定提高药物治疗质量的策略。
对选定出版物的评论与综述。
药剂师可通过改进提供药物治疗的组织结构来提高药物治疗质量，具体而言，通过创建药物使用系统并定期评估其性能。正如医学研究所所设想的，这些系统必须以患者为中心、具有协作性且跨专业。为使药剂师最大程度地参与此类系统，药学教育应包括药物使用系统课程，作为药物治疗学课程的必要对应课程。临床功能必须围绕患者需求进行组织并以结果为导向。临床实践应构成药学的主流实践，而非“可选”的专业领域。药学服务描述了临床药学的最初目的，当时它被视为一种专业实践而非一门健康科学。它描述了一种临床药学，尤其是专科药师和亚专科药师能够更有效协调其工作的方式。临床药学的概念为药剂师参与的过程部分增添了至关重要的清晰度，并加强了药学服务的学术基础。预防药物相关发病的临床、人道和经济理由充分，药学能提供很多帮助。再次强调，是时候作为一个专业共同努力规划我们的共同未来了。
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