Clinical pharmacy is a health science discipline in which pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention. Clinical pharmacy encompasses the patient's entire drug therapy and how it relates to the patient's global healthcare plan. Every aspect of medication management is monitored including drug selection, safety, efficacy, outcomes, education, and cost.

The Value of Clinical Pharmacy

Clinical pharmacy decreases adverse effects, increases cost-effectiveness, and enhances prescribing patterns and quality of care. As a result, overall costs decrease significantly.

The Tools of Clinical Pharmacy

Listed below are some of the integral components of managed pharmaceutical care that we employ to consistently achieve cost effective, successful patient health outcomes.

Drug Utilization Reviews

• Encompasses both proactive and retroactive prescribing analysis
• Proactive patient-specific drug selection recommendations
• Retroactive data review of monthly drug utilization and recommendations for improvement
• Continuous quality improvement tool used to track outcomes of prescribing changes

Drug Information Support and Education

• Timely one-on-one clinical consultations regarding medication therapy including dosing, drug interactions, kinetics, and cost-effectiveness
• Liaison to off-site hospitals and specialists concerning formulary compliance and continuity of care
• Patient specific drug regimen reviews performed to ensure efficacious and safe medication selection
• Monthly newsletter to provide education on current and pertinent medication topics
• Review of current medical literature to ensure up-to-date evidence-based care
• Coordination of speakers to provide in-house training on medication issues
• Educational opportunities can be customized to meet the unique needs of various health care professionals

Formulary/Disease State Management

• Results in consistent care and minimizes cost variability
• Regimented evaluation of new medications to determine place in therapy
• Treatment algorithm and protocol development based on current clinical evidence
• Results in cost effective positive patient outcomes
• Implementing therapeutic interchange protocols to enhance efficiency in drug selection and reduce costs
• P & T committee contribution/coordination to assist in an organized method of developing policies

Health Outcomes Research

• Evaluates individual patient outcomes or manages and improves outcomes on a system-wide basis
• Helps better understand how the cost and outcomes change as a result of using different therapeutic treatment options
• Provides real world evidence of patient outcomes beyond controlled clinical trials
• Pharmacoeconomics evaluates both costs and outcomes with the goal of obtaining the best possible outcome for health care expenditures

Site Monitoring/Auditing

• Ensures efficient, accurate and safe medication administration
• Reduces liability
• Helps meet contract requirements
• Provides an unbiased expert opinion regarding pharmacy matters

The Value of Clinical Pharmacy

"Decreases adverse drug events (ADEs)"
- JAMA 1999; 282(3):267-70

"Saves unnecessary drug costs"
- Archives of Internal Medicine 1999; 158:1641-7

"$500,000: Estimated cost savings for a medium size hospital's pharmacy department in one year due to clinical pharmacy services"
- American Journal of Health-Systems Pharmacy 1999; 56:945-9

"Increases cost-effectiveness of pharmaceutical care"
- Pharmacotherapy 2000; 20:429-35

"Enhances Prescribing Patterns and Quality of Care"
- Pharmacotherapy 2000; 20:abstract 159

"$45.6 billion: Cost-avoidance in drug-related problems if clinical pharmacy services were implemented in all U.S. ambulatory populations and nursing facilities"
- American Journal of Health-Systems Pharmacy 1998;55:1588-94