As early as the fourth century BC, the principles of pharmaceutical care had already been inscribed in one of the oldest medical texts known to mankind; the Hippocratic Oath. “I will apply my knowledge, experience and skills to the best of my ability to ensure optimal outcomes for my patients”.

Just like the music director in an orchestra, the role of a healthcare professional is central to the concept of pharmaceutical care, often overlapping to integrate medical, social, financial and psychological health components. The general perception is that pharmacists are at the front of providing pharmaceutical care. The pharmaceutical care concept does not diminish the roles or responsibilities of other health professionals, nor does it imply any usurping of authority by pharmacists. Pharmacists’ actions in pharmaceutical care should be conducted and viewed as collaborative with other health-care professionals, including physicians and nurses.

Healthcare professionals use their skills and knowledge to diagnose illness based on signs, symptoms, blood tests and so many other disease indicators. This is the first step for any pharmaceutical care plan. A wrongly diagnosed condition can only cascade into disaster. For this reason, it is important to always consult the right health professionals and avoid self-diagnosis and self-medication thereafter.

Like fitting in pieces of a giant ‘jig-saw’ puzzle, proper medicine selection follows the diagnosis stage of pharmaceutical care. Selection is based on a multiplex of factors such as age, severity of illness, co-morbidities and so on. With the right drug selection, the image in the puzzle begins to take shape.

In the provision of pharmaceutical care, pharmacists use their unique perspective and knowledge of medication therapy to evaluate patients’ actual and potential medication-related problems. To do this, they require direct access to clinical information about individual patients. They make judgments regarding medication use and then advocate optimal medication use for individual patients in cooperation with other professionals and in consideration of their unique professional knowledge and evaluations. Pharmaceutical care includes the active participation of the patient (and designated caregivers such as family members) in matters pertinent to medication use.

Counselling and patient education regarding the medications given. A simple instruction like “take this three times a day” may be taken out of context. Quality pharmaceutical care should break down even the simplest of instruction with examples to ensure the patient has understood the instruction. Advice in form of non-pharmacological interventions like “have a 30 minutes’ walk” goes a long way in alleviating some minor aches. It’s not always about drugs!

Through follow up and review, the humanistic attribute of care comes to life. Patient follow-up is a means of monitoring improvement due to the medicines given. Patient feedback in form of side effects can be used to modify the treatment plan or even reassure the patient so as to get better.

Once each piece of the puzzle fits in, the image is complete and the outcome is clear; the patient gets better!

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