1999 Pharmacy Handbook - Pharmacy practice II

Pharmacy practice II

Introduction
General objectives
Syllabus
Practical and tutorials
Textbooks
Assessment

Introduction

Mr Arthur Pappas
42 lectures, 15 small group tutorials and 18 hours of practical work.
This subject follows on from 'Pharmacy practice I' and concentrates on patients and their environment, with particular attention to the interaction between pharmacist and patient. It introduces the concepts of pharmaceutical care, including the recognition of potential or actual drug therapy problems and the application of problem solving skills to prevent or overcome them. In addition, this subject addresses the legal asects of the practice of pharmacy. Accordingly, the main aims of this subject are to provide students with a knowledge and understanding of the principles of counselling, illness behaviour, compliance, problem solving, and the legal underpinnings to the practice of pharmacy.

General objectives

In this teaching program students are expected to develop:

understanding of effective communication with patients and prescribers; the problems of medication non-compliance and means of overcoming them; the role of the pharmacist in patient education; illness behaviour, normal and abnormal; the placebo effect and how it relates to pharmacy practice; the concepts of self role and sick role; the process of pharmaceutical care; the legislation applicable to drugs and poisons and the practice of pharmacy;
abilities in the areas of accessing information; written and oral communication; patient counselling; problem-solving in clinically oriented situations; creating, maintaining and utilising individual patient;
an appreciation of the relationships existing between drugs, medicines, patients and society; and the role of the pharmacist in patient care.

Syllabus

Counselling and communications. Communication skills, professional-patient communication, interprofessional communication. Listening skills, barriers to communication, rapport, empathy, interviewing skills. Advanced counselling skills.
Patient compliance. The problem of non-compliance to health oriented regimens. Statistics and reasons for non-compliance to therapeutic regimens. The patient, the health care provider, the social milieu, the therapeutic regimen, the health belief system. Predictng, explaining and detecting non-compliance. Methods of improving compliance.
Patient education. Definition of health education, methods of health education, improving compliance. Practical recommendations to improve comprehension, recall and compliance. The principles of brevity, organisation, primacy, readability, repetition and specificity. Health promotion and disease prevention.
Social pharmacy. The influence of others on behaviour. Categorisation and its dangers in the patient-provider situation. Groups and behaviour, obedience and behaviour. Person perception, behaviour and the patient.
Illness behaviour. Definition. Parson's concept of role; the sick role; the well role. Social class and the sick role. Mechanic's Help Seeking Process. Suchman's five stages of the illness experience. Models of health behaviours. Medication taking behaviours.
The placebo. Historical perspective, definitions, incidence, mechanisms, practitioner behaviour and placebo effect, patient characteristics and placebo effect, patient-practitioner communication and placebo effect, situational determinants of placebo effects, social norms and the placebo effect, generalisability and the placebo effect, the placebo as a methodological tool, alternative therapies and the placebo effect.
Pharmaceutical care. Definition. Steps in the pharmaceutical care process. Drug therapy problems - definition, detection, prevention and resolution. Information retrieval and evaluation, problem solving.
Forensic pharmacy. Legislation applicable to drugs, medicines, poisons, and pharmacy generally, including the following Acts and Regulations: Pharmacists Act; Drugs, Poisons and Controlled Substances Act; Health Act; National Health Act; Animal Preparations Act; Therapeutic Goods Act; legal and professional responsibilities; professional conduct; pharmacy organisations in Australia.

Practical and tutorials

Practical classes and small group tutorial sessions are designed to reinforce the lecture material by providing practical experience of dispensing, communication and counselling, information retrieval and evaluation, problem solving and the application of the pharmaceutical care process.

Textbooks

Recommended texts

Australian pharmaceutical formulary 16th edn, Pharmaceutical Society of Australia, 1997
Pharmacy Board of Victoria Office consolidation 2nd edn and amendments, PBV (loose-leaf)
Quintrell N Communication skills. A handbook for pharmacists rev. edn, Pharmaceutical Society of Australia, 1994
Smith M C and Wertheimer A I Social and behavioural aspects of pharmaceutical care Pharmaceutical Products Press, 1996
Victorian College of Pharmacy Pharmaceutics II/Pharmacy practice II laboratory manual VCP, 1999

Reference books

Australian prescription products guide APPCo, 1998
Drug information for the health care professional Vol. 1, USP-DI (annual)
Drug interaction facts Facts and comparisons (loose-leaf)
Fitzpatrick R and others The experience of illness Tavistock, 1984
Hansten P D and Horn J R (eds) Hansten & Horn's drug interactions analysis and management Applied Therapeutics Inc. (loose-leaf)
Martindale W The extra pharmacopoeia 31st edn, Pharmaceutical Press, 1996
Mosby's medical nursing and allied health dictionary 5th edn, Mosby, 1998 (or other medical dictionary)

Journal references

Australian Adverse Drug Reactions Bulletin
Australian Journal of Hospital Pharmacy
Australian Journal of Pharmacy
Australian Pharmacist
Australian Prescriber

Assessment

Subject assessment will reflect the learning objectives outlined above. Methods of assessment will include:

Mid-year written examination (June) (1.5 hours): 40%
End-of-year written examination - Forensic pharmacy (October) (1.5 hours): 40%
Open-book laboratory-based examination (October) (3 hours): 20%
Dispensing. Students are required to reach a satisfactory level of competence in dispensing by the end of the course