First time in Nepal
PUSKAR KUNWOR, MClinPharm, RPh
Unit Head, Clinical Pharmacy Services
Nepal Cancer Hospital & Research Center
ONCOLOGY CLINICAL PHARMACY SERVICES: A NEW APPROACH TO PATIENT SAFETY AT NEPAL CANCER HOSPITAL
“We advance the safe and effective use of medicines”
Prescription medication use is widespread, complex, and increasingly risky. Advances in clinical therapeutics have undoubtedly resulted in major improvements in health for patients with many diseases, but these benefits have also been accompanied by increased risks. It has forced pharmacists to take a patient-centered approach. Pharmacist-directed Medication therapy management is more important than ever.
Previously the pharmacist worldwide was seen as responsible primarily for a medication compounding and dispensing, today the pharmacist's role has evolved towards a clinical orientation.The pharmacist in the white coat standing behind the counter dispensing medication has already expanded to new opportunities. Today pharmacists see patients to manage complicated drug therapies called as Clinical Pharmacist.
While regular pharmacists normally work in a pharmacy, a Clinical pharmacist works directly with medical professionals and patients. Clinical pharmacists are practitioners who provide comprehensive medication management and related care for patients in health care settings. Clinical pharmacist work directly with physicians, other health professionals, and interacts one-on-one with their patients which will minimize risks of drug-related problems and maximize therapeutic benefits.
In many parts of the world, clinical pharmacist have played a significant role in provision of pharmaceutical care services.Within the context of Nepal the term clinical pharmacist is still new. And to split that, for the first time in the field of oncology, clinical pharmacist concept has transformed by the Nepal cancer hospital and research center (NCHRC) to be more accountable in patient care especially to ensure the patient safety. Currently clinical pharmacists are busy in this hospital scattering the following major services but not limited to only these.Here in Nepal cancer hospital once you admitted:
Ø Prescription Review:Clinical pharmacist checks your prescribed medicineson daily basis to ensure your medicine is right for you.
Ø Drug Interactions:Checks drug interactions between all your medicinesso that you can take your medicines safely.
Ø Chemo Mixing:Chemo mixing technician mix your chemo medicines under the direct supervision of clinical pharmacist.
Ø Pre Chemo Counselling:Before start of your chemotherapy Clinical pharmacist visits you in your bedside and counsels about your specific chemo regimen, their side effects and precautions that you can take at your home.
Ø Adverse drug reaction monitoring:Identifies, manages side effects of your chemotherapy and helps doctors in dose modification based on severity of your drug reaction.
Ø Anticoagulant therapy management:Meets the patients taking blood thinning medicine (WARFARIN) and advise you on how to best take it and checks any interactions with your other medications to make you free from risk of bleeding.
Ø Renal & Hepatic Dose Adjustment:Your medicine’s dose need to adjust if that affects your kidney and liver so your clinical pharmacist is always ready to prevent you from that risk.
Ø Antibiotic Use:The antibiotic pharmacist makes your antibiotic treatment saferconsidering your clinical status, new culture or susceptibility results, side effects or superinfection with a non-susceptible organism.
Ø Discharge medication reconciliation:Once you are ready for discharge, clinical pharmacists again checks your discharge medicines that are safe to take at your home.