Washington e Acne Vulgaris Debra Sibbald Psoriasis Rebecca M. Law and Wayne P. Gulliver Atopic Dermatitis Rebecca M. Law, Wayne P. Gulliver, and Poh Gin Kwa Alopecia Rebecca M. Law, David T. Law, and Howard I. Yee Anemias Kristen M. Cook and Devon M. Greer McCavit, and Lauren Duran Sickle Cell Disease C. Jennifer Chan and Melissa Frei-Jones e Greene and Tracy M. Werth, Katie E. Barber, Jordan R. Smith, and Michael J. Rybak Antimicrobial Regimen Selection Grace C. Lee and David S.
Burgess Rotschafer Zasowski and Martha Blackford Frei and Bradi L. Frei Influenza Jessica Njoku Fish Infective Endocarditis Daniel B. Chastain and Angie Veverka Tuberculosis Rocsanna Namdar and Charles Peloquin Roecker and Brittany N. Bates Intra-Abdominal Infections Alan E. Gross and Keith M. Olsen e Parasitic Diseases Jason M. Cota Fernandez and Elizabeth A. Coyle Burnett Bone and Joint Infections Scott J.
Bergman and Edward P. Armstrong Sepsis and Septic Shock S. Lena Kang-Birken and Sul R. Jung Superficial Fungal Infections Thomas E. Brown and Linda Dresser Invasive Fungal Infections Peggy L. Carver Infections in Immunocompromised Patients Scott W. Mueller and Douglas N. Antimicrobial Prophylaxis in Surgery Salmaan Kanji Vaccines and Immunoglobulins Mary S.
Hayney Anderson, Jenna Yager, and Courtney V. Cancer Treatment and Chemotherapy Lisa M. Cordes and Stacy S. Shord Patel, and Laura Boehnke Michaud Lung Cancer Val R. Adams and Keith A. Hecht Colorectal Cancer Lisa M. Holle, Jessica M. Clement, and Lisa E. Davis Prostate Cancer LeAnn B. Norris Ovarian Cancer Emily B. Borders and Judith A. Smith Chronic Leukemias Patrick J.
Kiel and Meagan Grove Multiple Myeloma Amy M. Pick and Kamakshi V. Rao e Myelodysplastic Syndromes Jill S. Bates e Renal Cell Carcinoma Daniel J.
Crona and Amber B. Cipriani Melanoma Cindy L. Poust, and Christina M. Chessman and Vanessa J. Kumpf Parenteral Nutrition Todd W. Mattox and Catherine M. Crill Enteral Nutrition Vanessa J. Kumpf and Diana W. Mulherin Chen, and Jack A.
All contributors will complete, sign, and submit a conflict of interest COI disclosure statement to the Editors. Starting with the 11th edition, the COI disclosure must be submitted after an invitation has been extended and before a contributor agreement is signed. No contributor may receive a payment or services from a third party commercial entity, government agency, professional organization, private foundation, etc.
Starting with the 11th edition, potential contributors who are employees of a commercial entity that produces, markets, sells, or distributes medications or healthcare products generally will not be invited or re-invited to contribute. COI disclosures for all contributors to Pharmacotherapy: A Pathophysiologic Approach will be made available to readers online.
The internet address for the COI disclosure page will be published in the Contributors section of the text. Contributors Val R. Louis College of Pharmacy St. Louis, Missouri Chapter Lucinda M.
Louis, Missouri Chapter Alan E. Louis, Missouri Chapter e34 Steven C. Pharmacy education and practice have seen many changes over this same period. Throughout this time, Pharmacotherapy: A Pathophysiologic Approach has been the most adopted textbook used by colleges and schools of pharmacy in the United States to prepare students to provide a strong foundation for the provision of their patient-centered care. Moreover, with a growing acceptance in clinical care by pharmacist in other countries, Pharmacotherapy: A Pathophysiologic Approach has experienced a growing international audience in this same time period.
The conversion of the entry level degree required for licensure to practice pharmacy in the United States from the 5-year Bachelor of Science degree to the 6-year Doctor of Pharmacy PharmD occurred with the entry level pharmacy classes in the year The original all PharmD Standards in Standards were followed by subsequent revisions, Standards and Standards The 11th edition is no exception.
In , the then 11 members of JCPP approved the following vision statement for the profession of pharmacy in the United States: Patients achieve optimal health and medication outcomes with pharmacists as essential and accountable providers within patient-centered, team-based healthcare. The process is applicable to any practice setting where pharmacists provide patient care and for any patient care service provided by pharmacists.
This new feature should make the 11th edition of Pharmacotherapy: A Pathophysiologic Approach stand out from any other clinical textbook for pharmacy students. Peter H. This was the first effort to compile a formal, accepted list of the ingredients in common use in the fledgling United States and standardize the acceptable quality of the products, most of which were botanical in origin.
The founding of USP led quickly to the maturation of both pharmacy and medicine. While two medical schools had been formed in the United States in the late s, pharmacy remained an apprentice-based profession. Immediately after the USP founding, pharmacy began establishing schools for educating new members of the profession, starting with the Philadelphia College of Pharmacy in The American Journal of Pharmacy was established soon thereafter in Formal organizations of physicians and pharmacists were founded in this era, including the British Medical Association in , the American Medical Association in , and the American Pharmaceutical Association in As Pharmacotherapy: A Pathophysiologic Approach enters its 11th edition, these events from years ago are important and relevant, for they illustrate the long-standing professional partnership between pharmacists and physicians to ensure the appropriate and optimal use of medications in the prevention and treatment of disease.
These events also provide clear evidence of the importance and role of published works in establishing consensus and driving positive changes in healthcare.
As Dr. In this 11th edition, we sought to ensure that this work continued to provide evidence-based and comprehensive information about pathophysiology of disease states and how diseases can be prevented or treated. Like those who met in Philadelphia in , we also examined trends in healthcare and considered the advice of others in the field. This framework is directly relevant to the educational and practice process supported by the material in this work. All health professionals who provide direct patient care should use a systematically and consistently applied process of care in their practice.
By adding Patient Care Process boxes to key chapters and posting the material in Chapter 1 of this edition as an online supplemental chapter to the 10th edition, we took our first steps toward making major changes to the online content between the printing of editions. The 11th edition was built online over many months before the print version was typeset and sent to print. We identified several conditions not covered in our 10th edition, including cardinal symptoms of disease such as pain and fever that are typically managed by the patient using over-the-counter medications and other nonprescription products.
The first edition of Pharmacotherapy was used as important evidence in the petition to recognize pharmacotherapy as a specialty in the late s. Over the years, we have had added chapters covering areas later recognized as specialties. For this 11th edition, we realized the time had come to provide a greater level of depth for special populations in specialty areas not adequately addressed in our disease-focused, organ system approach to pharmacotherapy. In making decisions based on these developments, our intent remains the same as in our first edition: to provide both students and practitioners with the tools they need for the contemporary practice of pharmacotherapy.
Bringing these threads together, the following are the key changes and new content included in the 11th edition of Pharmacotherapy. In addition to coverage of symptoms such as pain, fever, and cough, chapters have been added that recognize the importance of oral health to overall health and prepare pharmacists and other primary care professionals to assist patients with their daily oral health needs.
Other new chapters in this section cover minor otic, ophthalmic, and dermatologic disorders. We wish to thank our retiring editors—Barbara Wells, Robert Talbert, and Gary Matzke—who worked on the text for decades and helped make Pharmacotherapy the gold standard in the profession.
Ellingrod, Stuart T. Haines, and Thomas D. Without their dedication to the cause of improving pharmacotherapy and maintaining the accuracy, clarity, and relevance of their chapters, this text would unquestionably not be possible. A special thanks goes to Michael Weitz and Juanita Thompson of McGraw Hill and Ruma Khurana of MPS Limited for leading us into the new world of online authoring tools implemented with this edition and providing the path to a 21st-century workflow.
While at times our impulses bordered on those of the Luddites, we recognize the importance of moving Pharmacotherapy to a world in which content can be continually updated as new data become available.
Many thanks to Terry Schwinghammer for his insights during our editor meetings and continued devotion to the Pharmacotherapy Casebook: A PatientFocused Approach companion to this work and the tools, chapter updates, and innovations he has shepherded onto the Access Pharmacy website. Finally, we thank James Shanahan, Peter Boyle, and their colleagues at McGraw Hill for their consistent support of the Pharmacotherapy family of resources, insights into trends in publishing and higher education, and the critical attention to detail so necessary in pharmacotherapy.
A professional patient care practice is predicated on a patient-practitioner relationship established through respect, trust, and effective communication. Patients, and when appropriate caregivers and family, are actively engaged in decision making. Adopting a uniform patient care process—a consistently implemented set of methods and procedures—serves as a framework for each patient encounter, increases quality and accountability, and creates shared language and expectations.
The patient care process includes five essential steps: collecting subjective and objective information about the patient; assessing the collected data to identify problems and set priorities; creating an individualized care plan that is evidence-based and cost-effective; implementing the care plan; and monitoring the patient over time during follow-up encounters to evaluate the effectiveness of the plan and modify it as needed.
The patient care process is supported by three inter-related elements: communication, collaboration, and documentation. Interprofessional teamwork and information technology facilitate the effective and efficient delivery of care. A practice management system includes the infrastructure to deliver care. This includes physical space, documentation systems, payment for services, and qualified support personnel. Indeed, medicine, nursing, and dentistry all follow a putatively similar process of care3 see Table To practice is what health professionals do to bring their unique knowledge and skills to patients.
A practice is not a physical location or simply a list of activities. Rather, a professional practice requires three essential elements: 1 a philosophy of practice, 2 a process of care, and 3 a practice management system. Health professionals have an ethical obligation to promote the health and well-being of the patients they serve. Thus, a philosophy—the moral purpose and a commonly held set of values that guides the profession—is the critical foundation on which the practices of pharmacy, medicine, nursing, and dentistry are built.
In addition to a code of ethics, most professions have an informal set of beliefs and values that also inform the self-proclaimed and societal expectations. For example, the concept of pharmaceutical care is not formally included in the code of ethics for the profession of pharmacy or the oath of a pharmacist. A process of care that is systematically and consistently applied during each patient encounter increases the likelihood that optimal health outcomes are achieved.
In addition to the five fundamental steps, a patient-centered approach to decisionmaking is essential. It also requires interprofessional collaboration — working with other health professionals to development and implement a shared plan of care. These steps are interdependent and completing all five steps is necessary to achieve the greatest impact.
While the process of care is common to all, each profession has a unique body of knowledge and skills they bring to bear when assessing the data and formulating plans. A practice must also have a practice management system that supports the efficient and effective delivery of services. This includes the infrastructure—the physical, financial, and human resources—as well as policies and procedures to carry out the patient care work. Successful practices have a clear mission statement that defines who the practice serves, the organizational values, and what they hope to accomplish.
Furthermore, to achieve its mission, a practice must implement quality improvement methods that measure, evaluate, and improve the actions of practitioners individually and the practice collectively. While every practice is built on three essential elements—a philosophy of practice, a well-defined patient care process, and a practice management system —the focus of this chapter is to describe the patient care process applied to drug therapy management and explore some environmental issues that are influencing the adoption and application of this process by pharmacists.
Since the turn of the twenty-first-century, much effort has focused on gaining control of a disparate, disjointed, costly health system that is not adequately producing desired patient outcomes despite the healthcare workforce laboring harder than ever. The Triple Aim can only be achieved with significant transformations in the delivery of care and by adopting payment models based on value. Among these principles is to standardize what works in order to reduce unnecessary variation.
Standardization is important because healthcare systems are embedded in a network that reaches well beyond traditional walls. For a specific patient care service to be widely adopted and valued, it is imperative that clarity exists both in the execution of care and the terminology used to describe the care.
The stimulus for developing the patient care process for pharmacy was the wide variation observed as pharmacists provided direct patient care, often using the same terminology to describe diverse services or conversely, the same service is described using different terminology. As patient care services provided by pharmacists, physicians, and any other healthcare practitioner cannot operate in a silo, the services must be clearly articulated and well understood by patients, their caregivers, payers, and other members of the care team.
Moreover, the patient must know and understand what is to be delivered and to determine how best to receive the care provided. Creating a standardized process of care is not unique to pharmacy. It is well recognized in healthcare that setting standards encourage providers to approach patient care in a consistent manner. Systematically implementing a framework for care that is consistently applied assures no important step is overlooked and actions that may lead to greater harm than benefit are reduced or eliminated.
Defining the standards of care enables the generation of outcome data that can be compared and used to demonstrate the value of a service. In a rapidly changing environment, the structure is essential to maintain consistency. In the hospital setting, care pathways and standard order sets are examples of standardized care processes that have been used for many years. A process of care must be built on a set of fundamental steps that can address the wide range of complexity that exists among patients.
The process needs to be adaptable to varied settings, diverse populations, and different acuity levels. The process described throughout this text provides a unifying and comprehensible approach that is universally recognized.
Several publications and resources have outlined elements of the patient care process to deliver comprehensive medication management services. What varies is the specificity of the operational definition of each of the process components. Detailed operational definitions help to establish consistency across all practitioners applying the patient care process. What often varies is the information collected and its source as well as the duration of time to complete the process. For example, in an ambulatory care clinic the patient is often the most important source of information but in a critical care unit of a hospital there is a greater reliance on laboratory tests and special diagnostic studies.
Similarly, the process of care unfolds in hours or days in acute care settings but may extend over weeks or months in chronic care environments. Collect Information When initiating the patient care cycle, a practitioner assures the collection of the necessary subjective and objective information about the patient and is responsible for analyzing the data in order to understand the relevant medical needs, medication-related problems, and clinical status of the patient.
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