PELAYANAN

KEFARMASIAN

Wahyu Utaminingrum

HISTORY OF PHARMACY
a pharmacy has been the place
for:
storing drugs
making medicines
supplying and distributing drugs
to customers
The art of compounding
(individual massal)

Phenomenon
Physician - Pharmacist

OLD VS NEW PARADIGM

Dispensing Pharmacy
(Old Paradigm)
Product business
Objective is to bring product to the
customer
Decisions focus on the business
Inventory generates revenue
Available service supports the
product
Success measured as number of
prescriptions
Space is organized to display and
sell products
Records are kept primarily to meet
legal requirements concerning the
drug product
Schedule for refill determined by
customer supply of drug product

Business is passively sought

Pharmaceutical Care
(New Paradigm)
Service (people) business
Objective is to bring the pharmacist to
the patient
Decisions focus on the patient
Patient care generates revenue
Available product supports the service
Success is measured as patient
outcomes

Space is organized to meet patients

needs
Documentation supports patient care
Schedule for follow-up determined by
risk and benefit of drug therapies and
needs of the patient
Business is actively sought through the

PERUBAHAN PARADIGMA
Kebutuhan obat meningkat,
perkembangan produk inovasi,
tekanan kompetisi perdagangan,
inovasi penemuan obat baru, lahirnya
berbagai penyakit baru
Timbul permasalahan penggunaan
obat
Patient oriented : Pharmaceutical Care

PHARMACEUTICAL CARE AS A
PRACTICE

PC is applying knowledge to
promote the well being of
others

PHARMACEUTICAL CARE AS PRIMARY

HEALTH CARE

PC is generalist practice that

emphasizes health, prevention, and
care
PC requires responsiveness,
sensitivity, and commitment to
others
PC is a form of primary health care

FILOSOFI PC
Pharmaceutical care adalah
tanggung jawab profesi apoteker
dalam memberikan pelayanan dengan
obat secara langsung dengan tujuan
pencapaian hasil yang jelas yaitu
peningkatan kualitas hidup pasien
A patient-centered approach

DEFFINITION
Mikeal and others (1975)
the care that a given patient requires and receives which
assures rational drug usage
Strand and others (1992)
Pharmaceutical care is that component of pharmacy practice
which entails the direct interaction of the pharmacist with the
patient for the purpose of caring for that patients drugrelated needs.
The American Society of Health-System Pharmacists (ASHP),
2003
The mission of pharmacist is to provide pharmaceutical care.
Pharmaceutical care is the direct, responsible provision of
medication-related care the purpose of achieving definite
outcomes that improve a patients quality of life

Pharmaceutical care is a patient-centered practice in

which the practitioner assumes responsibility for a
patient's drug-related needs and is held accountable
for this commitment (Helper & Strand,1990)

PERAN PC
Identifikasi DRP potensial & aktual
Mencegah DRP potensial
Mengatasi DRP aktual

MEDICAL VS DRUG THERAPY

PROBLEMS
Medical problems are disease
states; that is, problems related
to altered physiology that result
in clinical evidence of damage.
Drug therapy problems are
patient problems that are either
caused by a drug or may be
treated with a drug.

Pharmaceutical Care Cycle

(Hepler &Strand,1990)
Why do anything?
(identify the problems)

How will you know you did it?

(monitor and follow up)

What do you want to do?

(set goal)

How will you do it?

(develop a care plan)

Pendekatan sistematik Pharmaceutical

Care (WHO,2006)
Pasien menerima atau membutuhkan
produk dan pelayanan farmasi

Tahap I
Penilaian kebutuhan dan
identifikasi DRP
Tahap IV
Monitoring dan review
Care plan

Tahap II
Pengembangan Rencana
Asuhan(Care plan)

Tahap III
Impelementasi care plan

OUTCOMES OF PC

Cure of disease
Elimination of reduction symptomps
Arrest or slowing of a disease process
Prevention of disease or symptoms

Drug-related Morbidity
and Mortality are The
Challenge for
Pharmaceutical Care

TAHAP PC PROCESS
1. Hubungan profesional antara farmasis dan
pasien harus dibangun
2. Adanya informasi medis yang spesifik untuk
setiap pasien
3. Adanya evaluasi terhadap informasi medis
pasien dan melakukan rencana terapi obat
bersama dengan pasien
4. Farmasis harus memastikan bahwa pasien
memiliki informasi dan pengetahuan yang
benar tentang terapi obatnya
5. Farmasis melakukan monitoring dan
modifikasi terapi obat pasien bekerjasama
dalam tim kesehatan

WUJUD PHARMACEUTICAL
CARE
Memberikan pelayanan resep
skrining, dispensing, evaluasi &
monitoring
Swamedikasi jaminan efektivitas &
keamanan
Pelayanan informasi obat dan
konseling jelas, relevan,
terpercaya

 Konsultasi obat identifikasi DRP &

peningkatan kepatuhan
Membuat formulasi khusus sediaan
obat yang mendukung proses terapi
formulasi, dispensing, etiket,
aturan pakai, Pertimbangan stabilitas
sediaan, kondisi pasien,
kenyamanan, bersifat individual

 MESO
TDM berbasis farmakokinetika
Handling sitostatika
DUE

HEALTH CARE SYSTEM

PC IN HEALTH CARE SYSTEM

INTEGRATED PHARMACEUTICAL
MEDICAL CARE
Medical Care
SOLVE
PATIENT PROBLEM
ANALYSIS DIAGNOSIS

RECOGNIZE
PATIENT PROBLEM

PLAN
(PRESCRIBE
MEDICINE)

PATIENT
INFORMATION

CONSIDER
PHARMACEUTICAL
PROBLEMS

Drug
informatio
n

COLLECT &
INTERPRET
MONITORING
INFORMATION

(ASSESS)
THERAPEUTIC
OBJECTIVES
THERAPEUTIC PLAN

Therapeut
ic Cycle
Drug
informatio
n

IMPLEMENT
MONITORING PLAN
(FOLLOW-UP)

Pharmaceutical
Care

DESIGN
MONITORING PLAN

IMPLEMENT
THERAPEUTIC PLAN
(DISPENSE, ADVISE)
IMPLEMENT
THERAPEUTIC PLAN
(ADMINISTER/CONSUME)

Colaborating
physicianpharmacistpatient

Drug
informatio
n