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Introduction to Patient Assessment for Pharmacists

INTRODUCTION

As pharmacy continues its rapid transition to a more patient-centered profession, patient assessment is one of the most important skill sets a pharmacist will use in daily clinical practice. Patient assessment has five important roles in providing pharmaceutical care. First, it is essential to identify drug-related problems. Many times the pharmacist is required to determine whether a problem is caused by a drug or the patient’s illness. Second, patient assessment skills are needed to monitor or manage patients requiring chronic drug therapy. Third, they enable the pharmacist to diagnose and treat common minor acute illnesses and/or appropriately refer patients who require a higher level of care. Fourth, they enhance the pharmacist’s ability to educate patients about their disease, its presentation, complications, and management. Finally, since the foundation of communication among health professionals is based on the patient assessment process, it enables the pharmacist to more effectively communicate with other providers (Table 1).

TABLE 1

Pharmacist Roles That Require Patient Assessment Skills

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TABLE 1

Pharmacist Roles That Require Patient Assessment Skills
Identifying potential drug-related problems—Pharmacist may have to differentiate cause of patient’s problem regarding drug induced versus disease induced
Monitoring/managing patient drug therapy for chronic diseases—Must evaluate response to therapy and for the presence of adverse drug effects or complications due the chronic disease
Assessing patients for appropriateness for self-care treatment or referral to higher levels of medical care—More accurately assess patients for self-care or referral
Counseling/educating patients about disease and drug therapy
Communicating effectively with other health professionals—The protocol for “presenting” patients among providers generally follows the format used in chief complaint history taking or history of present illness (HPI)

This textbook is intended to fill the significant resource gaps in patient assessment that are needed by pharmacists to provide optimal patient-centered pharmacy services, including primary care. Existing pharmacy materials do not include the necessary breadth and depth in this area. There are several areas that are intentionally not covered in detail, as other sources exist for this information. This is not a therapeutics text, but it will provide skills needed to monitor a patient’s drug therapy or assist in controlling their chronic disease. It is not a physical examination textbook, but shows the reader how to integrate physical findings into the overall assessment process. While it does cover chief complaint history taking, it is not a textbook on patient communication. While there is some pathophysiology content in the textbook, in-depth coverage of this material is not the primary intent. Instead, it shows the reader how to integrate pathophysiology, medical history, physical findings, and laboratory tests to accurately assess and monitor patient problems. The focus of this textbook is on two major practice areas for pharmacists. The first is the management of patients with chronic diseases in the ambulatory care. The second is the community pharmacy setting, where pharmacists advise ...

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