Development of the medication management services model

Ljekarnici kao najeduciraniji zdravstveni djelatnici na području lijekova imaju važnu ulogu u riješavanju terapijskih problema i povećanju adherencije. Potreba za modelom upravljanja farmakoterapijom pojavljuje se zbog sve kompleksnijih terapija, povećanja broja propisanih lijekova i cijene tih lijekova, kao i zbog nedostatka strukturiranog, sistematičnog modela donošenja odluka o odabiru lijeka i njegove doze koji dovode do povećanja stope mortaliteta i morbiditeta povezanog s farmakoterapijom. Cilj ovog diplomskog rada bio je prikazati strukturu usluge upravljanja farmakoterapijom, objasniti njenu važnost, potencijal, dosadašnje rezultate postignute diljem svijete te definirati ulogu farmaceuta u ovom modelu. U izradi rada korišteni su znanstveni radovi iz časopisa dostupnih u bazama podataka Medline, PubMed i Mendeley, te udžbenici i ostala dostupna literatura. Rezultati upućuju na model usluge upravljanja farmakoterapijom koji se sastoji od tri dijela: - filozofije prakse koja definira pravila, uloge i odgovornosti praktičara te ga štiti od titule "prodavača lijekova", a pacijenta stavlja u središte ljekarničke skrbi - procesa skrbi za pacijente koji uključuje procjenu pacijenta, procjenu njegovih terapijskih problema i riješavanje istih, razvoj individualnog plana skrbi s dogovorenim terapijskim ciljevima te naknadnu evaluaciju pri kojoj se utvrđuje jesu li ciljevi postignuti te jesu li se pojavili novi terapijski problemi - sustava upravljanja praksom koji osigurava uspješnost i financijsku održivost prakse. Vrijednost ovog modela utvrđena je, dokumentirana, objavljena i reproducirana u mnogim ustanovama diljem svijeta. Ovaj model osigurava da su svi propisani lijekovi prikladni, učinkoviti i sigurni te da pridonose adherenciji svakog pojedinog pacijenta. Osim evidentne koristi za pacijenta i zdravstveni sustav, ovaj model koristan je i za same farmaceute jer se njihovo zadovoljstvo poslom povećava aktivnim uključenjem u zdravstveni sustav i proces skrbi za pacijente gdje vide pozitivne ishode svog djelovanja.Pharmacists as the most educated health care providers in the area of medication have important role in solving drug therapy problems and improving medication adherence. The need for medication management services comes from increased complexity and specificity of the therapy, increases in the number of prescriptions being written and increased costs of new medications, as well as lack of structured, systematic decision-making process for drug selection and dosing that leads to the increased drug-related morbidity and mortality. The aim of this study was to present the structure of medication management services, explain its importance, potential and achieved results all over the world, and to define the role of pharmacists in this model. The research for this work has been conducted through academic research papers published in professional journals and available for review through the following databases: Medline, PubMed, Mendeley; textbooks and other literature. The results point to the medication management services, divided in three parts: - the philosophy of the practice that defines rules, roles and responsibilities of the practicioner as well as protects him from the title of "drug salesman" and puts patient in the center of care. - the patient care process that includes the assessment of the patient, his drug therapy problems and resolving them, developing the care plan with agreed goals of therapy and the follow-up evalutations that serve for checking the success of achieving goals of therapy and eliminating new drug therapy problems - managing medication management services in a way that ensures the practice is viable and financially sustainable The value of this service is established, well documented and reproduced in many practices all over the world. This model ensured that all prescribed medications are appropriate, effective and safe for individual patient. Except those evident benefits for patients and the health care system, the service is useful for pharmacist too, giving them professional satisfaction for being involved directly in the health care system and the patient-care process and seeing positive results from their action