Pharmacist

Main Function

Conduct comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs).

Assess medication regimens for:

• Appropriate medication selection
• Appropriate dose
• Appropriate route
• Appropriate frequency
• Appropriate indication
• Therapeutic effectiveness
• Safety concerns
• Patient adherence and barriers
• Identify, prevent, and resolve medication-related problems
• Develop individualized medication action plans
• Communicate recommendations to providers and healthcare teams
• Follow up on medication changes and clinical outcomes

Clinical Pharmacist Assessment

Evaluate Patient-specific Factors Including:

• Drug-drug interactions
• Drug-disease interactions
• Allergies and intolerances
• Renal function considerations
• Hepatic function considerations
• Laboratory monitoring needs
• Contraindications and precautions
• Duplicate therapy
• Medication affordability and access barriers

Patient Care & Education

Provide medication counseling and education to patients and caregivers.

Promote medication adherence and self-management strategies.

Education patients regarding:

• Medication purpose
• Expected benefits
• Potential adverse effects
• Monitoring requirements
• Lifestyle modifications

Support patients in understanding and managing chronic conditions.

Chronic Disease Management Support

Support Pharmacist-led Interventions And Monitoring For Conditions Such As:

• Diabetes
• Hypertension
• Hyperlipidemia
• Anticoagulation therapy
• Asthma/COPD
• Heart failure
• Other chronic disease states as identified by clinic needs