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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Polypharmacy as a Clinical Pharmacist Specialist Practice.

Michael J Schuh, Sheena Crosby

The Senior Care Pharmacist

|December 30, 2019

Summary

This review details the evolution of ambulatory care pharmacy services into specialized polypharmacy care, particularly for older patients with complex medication needs. Pharmacists now act as expert troubleshooters for intricate medication regimens.

Area of Science:

Clinical Pharmacy
Pharmacotherapy
Geriatric Medicine

Background:

Ambulatory care pharmacy services have expanded significantly.
Patients, especially those over 65, often present with polypharmacy and complex medical needs.
The healthcare landscape has evolved with sophisticated medications, direct-to-consumer marketing, supplements, and pharmacogenomics.

Purpose of the Study:

To review the development of an ambulatory care pharmacist service into a specialized polypharmacy service.
To highlight the increasing complexity and scope of pharmacist roles in managing multiple medications.
To identify the factors driving the need for advanced pharmacist expertise in tertiary care settings.

Main Methods:

Review of an established ambulatory care pharmacist service.

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Analysis of the service's evolution into a polypharmacy submodel.

Description of the practice setting: a multispecialty, tertiary care clinic in Florida.

Main Results:

The ambulatory care pharmacist service has successfully evolved into a comprehensive pharmacotherapy and polypharmacy service.
The service addresses complex medication issues in patients with multiple comorbidities, often the elderly.
Pharmacists are increasingly functioning as expert troubleshooters in pharmacology.

Conclusions:

Polypharmacy management is a viable and necessary clinical specialty for pharmacists.
Advances in technology and the increasing complexity of medications necessitate specialized pharmacist expertise.
Pharmacists play a crucial role in optimizing medication therapy for patients with multiple health conditions.