Opportunities for Progressive Pharmacy Practice in Homecare

Abstract

This article will describe the many opportunities for progressive pharmacy practice in the homecare area, particularly when dealing with parenteral therapies. Progressive pharmacy practice in the home requires that the technical and clinical pharmacy expertise first developed in the institutional setting be applied in a decentralized environment. The decentralization of high-tech care into the patient's home presents major challenges and opportunities to all health care professionals. The pharmacist, in particular, is given the opportunity to provide progressive pharmacy services, especially clinical services, as a result of patient need and agency requirements (ie, JCAHO, State Pharmacy Board, HCFA). This group of patients has generally a higher acuity than traditional ambulatory and homecare patients; thus, health care professionals, reimbursement organizations, and regulatory and accrediting agencies are very concerned about the coordination of patient care. The pharmacist's knowledge base and interest in drug therapy is well suited for and used to benefit the patient and health-care team; this is important in many areas of patient care. A knowledge of drug therapies is required in predischarge planning, patient training, plan of care development, and patient monitoring. Therefore, the hospital and/or homecare pharmacist can be involved from the start (patient selection) to the completion of therapy for the homecare patient. Since homecare patients have an increasing acuity, the traditional hospital pharmacy services need to be provided and expanded upon so that safe and efficacious therapy is provided.