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Patient Profile Review Using the PPCP

Pharmacists’ Patient Care Process (PPCP) (Five Steps)

  1. Collect patient information (subjective / objective information).
  2. Assess the patient’s drug therapy for any drug therapy problems and discuss it with the clinical instructor. Students should make recommendations for any drug therapy problems identified.
  3. Develop an individualized plan for the patient using evidence-based guidelines.
  4. Plans should be implemented in collaboration with the patient and other health care providers.
  5. Follow up by monitoring and evaluating the care plan for effectiveness.

Evidence-Based Guidelines

When reviewing patient profiles for this assignment, students should utilize at least five different evidence-based guidelines. Students should incorporate guidelines applicable to the patient populations encountered at the 741-practice site. Examples of evidence-based guidelines include:

  • Asthma
  • COPD
  • Coronary Artery Bypass Grafting
  • Diabetes
  • GERD
  • Heart Failure
  • Hip/Knee Replacement
  • Hyperlipidemia
  • Hypertension
  • Myocardial Infarction
  • Oncology
  • Pneumonia

Patient Profile Review Evaluation Form Rubric

The Patient Profile Review Using PPCP – Evaluation Form is used to evaluate the student’s ability to provide patient-centered care that is safe and effective. At a minimum, clinical monitoring should consist of the following areas:

  1. Database information (subjective and objective data that is gathered in the COLLECT phase of the PPCP). BE SURE TO FOLLOW HIPAA GUIDELINES FOR THIS DOMAIN…. which includes, but is not limited to:
    1. Patient initials, age, sex, height and weight. This information should be obtained to identify if the patient is at risk for developing side effects from a particular class of drug(s) or if these factors will affect the ADME (absorption, distribution, metabolism, excretion) characteristics of a particular drug.
    2. Source of medication history, reliability, compliance, lives alone, or functional limitations.
    3. Allergy/Adverse Drug Reaction History. An accurate and complete history of allergic or adverse reactions to medications or foods, which the patient has been exposed to, should be identified. Additionally, information on the type of reaction, when the reaction occurred, how it was managed, and if the patient has been re-challenged must be documented.
    4. Renal Function. Identification of the status of the patient’s renal function using the serum creatinine to calculate creatinine clearance or using an actual measured creatinine clearance is critical for providing dosing adjustments.
    5. Hepatic Function. Generally, laboratory tests commonly referred to as liver enzymes (LFTs) provide a poor indication of function and they should be used in concert with the patient’s past medical history, or signs of liver dysfunction observed during the physical examination.
    6. Medical and Medication History. This should include a brief but complete listing of past and current medical problems, which require medication therapy. Medication therapy (prescription and nonprescription) used in the past and currently should be documented.
    7. Insurance Information. The issue of reimbursement may ultimately influence the patient’s compliance with a prescribed regimen.
  2. The patient’s medical or drug-related problems that require monitoring (Reflects the ASSESS phase of the PPCP and is derived from the collect phase). See drug therapy worksheet posted on the course web page. Drug-related problems may include:
    1. No drug indication
    2. Appropriate drug selection
    3. Drug duplication
    4. Drug dose too high / low
    5. Drug administration problems (e.g.: crushing meds, timing of meds)
    6. Drug allergy
    7. Drug interactions
    8. Drug contraindicated
    9. Adverse drug reactions
    10. Drug no longer needed
    11. Adherence
  3. Progress Notes (This incorporates the PLAN, IMPLEMENTATION and FOLLOW-UP phases of the PPCP)
    1. Subjective and objective information that is pertinent to the patient problem list. This can be disease or drug-related information.
    2. Assessment and Plan. In this component of clinical monitoring you will evaluate the available subjective and objective information and establish a therapeutic plan that is patient specific and appropriate for the problem list. You will make therapeutic recommendations, identify end-points/goals of therapy, determine the follow-up plan, and evaluate the response to therapy. Students are expected to be proactive. Your clinical monitoring should not be an exact re-writing of the physician’s plan of care.

741 Manual