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    Evidence Based Medication General Guidelines For Clinical Pharmacy Practice

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    Mahum Sohail
    1) Evidence-based medicine (EBM) is an approach to clinical decision making that integrates the best available research evidence with a clinician's expertise and patient values and circumstances. 2) The steps of EBM include forming a focused clinical question, conducting an efficient literature search, critically appraising the evidence, and applying the results to patient care. 3) Clinical practice guidelines are systematically developed statements that provide recommendations to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Guidelines are intended to optimize patient care and treatment outcomes.

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    Evidence Based Medication General Guidelines For Clinical Pharmacy Practice

    Uploaded by

    Mahum Sohail
    19 views10 pages
    1) Evidence-based medicine (EBM) is an approach to clinical decision making that integrates the best available research evidence with a clinician's expertise and patient values and circumstances. 2) The steps of EBM include forming a focused clinical question, conducting an efficient literature search, critically appraising the evidence, and applying the results to patient care. 3) Clinical practice guidelines are systematically developed statements that provide recommendations to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Guidelines are intended to optimize patient care and treatment outcomes.

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    1) Evidence-based medicine (EBM) is an approach to clinical decision making that integrates the best available research evidence with a clinician's expertise and patient values and circumstances. 2) The steps of EBM include forming a focused clinical question, conducting an efficient literature search, critically appraising the evidence, and applying the results to patient care. 3) Clinical practice guidelines are systematically developed statements that provide recommendations to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Guidelines are intended to optimize patient care and treatment outcomes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    19 views10 pages

    Evidence Based Medication General Guidelines For Clinical Pharmacy Practice

    Uploaded by

    Mahum Sohail
    1) Evidence-based medicine (EBM) is an approach to clinical decision making that integrates the best available research evidence with a clinician's expertise and patient values and circumstances. 2) The steps of EBM include forming a focused clinical question, conducting an efficient literature search, critically appraising the evidence, and applying the results to patient care. 3) Clinical practice guidelines are systematically developed statements that provide recommendations to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Guidelines are intended to optimize patient care and treatment outcomes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 10

    Evidence Based Medication

    General guidelines for clinical


    pharmacy practice
    https://accesspharmacy.mhmedical.com/content.
    aspx?bookid=689&sectionid=48811429
    Intro- Sources
    clinicians are presented with diseases and possible treatments to consider.
    healthcare professionals are expected to stay current in their fields of expertise

    Sources of Information: college courses


    continuing education (e.g., seminars and journals)
    pharmaceutical representatives
    Colleagues
    guidelines from committees of healthcare facilities
    government agencies
    expert committees and organizations.
    evidence-based medicine (EBM)
    a component of clinical decision making.
    uses the results of patient care research and other available objective evidence .

    Defination:
    an approach to decision making whereby clinicians appraise scientific evidence and its
    strength to support their therapeutic decisions
    Etminan et al
    EBM Enable HCP to integrate the best current evidence into their pharmacotherapeutic
    decision making

    to distinguish beneficial pharmacotherapies from those that are


    ineffective/harmful.
    EBM:
    integrates knowledge from research .
    does not replace clinical judgment.
    informs clinical judgment with the current best evidence
    experience of the clinician are crucial in determining whether the external evidence applies to
    the patient's disease
    Steps of EBM
    • consider the evidence in light of the actual
    circumstances, and integrate the evidence into a
    medical plan
    Building a Recognize information needs.
    Focused Question convert them into answerable questions.
    Should clopidogrel be prescribed to this 65-year-old man with unstable
    angina?

    P =patient the questions must be rephrased with more precision and specificity
    I = intervention the patient or problem, intervention being considered, comparison
    C = comparison intervention, outcome(s) of interest
    O = outcome Would clopidogrel in addition to aspirin (intervention) prevent death or
    coronary events (clinically relevant outcome) in this patient with unstable
    angina (patient with a problem) who is currently on aspirin alone
    (comparison intervention)?
    Conducting an Ask a colleague for his or her expert opinion.
    efficient search Review practice guidelines
    Consult electronic databases of systematic reviews/meta-analyses.
    Conduct a literature search using an electronic database
    Critically appraise the minimize systematic bias and random error as much as possible
    evidence for its validity https://accesspharmacy.mhmedical.com/ViewLarge.aspx?figid=48
    and usefulness. 831700&gbosContainerID=0&gbosid=0&groupID=0

    Apply the results to https://accesspharmacy.mhmedical.com/ViewLarge.aspx?figid=488


    patient situations to best 31703&gbosContainerID=0&gbosid=0&groupID=0
    assist clinical decision
    making.
    Considering Clinical benefit outweighs the risks, costs.
    Relevance demonstrating improvements important to the patients?

    Updated EBM
    medical information is growing exponentially. 0,000 RCTs are published every year.

    clinician must recognize the areas important in his or her practice and scan the literature for
    clinically relevant studies .

    studies that report the effect of a pharmacotherapy on quality of life, cost-effectiveness,


    mortality, or morbidity.

    RCTs are considered the gold standard and should be preferred over observational studies.
    Applying Results
    • which studies are important.
    • which are not comes down to the decision of how
    to treat each patient.
    the population studied has a similar disease state and prognostic
    Compare the patient with those in factors as the patient now being treated
    the study
    (similar disease state and stage,
    similar baseline characteristics).
    For example, premenopausal women, in general, have a lower
    Consider the patient's baseline risk cardiovascular mortality risk than men.
    for the outcome of interest. Therefore, an intervention shown to prevent cardiovascular
    other potential risks associated mortality in men may result in a smaller benefit in women
    with the therapy.
    C cost and accessibility
    onsider the patient's values, beliefs,
    concerns, and readiness for the
    intervention.
    Guidelines
    • Definition
    “-systematically developed statements.
    - assist practitioner and patient decisions
    - for specific circumstances.”

    Guidelines are
    disease management tools for the use of a medicine .
    or the management of a clinical condition
    To enhance treatment and drug-therapy adherence.
    guide and support prescribers in choosing which medicines they should
    prescribe.

    guidelines make evidence- based standards of care explicit and accessible

    They indicate the need for


    structured use of medication to optimize effectiveness
    recognise there is an accreditation scheme to recognise organisations who achieve
    organisations high standards in producing health or social care guidance.
    Local guidelines developed to provide a local context and interpretation of national
    guidance
    inform the about medicines with which they may not be very familiar.
    prescriber
    pharmaceutical has a very wide and important influence in the compilation of clinical
    industry guidelines.
    interdisciplinary Guidelines provides the statement that reflects the type of
    cooperation interdisciplinary cooperation that must be achieved in practice.
    Health care Health care organizations incorporate guidelines into their software to
    organizations provide guidance to practitioners.
    Practice variance frequently Practice variance can be reduced by use of practice guidelines.
    best practice Guidelines are best practice within a range of acceptable choices
    Use of guidelines in to improve the consistency of care, reduce the likelihood of errors, and
    Hospitals reduce costs.
    literature citations literature citations found through the database searches serves for the
    development of treatment guidelines.
    need for a treatment failures, overuse of laboratory tests, or prolonged lengths of
    guideline. stay in the hospital signal a need for a guideline.
    CLINICAL PRACTICE GUIDELINES AND
    PATHWAYS
    • Guidelines should include specifications for care, which
    may be
    disease-based (eg, hypertension)
    process-focused (eg, guidelines for the use of
    serum levels in monitoring aminoglycoside therapy).

    Clinical practice guidelines and pathways should be


    specifically written.

    such that there is no confusion regarding the intent of the


    guideline or the exact process for application of the guideline.
    Pharmacist and Guidelnies
    • Pharmacists can keep a balance between the drug
    company’s marketing information and the medical
    literature

    • help to ensure that the information prescribers


    receive is consistent with health-system guidelines
    on drug use.

    • Pharmacists are trained to make appointments with


    physicians to review new drug guidelines and
    formulary additions.

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