OUR LADY OF FATIMA UNIVERSITY

COLLEGE OF PHARMACY
Valenzuela. Quezon City. Antipolo. Pampanga. Cabanatuan. Laguna

MODULE 7:
PHARMACY CLIENT SERVICES
EXPERIENTIAL PHARMACY PRACTICE IN
COMMUNITY PHARMACY

Name of Lecturer
Instructor- College of Pharmacy Date
COURSE FACILITATOR TIME
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OUTCOMES:
At the end of the session the
students will be able to:
• 1. Demonstrate competence on the
counseling of patients and efficient
and effective communication skills.
 OUTLINE:
• CLIENT SERVICES
• PATIENT COUNSELLING
• PHARMACOVIGILANCE
• EXPANDED SERVICES
• Adult vaccination services
of Pharmacists
READINGS:

• PHILIPPINE ASSOCIATION OF
COLLEGES OF PHARMACY (PACOP)
• FDA CIRCULAR 2020-003

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1. CLIENT SERVICING PROCESS
A. Patient counselling:
◦ It is the provision of verbal or written
information about drugs and other
health related information by a
pharmacist to a patient or an agent of
the patient during pharmacist-patient
interaction.
 PATIENT COUNSELING IN THE
COMMUNITY:

⮚Lack of expectation by customers for counseling and advice

should not be a barrier
⮚Counseling on medication is not optional but an integral
part of the dispensing of a prescription
⮚Pharmacists must ensure that they are visible and
accessible in community pharmacies to provide it.
Disadvantages:
1. No formal screening takes place.
2. The process is random.
 Factors which Necessitates Patient
Counseling

⮚Increase in drug use-related problems

⮚Increase in the number of drugs
⮚Increase in the number of drug regimens
⮚Inappropriate prescribing
⮚Increase in self-medication practice
⮚Increase in the use of alternative medicines
 Preparing for the Counseling Session

⮚Pharmacists should spend few moments mentally preparing for

the interchange that is about to occur
⮚Determine the physical state of the patient
⮚Have as much information as possible about the patient
⮚Review the prescription and patient’s medication record; for a
first pharmacy visit, ask the patient to fill out medication
history form if there is no time to complete a medication
history interview at the time the prescription is dispensed
 Process

1. Introduce yourself and identify the patient

2. Ask patient to talk with you about the medication. Explain the purpose and the
importance of the counseling session
3. Update the patient’s medication profile
4. Assess what the patient already knows about the newly prescribed drug and the reason it
was prescribed.
5. Assess whether the patient knows how to take the medication
6. Assess the patient’s understanding of what to expect from medication including the
expected outcomes of the therapy as well as its potential adverse effects
7. Ask the patient if he or she has any concerns or questions that have not been addressed
in the previous discussion
8. Check patient understanding of the information discussed in the counseling session
9. Close the session
 Content or Scope of Patient
Counseling
Any counseling episode may contain one or more of the
following information as deemed appropriate:
1. Trade name or generic name of drug
2. Use, action, and onset of action
3. Route, dosage form, and storage
4. Direction for use
5. Action in case of missed dose
 Content or Scope of Patient
Counseling
Any counseling episode may contain one or more of the
following information as deemed appropriate:
6. Precautions
7. Side effects and adverse effects
8. Techniques for self-monitoring
9. Potential drug interactions
10. Contraindications
 Content or Scope of Patient
Counseling
Any counseling episode may contain one or more of the
following information as deemed appropriate:

11. Relationship with laboratory and other procedures

12. Disposal of drug and devices
13. Any other health information unique to an
individual patient, disease or medication
 AIDS IN COUNSELING

⮚Patient information leaflets

⮚Placebo devices
⮚Warning cards
 Different Types of Patient
• Elderly
• Children/ Adolescent
• Person with Disability
• Pregnant

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Counseling Children and Adolescents

1. Talk to parents and children about how to

protect young children from accidental
poisoning and what to do if it occurs
2. When children are old enough to
understand, speak directly with them
about their medicines. Tell children what
you expect them to do and why.
3. Encourage children to ask you questions
about their illness and treatment
 Counseling the Elderly Patient

1. Elderly Patient may have functional

barriers
1. Vision and hearing are often impaired
2. Patient may have difficulty removing child-proof tops,
self-injecting insulin, or applying creams and
ointments.
3. Many elderly have low literacy skills
4. Cognitive impairments become more common with
increasing age
5. AS patients age, chronic condition and the number of
medication prescribed increase,
 Counseling the Elderly Patient
2. Additional time may be required to address the needs of the
patient
3. Written information and compliance reminder aids are
particularly helpful with large number if prescription
products.
4. Provide small pieces of specific information coupled with a
reminder aid and verbal reinforcement of the information.
5. Consider their own feelings about aging. One recommendation
to increase empathy for elderly patient is to consider what
the patient and the world were like when he/she was younger
and to remember that patient was not always old
 Communicating with Persons with
Disabilities
1. Speak and interact directly with the person
2. Identify yourself and other persons in the group to the
person who is virtually impaired.
3. Stoop or squat to communicate with a person in a
wheelchair; position yourself in front and at an eye level
4. Avoid leaning or sitting on a person’s wheelchair; use care
for handling assistive aids
5. Make the person who has hearing impairment aware of your
presence
6. Be patient and listen carefully when interacting with a
person who has difficulty speaking, use questions that
require brief responses.
 B. Pharmacovigilance
DEFINITION OF TERMS

▷ Pharmacovigilance is the science and activities relating to the

detection, assessment, understanding and prevention of
adverse effects or any other medicine/vaccine related
problem.

▷ Adverse Drug Reaction (ADR) is a response to a drug which is

noxious and unintended, and which occurs at doses normally
used in man for the prophylaxis, diagnosis, or therapy of
disease, or for the modification of physiological function.
 B. Pharmacovigilance
DEFINITION OF TERMS
▷ Serious adverse reaction is an adverse reaction which results
in death, is life threatening* requires inpatient
hospitalization or prolongation of existing hospitalization,
results in persistent or significant disability or incapacity or is
associated with a congenital anomaly/'birth defect.

▷ Non-serious adverse reaction is an adverse reaction that

does not meet the definition of a serious adverse reaction

▷ Safety concern is an important identified risk, important

potential risk or missing information.
 THE QUALIFIED PERSON FOR
PHARMACOVIGILANCE FUNCTIONS:
▷ The Market Authorization Holder must designate a
pharmacovigilance officer which also refers to as Qualified
Person for Pharmacovigilance (QPPV) who shall assume the
following functions:

• maintain an effective Pharmacovigilance system of the

MAH

• ensure conduct of pharmacovigilance and submission of

all pharmacovigilance related documents in accordance
with legal requirements
THE QUALIFIED PERSON FOR
PHARMACOVIGILANCE FUNCTIONS:
• have an overview of the safety profiles and any
emerging safety concerns in relation to the products for
which the MAH holds authorizations

• act as a single contact point during inspection and

monitoring and respond promptly for any request/inquiry
from FDA

• maintain and update company database of all adverse

reactions involving their products and have on file all
reported cases
 REQUIREMENTS:
1. The MAH must ensure the competence of their QPPV, the
QPPV must be a holder of any baccalaureate degree in
medically related courses. The MAH shall assess the
qualification of the QPPV prior to appointment.

1. Must be residing in the Philippines.

1. The name of the designated QPPV shall be submitted and

updated as part of the licensing requirements for distributors
(MAH).
WHAT TO REPORT

1. Local Serious Spontaneous Reports

2. Solicited Reports
3. Consumer Reports
4. Lack of efficacy
5. Overdose and Off-label use
6. Medication Error
7. Product Defects
8. Outcomes of Use during Pregnancy
9. ADR Reports from the Internet and Social Media (after verification)
10. Local Case Reports from Scientific Literature
11. Suspended, Cancelled or Withdrawn Product Registration

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HOW TO REPORT ADRS/ SIDE
EFFECTS
REPORTING OF ADVERSE DRUG REACTION
TYPES OF ADR REPORTING

1. Online
2. Manual Application

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TYPES OF ADR REPORTING

1. Online

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TYPES OF ADR REPORTING

2. Manual Application

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TYPES OF ADR REPORTING

2. Manual Application

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 2. EXPANDED SERVICES
A. Adult vaccination services of Pharmacists

INTRODUCTION
The Food and Drug Administration of the
Philippines released an advisory of its plan to
authorize Community Pharmacists in the
Philippines to administer vaccines last
September 9, 2014.

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 2. EXPANDED SERVICES
A. Adult vaccination services of Pharmacists
ROLE OF PHARMACIST IN VACCINATION

The Pharmacist will also be able to assist in the important

vaccine decisions that are considered part of the global
standards such as recognition of:
(a) The specific disease burden of the country
(b) Assessing severity of the disease
(c) Evaluating vaccine effectiveness and
(d) Vaccine safety

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EXAMPLES OF VACCINES THAT CAN BE
ADMINISTERED BY PHARMACISTS
The Expanded Program on Immunization
(EPI) in the Philippines started in:

1. BCG ( started in 1976)

2. DPT
3. oral polio vaccine
4. Tetanus toxoid.

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 TRAINING AND OBJECTIVES
A. REQUIREMENTS:
1. Pharmacist should hold a Certificate of Training under a PRC
accredited institution, to administer adult vaccines.
1. safe administration of adult vaccines
2. management of adverse event following immunization (AEFI)

2. Drugstores should apply for Variation of their License to

Operate, to conduct other activities like Adult Vaccination.
3. Ensure that the vaccine to be administered shall have a
doctor’s prescription which is not more than seven (7) days
old
4. Submit a monthly vaccination report and AEFI report to DOH
regional offices using the prescribed form.
 TRAINING AND OBJECTIVES
B. TRAINING
The Food and Drug Memorandum indicated the following
modules for the training course:
(a) Safe injection techniques;
(b) Cold chain management of vaccines and other biological
products
(c) Pharmacovigilance; including recognition reporting of adverse
event following immunization (AEFI)
(d) Management of anaphylaxis, in the rare case it occurs
 TRAINING AND OBJECTIVES
C. OBJECTIVES
(a) Explain the expansion of the role of pharmacists as vaccine
providers and describe the status of pharmacists’ authorization
to administer vaccine in the Philippines
(b) Demonstrate an understanding of the diseases where
vaccination applies including its etiology, clinical features and
epidemiology
(c) Discuss and compare available adult vaccines in the
Philippines, including dosage and route of administration and
describe important considerations when deciding which vaccines
to offer
 TRAINING AND OBJECTIVES
C. OBJECTIVES
(d) Identify who are eligible to receive adult vaccination under
the Philippine schedule of vaccination and recognize the
implications for a pharmacy immunization service
(e) outline clinical features of the most common adverse events
following immunization and the appropriate management of
these events
(f) Demonstrate the skills necessary in immunization delivery and
(g) Educate patients about the benefits of vaccines and address
common concerns about vaccines.
 TRAINING AND OBJECTIVES
C. OBJECTIVES
The objectives of this proposed program are also in line with that
of the APhA which are:
(a) Provide comprehensive immunization education and training
(b) Provide pharmacists with the skills, resources, materials necessary to
establish and promote a successful immunization service
(c) Train pharmacists to identify high-risk patient population needing
immunizations;
(d) Train pharmacists to maintain necessary immunization records the
proposed training objectives in this study is in line with that of the Philippine
Department of Health (DOH) and that of the American Pharmacists
Association (APhA) Immunization Training Certification Program.
TRAINING DESIGN FOR
PHARMACISTS
Questions:
1. What are the factors which Necessitates Patient
Counseling?
2. Can a Pharmacist administer vaccine here in the
Philippines? Yes or No. Explain.
3. In counselling a patient, do we need to consider their
age? And Why?
4. If a kid buys a prescription drug without his/her
guardian but with complete requirements, will you
dispense the drug?
5. Give some examples of Counselling aids that can help a
patient understand his/her medication?

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REFERENCES:
✔PHILIPPINE ASSOCIATION OF COLLEGES OF PHARMACY (PACOP)
✔https://www.iptsalipur.org/wpcontent/uploads/2020/08/BP703T_PP_
II.pdf
✔https://www.pharmacy.gov.my/v2/sites/default/files/document-
upload/gdsp-2016-final.pdf
✔Pharmacovigilance - Food and Drug Administration (fda.gov.ph)
✔fda-circular-no.2020-003.pdf (dataguidance.com)
✔INTERNATIONAL JOURNAL OF SCIENTIFIC & TECHNOLOGY RESEARCH
VOLUME 8, ISSUE 08, AUGUST 2019 ISSN 2277-8616
✔FDA ADVISORY 2017-131

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 Thank you!
Any questions?

You can find me at:

[email protected]

#RisetotheTOP

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