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From The CriticsReviewer: Melissa M. Ranieri, BS, PharmD (Temple University School of Pharmacy)
Description: Designed to complement Pharmacotherapy: Principles and Practice, 3rd edition, Chisholm-Burns et al. (McGraw-Hill, 2013), this case book presents over 100 cases to help student learners apply their knowledge of pharmacotherapy to real-world patient scenarios. The guide includes three comprehensive forms to guide them in organizing pertinent data, developing drug-related problems, and designing a pharmacotherapy care plan.
Purpose: This was developed to assist students in applying didactic knowledge to clinical patient scenarios. Application is a skill that is best learned through practice and repetition. The cases provide this opportunity and they reflect how patients present in a clinical setting. Designed to be realistic, cases include interrelated problems and supporting data that may be provided or may need to be further obtained. By evaluating these cases in a logical fashion, students can become confident in their abilities to independently assess potential drug-related problems. The use of patient database forms can help students approach a patient systematically, prioritizing the most acute issues. A drawback to this case-based workbook is that the solutions are not available in the text or online. This would be beneficial, helping students understand if they have identified the most clinically relevant problems and if their plans are patient-specific.
Audience: Pharmacy students can benefit greatly from this case-based learning approach, as the workbook reflects principles that are outlined in the main textbook. The emphasis is on identifying drug-related problems and developing evidence-based pharmacotherapy plans, which is within the realm of a pharmacist's practice. However, some of the assessment emphasizes medical problems, which is more aligned with the physician's role in diagnosis. The worksheets would best serve pharmacists if they are designed to identify drug-related problems rather than medical assessments. With over 150 patient cases from pharmacists with expertise in their respective fields, the scenarios cover a wide array of disease states and drug therapy problems. The cases are very realistic and reflect situations that clinical pharmacists encounter every day.
Features: The patient cases are outlined in an organized format that is typical of how cases are encountered in clinical practice. A history of the current illness is included each patient case, along with pertinent subjective and objective information. Notably, some of the relevant information is missing, which must be identified by students. Targeted questions guide students toward understanding key concepts of the case. Each question includes a hint, which directs the students to the accompanying pages in the main textbook, where they may find additional information. A brief clinical follow-up outlines some of the outcomes of the initial plan. Cases are designed to be realistic and reflect real-world drug-related issues. Three forms are provided, which have been adapted from the American Society of Health-System Pharmacists (ASHP). These include the Patient Database, the Drug Therapy Problem Worksheet and Pharmacotherapy Care Plan. These forms are also currently used to assess patient cases in the ASHP Clinical Skills Competition. Although the forms are comprehensive and can certainly guide students, some of the information may not be relevant and is directed more at medical issues. A more concise approach may need to be employed, especially considering the time constraints of practicing pharmacists in today's clinical settings. Appendixes offer additional resources for students. A section on conversion factors includes commonly used metrics and clinically relevant equations. Common laboratory tests are also outlined, including normal ranges in both conventional and system international units.
Assessment: This study guide offers a thorough, systematic approach to identifying drug-related problems and developing sound, evidence-based plans to resolve them. The variety of patient cases and the clinical presentation are very typical of real-world pharmacy practice. However, the system to work up drug-related problems may be time-consuming and is best suited to student learners. Once they practice assessing these patients and gain experience, their ability to identify drug-related problems and corresponding plans will become easier and more efficient.