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15 Cards in this Set
- Front
- Back
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The Patient Profile |
The Patient Profile has several functions. It serves as a means of distinguishing and identifying patients, serves as legal record of medication dispenses and most importantly serves as a resource of information that could protect the patient against potentially harmful drugs or procedures. |
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The outpatient Profile (retail setting) |
The following are included in an outpatient profile Identifying Information Drug Allergies and Adverse Reactions Concurrent Medications Medical History A history of Drug Abuse Special Considerations Insurance Information Current Prescriptions and Refill Information |
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Identifying Information |
This includes the patients name, address, telephone number, and date of birth |
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Drug Allergies and Adverse Reactions (Negative Effects Caused by a drug) |
Many times when a patient is allergic or sensistive to one type of durg, the allergy will extend to similar drugs as well. Rarely, food allergies will cause problems in the tolerance of a drug. (eg. Porcine or bovine insulin) or drug "carrier" ( a substance that the drug is put into in order to give it enough volume to swallow or inject). For example, dextrose would not be used for a diabetic patient. |
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Concurrent Medications ( use of more than one medication at the same time) |
Many drugs interact with each other. They may produce similar therapeutic ( or Toxic) effects that will be additive with each other or may amplify each other effects (synergism). They might also reduce the effectiveness of each other (antagonism). Depending on the drugs, concurrent therapy may also alter blood levels of the other drugs, requiring a change in the dosage of the drug(s). An accurate listing of concurrent medications is very important. Because many drugs sold over the counter are the same ( or very similar) to those sold by prescripton, all medications taken, including herbal preperations, must be recorded. Another reason that we need to determine concurrent patient medication is to see if any of the drugs prescribed are the same (drug duplication) or have the same therapeutic functions (Therapeutic Duplication). This applies to the over the counter medications as wee, which may contain a lower dosage of a prescription rug. |
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Medical History |
This includes any medical conditions that the patient may have and may also include those of the patients immediate family. (Certain medical conditions will be aggravated by some drugs, which should be avoided.) If the patients family members have inherited medical conditions that have not yet developed in the patient, it is reasonable to assume that these conditions could develop at any time; therefore, the possibility exists that certain drugs or procedures could be harmful, even through the condition has not yet developed. |
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A History of Drug Abuse |
This may indicate that the patient is not competent to use the medication properly. In an outpatient setting, this may mean that the patient must be supervised more closely and that the amount of medication given out at one time may be more strictly regulated |
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Special Considerations |
Any physical, mental, or cultural handicaps should be addressed. For example, a patient with limited vision may need large print labels on the dispensing container; another patient with a hearing deficit may need special attention during drug counseling by the pharmacist. A person with arthritis may need to have easy-open caps on dispensing bottles. Also, patients from other cultures may need special consideration due to language or to cultural and religious beliefs. |
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Insurance information |
This include determination of insurance eligibility, the type of third party payment (co-pay, self-pay etc.) and the coverage of prescribed drugs. This coverage varies widely among the various insurance plans. Many plans will no longer pay for certain drugs, due to price. Some will authorize only payment for generic drugs, and other will authorize payment for proprietary label drugs only under certain circumstances (ie. If no other drug is available or the drug is needed for a life threatening condition). |
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Current Prescription and Refill information |
The outpatient profile will show the status of the patients various prescriptions, so that the amount dispensed and the amount available on the prescription remain current. This information needs to be updated with each prescription refill. |
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The Institutional Profile |
The institutional patient profile may also include the patient’s height, weight, diagnosis, treatment, therapy, diet plans, blood tests, and lab results, as well the name of the primary physician. However, the institutional profile would not include information that is not applicable to institutional policy, such as refill information and concurrent medication other than those prescribed within the institution. The technician creates a computerized profile for every patient receiving medications form the pharmacy. Normally the format for the profile is contained in the pharmacy computer program and the information is entered into the program. Patients who are new to the pharmacy must be asked to obtain the information that is necessary for creation of the profile. The profiles of patients with existing profiles (repeat patients) need to be updated with each visit. IF any information has changes, such as allergies, concurrent medications, insurance information, or address and telephone number, for example, this information needs to be changed in the profile to reflect the correct information. This may require and additional patient questionnaire if the changes are lengthy; each time the patient comes to the pharmacy, he or she should be asked if the personal information is current and if he or she is taking any new drugs or has experienced any problems with the medication. In addition, the pharmacist may require that the patient be asked about changes in his or her medical condition. The reason for updating the patient profile is to make sure the pharmacist has the most recent information to take into consideration when counseling the patient, so that appropriate advice will be given. |
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Release of Patient Information |
In accordance with recent HIPPA revisions, information contained in the patient profile is not to be released, with the exception of non-identifiable information and information communicated within the various departments of an institution or appropriate business affiliates. In addition, the new regulations mandate that the patient is allowed to request a copy of his or her patient profile. The pharmacy is allowed to charge a fee for this service. |
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Comparison of Patient Profiles in Institutional and Retail Settings |
In general, the profiles in the institutional setting are more detailed than those in the retail or outpatient setting. |
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Factors common to both Institutional and Retail settings |
• Information used to locate and identify the patient ( eg. Address and phone number in the outpatient setting, and room and bed number in the institutional setting). • Insurance information • Date of Birth • Medications Prescribed Profiles in both settings also include the prescribers name and the date that the medication was prescribed and dispensed. |
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Differences Between Retail and Institutional patient profiles |
• Institutional (hospital) profiles may include diagnosis, a statement of the goals of the therapy, special diet (if any), medical tests that the patient has undergone, and the results of those tests. Since the profile may serve as a document for billing the patient, billing information may also be included. Also included is the hospital billing number assigned to the patient, which gives the billing department access to all insurance information. Retail pharmacy profiles do not contain this information. Refill information is included in an outpatient (retail pharmacy) profile but would not be appropriate in a hospital or institutional profile. |
