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Professor and Chair Department of Pharmacy Practice and Administrative Sciences College of Pharmacy Idaho State University Campus Box 8333 Pocatello, Idaho 83209-8333 fax 208/282-4305 vculb{at}otc.isu.edu
Published Online, August 3, 2004. www.theannals.com, DOI 10.1345/aph.1D182c
While we have since revised and continue to refine our system, the intent continues to be to develop a pharmaceutical diagnostic approach that parallels the medical model. In other words, pharmaceutical diagnoses should be based upon a specific etiology in order to define a limited number of potential therapeutic options and/or eliminate irrational interventions that do not address the underlying cause. For the same reason that physicians differentiate chest pain into specific diagnostic etiologies to more appropriately direct therapeutic interventions, so must pharmacists differentiate suboptimal therapy into its relevant patient-specific etiologies. Thus, as implied, this suggests that a differential diagnostic approach can be developed to provide a systematic approach to complicated drug therapy workups, and begins to define a unique set of skills and abilities that differentiates pharmacotherapists from other prescribers.
The authors correctly state "that the optimal DRP classification should lead to one choice of coding only, and therefore should be based on clear definitions." Although we have attempted to provide explicit definitions that dictate only one pharmaceutical diagnosis, it is not a simple task, and likely may require significant energy to accurately define and codify all potential pharmaceutical diagnoses. Nevertheless, the authors have successfully demonstrated the inherent problems associated with current classification systems and established the need for a universal system. Unfortunately, the authors may not have gone far enough in recognizing this critical element in the evolution and transformation of pharmacy from a distribution-oriented to patient-centered focus.
References
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