Pharmacist Patient Care and implementing change The role of the pharmacist has undergone a metamorphosis over the past century. Pharmacists entered the 20th century as apothecaries, whose function was to procure, prepare, and evaluate medicinal drugs. That function waned as the industrial age took over the production of pharmaceuticals and pharmacists simply distributed these medicines. About 25 years ago the picture began to change. With the development of more sophisticated medications and increased knowledge regarding their mechanisms of action, clinical pharmacists appeared on the scene. Now in the 21st century, the pharmacy profession, like other components of the health care system, faces new challenges; however one thing is very clear: as a result of the continuing revolution in education and training programs and practice innovations, pharmacy practice has a more patient-oriented and less product-oriented focus with a higher level of responsibility and accountability in providing direct patient care.
There is little debate that the use of prescription and non-prescription medications constitutes the primary therapeutic means available to treat illness. Although medication use has assumed this primary role, its provision to patients occurs through a highly fragmented system of prescribing, dispensing, administering, and monitoring. While each party in the process believes it is making rational, positive contributions to the process, increasing concern is being expressed regarding the need for improved quality of medication use, the need for a reduction in medication-related problems, and documenting improvements in healthcare delivery
The result of this fragmentation has been characterized as “medication misadventure.” Misadventure means great misfortune or disaster. In fact, much of the problem is not inherent in the drugs themselves but rather in the way they are prescribed, dispensed, used or misused. The contribution of patient non-compliance, preventable adverse effects and drug interactions, therapeutic failures, and medication-induced hospitalizations to health care costs is estimated to be in the tens of billions of dollars each year. Pharmacists are best equipped to have a major, direct, and positive impact towards resolving this problem.
National professional pharmacy organizations as well as pharmacy educators believe that pharmacists should accept additional responsibility and assume greater authority in cooperatively managing patients’ medication use. By assuming this leadership, pharmacists can assure optimal therapeutic outcomes and reduce the extent of preventable medication-related problems.
To these ends the profession has embraced the concept of “pharmacist patient care”. This approach includes the determination of the drug needs for a given individual and the provision not only of the required drugs but also of the services necessary (before, during and after treatment) to ensure optimally safe and effective therapy.
The Pharmacist Patient Care model is a patient-centered, outcomes-oriented pharmacy practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective.
Two components must be present whenever pharmaceutical care is delivered:
- the pharmacist taking the time to determine the patient’s wishes, preferences, and needs concerning his or her own health; and
- the pharmacist’s commitment to continue care once initiated.
“… patient care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life. Patient care is what an individual pharmacist does when he or she
- evaluates a patient’s drug-related needs;
- determines whether a patient has one or more actual or potential drug-related problems;
- works with the patient and other professionals to design, implement, and monitor a drug therapy plan that will resolve the illness or drug-related problem.”1
1adapted from an APhA White Paper on The Role of the Pharmacist in Comprehensive Medication Use Management.
To ensure that pharmacists have the tools to practice patient-oriented pharmaceutical care, curriculum design at the University of Texas College of Pharmacy has moved away from the traditional separate-discipline approach to drug design and drug action towards a more integrated and problem-based approach to the treatment of disease. For example: instead of discussing the etiology of hypertension, structure-activity relationships, mechanisms of action, and therapeutic aspects of hypertension medications in three separate courses, discussion of hypertension and antihypertensives are now integrated into a module in a single pharmacotherapy course. This is followed by a small group discussion (about 8 students) on the treatment of a hypertensive patient beginning with a discussion of the patient’s history, interpretation of laboratory results, review of current medication use, identification of any medication misadventures, and finally recommendations for drug therapy and improving the patient’s quality of life.
Because the delivery of patient care will require pharmacists to monitor a patient’s progress toward better health, expertise in such areas as patient assessment become critical. A broad exposure to disease management is also essential. To better meet these new demands of practice, the College adopted the Doctor of Pharmacy degree as its only entry-level degree to students admitted in 2000.
Doctor of Pharmacy (Pharm.D.) Program
(Required of all students who enter the professional sequence of courses as specified in the University Catalog for the year the student enters):
This four-year professional sequence, leading to the Pharm.D. degree, is designed to provide a combined academic and clinical experience for pharmacy students whose abilities and career aspirations suggest significant potential for innovative leadership in professional practice. This goal is accomplished through a carefully balanced and orderly curriculum that combines courses in basic and advanced pharmaceutical sciences with a structured clinical and professional practice experience program.
This professional curriculum provides students with a strong foundation in the basic pharmaceutical sciences, applying the principles of chemistry, biology and physiology mastered through successful completion of the pre-pharmacy program. This basic training is supplemented by advanced clinical and professional practice experience in the later semesters of the professional sequence, and by electives which allow the student to enhance particular areas of interest.
In addition to required coursework, students take professional elective courses to help explore career options and professional interests. Students must take the courses used to fulfill this requirement after admission to the professional curriculum.
The principles of the basic pharmaceutical sciences comprise much of the first segment of the professional sequence: Pharmacology, the study of how drugs work in the body; Pharmaceutics, which devotes attention to dosage forms and the related phenomena surrounding the absorption, distribution, metabolism and excretion of drugs and their metabolites; Medicinal and Natural Products Chemistry, the study of intermediary metabolism, macromolecular chemistry and the structure-activity relationships among drugs, including those of natural origin; and Health Care and Pharmacy Administration, which exposes students to the principles of personnel and financial management, applied to pharmacy practice and to the role of pharmacy in health care. The first year also includes coursework specifically designed to introduce students to contemporary pharmacy practice (introductory pharmacy practice experiences; IPPE), with the intent of demonstrating the direct applicability of the courses being taken to delivering patient care.
After establishing the principles of the basic pharmaceutical sciences in the first year of the curriculum, the second year will focus on disease states through an interdisciplinary approach to disease management moving away from the traditional separate-discipline approach to drug design and action towards a more integrated curriculum. For example: Instead of discussing the etiology of hypertension, structure-activity relationships, mechanisms of action, and therapeutic aspects of hypertension medications in three separate courses, all aspects of hypertension and antihypertensives are integrated into a single module in the pharmacotherapy series.
In addition to the coursework in the pharmaceutical sciences and pharmacotherapy, students learn to perform in various practice environments (IPPE). In the clinical training program students begin to provide pharmaceutical care to patients in the Student Health Center Pharmacy during their second or third professional year. By applying earlier lessons, students in this course learn about patient counseling, drug information, and patient profile monitoring. Students also complete IPPE learning experiences in both the hospital and community setting.
Clinical training is continued in the third professional year when students continue to learn about and apply that learning to the clinical management of drugs, drug literature evaluation, and other practical skills necessary to function as a pharmacist in any of today’s practice settings. The curriculum concludes with seven Advanced Pharmacy Practice Experiences (APPE’s) which span one calendar year. There are four APPE’s required of all students (Institutional, Community, Ambulatory Care, and Acute Care (Adult Medicine). The remaining three APPE’s allow for elective experiences for students to explore areas of specialization. These pharmacy practice rotations are in clinical, hospital and community settings in Austin/Temple/Waco, Dallas/Fort Worth, Galveston/Houston, and San Antonio.
View the Pharm.D. Curriculum page for more information.
M.S. and Ph.D. Programs
The College of Pharmacy also offers research-oriented graduate programs in Pharmaceutical Sciences (with specialized training in five different tracks: Health Outcomes and Pharmacy Practice, Chemical Biology and Medicinal Chemistry, Pharmaceutics, Pharmacology and Toxicology, and Pharmacotherapy) as well as an integrated Ph.D. in Translational Sciences
Inquiries should be directed to Char Burke, Administrative Manager of College Graduate Program, College of Pharmacy, PHR 4.220, 471-6590.
Graduation Under A Particular Catalog
To receive a degree in the College of Pharmacy, a student may select the catalog in effect when entering the College or any catalog published thereafter; however, the student must fulfill all the requirements set forth in a catalog under which he/she is entitled to graduate. The student should choose the catalog under which he/she intends to graduate during the first semester of registration in the professional curriculum of the College. For specific wording of Graduation Under a Particular Catalog, the student should consult the College of Pharmacy section of The Undergraduate Catalog from UT Austin under which he or she intends to graduate
Prescribed Work for All Degrees - Basic Education Requirement
- First-Year Signature Course – one course is required
- English Composition – three hours are required
- Writing Flag Requirement – three hours are required*
- Humanities – three hours are required
- American and Texas Government – six hours are required
- US History – six hours are required; three hours may be in Texas history
- Social and Behavioral Sciences – three hours are required
- Mathematics – three hours are required
- Natural Science and Technology, Part I – six hours are required
- Natural Science and Technology, Part II – three hours are required
- Visual and Performing Arts – three hours are required
*One three-hour writing flag is incorporated into the professional sequence of courses.
First-year Signature Course
One of the following courses, completed during the first year in residence:
Undergraduate Studies 302 or 303
Students in the Plan II Honors Program may complete this requirement by taking Tutorial Course 302
English 316L, 316M, 316N or 316P
Students in the Plan II Honors Program may complete this requirement by taking English 303D or Tutorial Course 303D.
One of the following courses:
Rhetoric and Writing 306
Nonnative speakers of English may complete this requirement by taking Rhetoric and Writing 306Q.
Students in the Plan II Honors Program may complete this requirement by taking English 303C or Tutorial Course 303C.
A three-hour course with a Writing Flag (incorporated into the professional sequence)
American and Texas Government
Government 310L is required for all students.
Government 312L or 312P may be used to satisfy the second half of this requirement.
Transfer students with five or more hours of coursework in U.S. government may complete this requirement of the core by taking Government 105, which includes Texas Constitutional content that is consistent with the legislative requirement. Rules prescribing which pairs of in-residence and transferred government coursework will fulfill the legislative requirement are very strict. Therefore students who plan to take only one government course on campus and the other at another public college in Texas, or who arrive at The University of Texas at Austin having taken one government course and plan to take the other one at the university, should visit the Office of Admissions website for transfer guidance before choosing courses to pair for this core requirement.
African and African Diaspora Studies 302M
Educational Psychology 371
Mathematics 302, 305G, 408C, 408K, 408N, 408R, 316
Statistics and Data Sciences 302, 303, 304, 305, 306, 328M
Social and Behavioral Sciences
African and African Diaspora Studies 324E
Anthropology 302, 305, 307, 318L
Core Texts and Ideas 302, 365
Economics 301, 304K, 304L
Geography 305, 306C, 207C, 319
Health and Society 301
Human Development and Family Sciences 304, 304H
Linguistics 306, 312D, 312
Mexican American Studies 301, 309
Religious Studies 310
Sociology 302, 307C, 307D, 307E, 307F, 307G, 307J, 307K, 307L, 307N, 307P, 307Q, 307S, 307T, 308D, 308E, 308F, 308G, 308J, 308K, 308L, 308M, 308N, 309, 313K, 318 318
Students in the Plan II Honors Program may complete this requirement by taking Social Science 301.
Natural Science & Technology, Part I
The following courses may be counted and paired as indicated below:
Astronomy 301, 307, 309C, 309G, 309L, 309N, 309R, 309S
Choose either Astronomy 301 or 307 and one course from Astronomy 309C, 309G, 309L, 309N, 309R and 309S.
Biology 301D, 301E, 301G, 301L, 301M, 305F, 309D, 311C, 311D, 315H, 325H, 326M, 446L, 364S
Choose two courses from Biology 301D, 301G, 301L, 301M, 305F, 309D; or complete one of the following recommended pairs: BIO 311C and 311D, BIO 311C and 326M, BIo 311C and 446L, BIO 311C and 364S, BIO 315H and 325H.
Student in the Plan II Honors Program may pair Biology 301E with Biology 301D, 301G, 305F, 309D, 311C, or 315H
Chemistry 301, 301H, 302, 302H, 304K, 305
Students should complete one of the following pairs of courses:
Chemistry 301 and 302, 301H and 302H, 304K and 305.
Geological Sciences 401, 302C, 302D, 302E, 302M, 302P, 303, 303C, 405
Only one of the following may be counted: Geological Sciences 401 or 303
Marine Science 307, 308
Natural Sciences 306J, 306K, 306L, and 306M
Physics 301, 302K, 302L, 303K, 303L, 309K, 309L, 316, 317K, 317L, 321;
Physical Science 303, 304
Students should complete one of the following pairs of courses:
Physics 301 and 316, 302K and 302L; 303k and 303L; 309K and 309L; 317K and 317l:
Physical Science 303 and 304.
Physical Science 303 may not be counted with Physics 301, 302K 303K, 309K, and 317K to complete Science and technology Part I;
Physical Science 304 may not be counted with Physics 302L, 303L, 309L, 316 and 317L to complete Natural Science and Technology Part I.
Student in the Plan II honors program may pair Physics 321 with any of the physics or physical science courses listed above.
If Plan II students do not use Biology 301E or Physics 321 to fulfill Natural Science and Technology Part I, they may use one of them to fulfill the Natural Science and Technology Part II requirement as long as the two parts are in different fields of study.
Natural Science and Technology, Part II
Anthropology 301, 304, 304T
Computer Science 302, 303E, 312
Electrical and Computer Engineering 302
Geography 301C, 301K, 304E
Natural Sciences 306J, 306K, 307L, and 306M
Visual and Performing Arts
African and African Diaspora Studies 311C, 356C, 356D, 356E
American Studies 330
Architecture 308, 309W, 318K, 318L, 342C
Arts & Entertainment Technologies 304
Art HIstory 301, 302, 303, 325, 327N, 327R, 327S, 328J, 329J, 329N, 329R, 330G, 331, 331K, 332K, 332L, 333L, 335J, 337K, 338L, 338M, 339J, 339K, 339L, 339M, 339P, 341K, 341L, 342J, 345J, 346L, 347K, 347L, 347M, 347N, 349K
Classical Civilization 301, 302, 303, 307C, 307D
Core Texts and Ideas 350, 351
English 310F, 321P, 379P
Fine Arts 308
Music 302L, 303C, 303D, 303E, 303M, 306M, 307, 334
Philosophy 317K, 346K
Theater and Dance 301, 317C, 317D
P3/P4 Relocation Appeals Policy
Policy Statement: Policy for students to appeal assignment to a P3 and/or P4 region.
Reason for Policy: A policy is needed to address student appeals to attend the P3 and/or P4 year in a region other than what they were assigned as a P1 student.
Procedures: All appeals go through the Colleges standing Region Appeals Committee
Forms/Instructions: Student Region Appeals Form
Related UT Policy: None
Approved: April 6, 2011
Effective: April 2011
Last Updated: April 2011
Responsible University Officer: Asst. Dean Experiential Programs
Policy Owner: Asst. Dean Experiential Programs
Policy Contact: Asst. Dean Experiential Programs
Additional Contacts: Sr. Assoc. Dean Academic Affairs, Faculty Chair of Region Appeals Committee
Mandatory Review Timeline: As needed
This policy is intended to address an appeal by a student to attend the P3 and/or P4 year in a region other than what they were assigned as a P1 student. The policy is designed to address any student assigned any region to appeal to stay in (or relocate to) any other region. The basis of the appeal may be programmatic (e.g., participation in the Honors or PharmD/PhD Program), for serving as one of the Executive Officers in Pharmacy Council, or for personal reasons (e.g., hardship, special circumstances, etc.). All appeals go through the Colleges standing Region Appeals Committee.
Guidelines and Procedures
- Appeals must be submitted no later than January 15th of the Spring semester prior to relocation using the official Regional Appeals Form.
- Students may appeal special circumstances (including hardship cases). The Committee will first decide whether the request is meritorious, and if so, whether adequate resources (lab space, classroom space, etc.) are available. If meritorious requests exceed resources, the Committee will prioritize approvals to determine those that can be accommodated.
- For the Honors Program, students must submit the formal appeal by January 15th, but it will automatically be granted for the P3 year only. Since Honors students must complete all aspects of the Program prior to the start of rotations in the P4 year, these students will be required to attend the P4 year in their assigned region. Further, Honors students must complete their Institutional IPPE in the region assigned, and if a student drops out of the Honors Program prematurely, they will immediately revert to their assigned region with the start of the next semester.
- For the PharmD/PhD Program, students must submit the formal appeal by January 15th, but it will automatically be granted for the P3 year and for either the first three (#1-#3) or the last three (#6-#8) rotations of the P4 year. PharmD/PhD students will be required to attend the balance of the P4 year (either the last five rotations if rotations #1-#3 are research, or the first five rotations if rotations #6-#8 are research) in their assigned region. PharmD/PhD students must complete their Institutional IPPE in the region assigned, and if a student drops out of the PharmD/PhD Program prematurely, they will immediately revert to their assigned region with the start of the next semester.
- For student officers, only the five executive officers of Pharmacy Council may submit an appeal by January 15th, and it will be automatically granted for the P3 year only. Appeals will not be approved for other organizational officers. Since the Pharmacy Council officer responsibilities conclude at the end of the P3 year, these students will be required to attend the P4 year in their assigned regions. Pharmacy Council officers must complete their Institutional IPPE in the region assigned, and if they leave their office prematurely, they will immediately revert to their assigned region with the start of the next semester.
- For all Cooperative Program students, participation in the Honors Program, the PharmD/PhD Program, and/or serving as a Pharmacy Council Officer the P3 year will satisfy their Service Learning requirement.