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[Naveed Rivas]

1- who will do the counseling?

Pharmacists and pharmacy interns under supervision of pharmacist even your manager, assistant manager and supervisor can also go for counseling. usually we have one pharmacist on clinical rotation from every area so he or she is doing discharge counseling but he is not 24/7 and patients are getting discharge 24/7 to cope up with this situation we have separate discharge pharmacy (take home pharmacy) their staff is going for counseling. we have designed education material for patient education in form of booklets and pamphlets in case pharmacist or intern is not available for discharge counseling that is a rare scenario.

2- whom will be eligible to be counseled? Any criteria?

When we started discharge counseling ( five years back) at that time our target group was cardiac patients especially patients on warfarin and other anticoagulants as we have started anticoagulation clinics also, transplant patients, pediatric patients, oncology patients and patients getting discharge on pharmacy compounding but now it is extended to all discharge patients.

3- when the physician write a discharge medications, do the clinical pharmacist review those medications before being dispensed by pharmacist.

In akuh (Pakistan) we don’t have two terms in practice i.e. pharmacist and clinical pharmacist as we have six years Pharm-D graduates (5 years of Pharm D and one year internship) so our pharmacists are clinical pharmacists. our process flow is physician enter discharge order in CPOE then one pharmacist process the order after that technician fill the order as we don’t have automated prescription filling system, if you have automated prescription filling then it will add another feather in your cap, then second pharmacist review that order. our goal is to dispense the discharge medication within 45 mins.