Clinical Therapeutics

Clinical Therapeutics
Therapeutics: In medicine, the branch that deals specifically with the treatment
of disease and the art and science of healing.

In pharmacology, therapeutics accordingly refers to the use of drugs and the method of their
administration in the treatment of disease.

The word comes from the Greek "therapeia" meaning "a service, an attendance"

Therapeutics, treatment and care of a patient for the purpose of both preventing
and combating disease or alleviating pain or injury.

In a broad sense, clinical therapeutics means serving and caring for the patient in a
comprehensive manner, preventing disease as well as managing specific problems. Exercise,
diet, and mental factors are therefore integral to the prevention, as well as the management, of
disease processes.
TREATMENT AND MANAGEMENT
TREATMENT AND MANAGEMENT

M ANAGEMEN
T
 DISEASE MANAGEMENT
Disease management is the concept of reducing health care costs and improving quality of
life for individuals with chronic conditions by preventing or minimizing the effects of the
disease through integrated care.
Disease management programs are designed to improve the health of persons with chronic
conditions and reduce associated costs from avoidable complications by identifying and
treating chronic conditions more quickly and more effectively, thus slowing the progression
of those diseases.
Disease management is a system of coordinated heath care interventions and
communications for defined patient populations with conditions where self-care efforts can
be implemented.
Disease management empowers individuals, working with other health care providers to
manage their disease and prevent complications.
 DISEASE MANAGEMENT
Disease management is an approach to healthcare that teaches patients how to
manage a chronic disease.
Patients learn to take responsibility for understanding how to take care of themselves.
They learn to avoid potential problems and exacerbation, or worsening, of their
health problem.

If some one have a chronic condition, they are not alone.

As many as 6 in 10 adults have a chronic disease and 4 in 10 have at least two.

 DISEASE MANAGEMENT
Medical management is the collective effort of many experts for the well-
being of a patient. It includes sectors such as IT, finance, and medicine to
cure a person.

Management of a disease includes treatment of the disease, the cheapest

method for acquiring treatment, and making the patient understand the
dimensions of the disease.

Management of a disease takes care of pre-treatment measures and post-

treatment measures.

Medical management is also called as health care management and consists of

a group of profession that can recover the diseased effectively.
 DISEASE TREATMENT
Medical treatment is the assistance provided for the needy to protect themselves against the
disease that conquers them. It includes the medications given to them and the physical support
provided to them until they get cured. A treatment is required for a defined time, until the
disease completely gets cured.

Medical treatment is a pre-defined procedure that is determined by medical professionals after

examining the diseased thoroughly. Different kinds of treatments exist for different diseases and
there are many specializations required to fix a particular treatment for a certain disease.

Treatments are the primary need of a patient, all the other care is considered secondary. The
physical assistance one need, when diagnosed with a certain illness, is what medical treatment
aims for.

Medication is the primary goal of medical treatment and the procedure

continues until the curable diseases get completely cured.
 DISEASE MANAGEMENT

Medical management is a collective process that includes treating the diseased,

supporting them physically and mentally, and financially.

Medical treatment is a more narrow process which is interested only in improving the
illness caused by the disease.

Both these terms are used in medical sciences for providing better services to the
diseased. However, managing a disease is much more effective than treating a disease.
 DIFFERENCES BETWEEN MANAGEMENT & TREATMENT
 Management of a disease consists of numerous factors that take care of all the aspects related
to the illness. Medical treatment consists of procedures that can cure the illness alone.

 Management of a disease supports the patient by giving him/her all the assistance that
includes physical, mental, and emotional care that one needs. Treatment of a disease only
concentrates to cure the disease that he/she is diagnosed.

 For managing a disease, we need a group of expertise whereas for treating it we only need
the specialists who can cure the disease.

 For certain prolonged diseases, we need medical management to support the patients. Such
cases that cannot be cured by treatments are called conditions. Treatments can cure only
diseases and not conditions.

 Managing a disease is more effective as it contains all aspects of curing a person. Treating a
person is only concentrated on a certain part of the illness that is usually the major one.
 Components of Disease Management
The Disease Management Association of America identifies these components:

 Identify the target populations: which diseases should be addressed and how can people
with those conditions be enrolled in a disease management program?
 Establish evidence-based practice guidelines for the conditions that will be managed.
 Build collaborative practice models: In addition to physicians, disease management
programs utilize nurses, dietitians, pharmacists, and other team members.
 Educate the Patient: Design a program to teach self-management to patients.
 Measure outcomes: establish procedures for tracking costs, utilization, health outcomes.
 Feedback and reporting.
DISEASE MANAGEMENT
DISEASE MANAGEMENT
DISEASE MANAGEMENT
 Managing Your Medication Regimen
According to the latest statistics, 46 percent of Americans take prescription medications
every year. Your pharmacist can help you get on the best medication regimen while also
monitoring you for symptoms.
 Medication Adherence
Medication adherence usually refers to whether patients take their medications as
prescribed (eg, twice daily), as well as whether they continue to take a prescribed
medication
 Medical Education
 Medication Synchronization
A medication management strategy that aligns the refill dates for two or more prescriptions
 Side Effect and Symptom Monitoring
 Decreasing the Cost of Chronic Conditions

The United States spent $1.3 trillion on direct care for chronic conditions in 2018. When indirect
costs are also taken into consideration, e.g., absenteeism from work and decreased productivity,
those costs increased to $3.7 trillion, nearly a fifth of the U.S. gross domestic product (GDP).
If anyone knows how expensive medications are, it is your pharmacist. They can give you tips
and tricks for decreasing your out-of-pocket costs by:

 Changing to Generic Medications

 Manufacturer Drug Coupons
 Medicare Part D options
 Prescription Assistance Programs
 Improving Clinical Outcomes
Pharmacist-led interventions have been shown to improve clinical outcomes for a number
of chronic conditions, Like:
 Cancer
Cancer medications can have unpleasant side effects, making people less likely to adhere
to treatment, but counseling with a pharmacist can help.

A 2017 systematic review shows that counseling with a pharmacist about how to manage
those side effects helps to improve medication compliance and decreases symptoms like
nausea and vomiting.
 Diabetes
A 2018 systematic review showed that pharmacist interventions like these decreased
hemoglobin A1C levels, tightened blood pressure control, optimized lipid levels (lowered
LDL (bad) cholesterol, increased HDL (good) cholesterol, and decreased triglycerides),
improved BMI, and boosted medication adherence.
Drug Selection
 Drug Selection

 Prescribing is the most important tool used by physicians to cure illness, relieve symptoms
and prevent future disease.

 It is also a complex intellectuals that requires formulation of an appropriate treatment

regimen from the many thousands available, taking into account the infinite variation in the
patients they encounter.

 Prescribing is also a complex task that requires diagnostic skills, knowledge of common
medicines, understanding of the principles of clinical pharmacology, communication skills,
and the ability to make decisions based on judgments of potential benefit and risks, having
taken into account available evidence and specific factors relating to the patient being treated.

 Unfortunately, the selection of a medicine and dosage regimen is sometimes suboptimal,

leading to poor patient outcomes (eg. treatment failure, avoidable adverse reactions).
 Drug Selection

 Prescribing is a complex task that requires interpretation of evidence from clinical

trials in light of individual patient factors.

 Rational prescribing describes a logical approach that includes making a (differential)

diagnosis, estimating prognosis, establishing the goals of therapy, selecting the most
appropriate treatment and monitoring the effects of that treatment.

 Patients should be involved in several of these stages and their beliefs, expectations
and attitudes to risk will contribute to rational prescribing decisions.

 Pharmacogenetics will help to individualize prescribing choices but will not replace the
need for an understanding of the clinical pharmacology underpinning the selection of the
most appropriate drug and treatment regimen.
 Drug Selection

 Rational Prescribing
Rational prescribers should attempt to:

 Maximize clinical effectiveness

 Minimize harms

 Avoid wasting scarce healthcare resources

 Respect patient choice

 Drug Selection
 Goals of Therapy
It may include:
 Curing a disease (eg breast cancer, chest infection)
 Relieving symptoms without affecting the underlying condition (eg headache, diarrhea)
 Combining both of the above goals (eg inflammatory bowel disease, rheumatoid
arthritis)
 Long-term prevention (eg hypertension, osteoporosis)
 Replacing deficiencies (eg hypothyroidism)
 Addressing lifestyle wishes (eg hormonal contraception) and, occasionally,
 Therapeutic trials to aid diagnosis (eg edrophonium to diagnose myasthenia gravis).
 Ideally, patients should be fully informed about the goal of treatment before commencing it,
especially for preventative therapy where there is no prospect of immediate improvement in
quality of life and any benefits will only be delivered by adherence to treatment over many
years.