Clinical Pharmacy Practice in the Noninstitutional Setting

The great majority of patients seek care and are managed in noninstitutional settings. Many procedures that were recently performed only in the hospital are now done on an ambulatory basis due to the emphasis on outpatient care. The profession of pharmacy is well positioned to meet the primary care needs of consumers. However, there continue to be major challenges to the provision of clinical pharmacy services in noninstitutional settings. Numerous studies have demonstrated the value of clinical pharmacists in the long-term management of hypertensive, diabetic, and anticoagulated patients in the am bu I ato ry e nvi ro n men t . 1-14 Studies in n on i nst i t u t io nal settings have docu men t ed that clinical pharmacy services can improve disease control, and that they can reduce adverse drug reactions and n ~ n c y n p l i a n c e . ’ ~ ~ ~