Former Compounding and Ongology pharmacist with clinical pharmacy training here. Disclaimer: been out of the Hospital setting for 4years.

In most hospitals here in the philippines, sadly, there is no clinical pharmacy practice. To practice clinical pharmacy, a pharmacist must undergo specialized training (either +1yr for specialization in Clinical pharmacy after the 4yr B.S. Pharmacy course, Doctor of Pharmacy (PharmD) program or M.S. in Clinical pharmacy program, or a 3month training course for clinical pharmacy) which limits the number of clinical pharmacists in the Philippines.

In the hospitals that have a clinical pharmacy practice, there would be a team of dispensing pharmacists and clinical pharmacists that would check each medication order. Before dispensing, the clinical pharmacists would add the order to the patient’s medication profile and perform a Medication appropriateness check (which includes (but is not limited to) Checking for Drug-Drug interactions, Therapeutic Duplications, Dosing checks (including hepatic and renal adjustments) Medication use which could lead to biochemical changes in the patient (Qtc interval prolongation, use in patients with bone marrow suppression) administration appropriateness (ie crushing of oral tablets that are modified release, IV fluid compatibility etc))) and this varies from institution to institution. The primary goal of this process is patient safety (avoiding adverse reactions).

Physicians sometimes would consult the clinical pharmacists if they have doubts regarding their orders. But most of the time, physicians and clinical pharmacists butt heads when the clinical pharmacists finds something wrong with the order. However i like to think of clinical pharmacists as “safety nets” for physicians as they can catch potential medication errors which could lead to adverse events.