Pharmacists are more integrated and influential in medication therapy decisions in hospitals than ever before, according to the latest installment of an annual survey of hospital pharmacy directors. The results ofthe ASHP National Survey of Pharmacy Practice in Hospital Settings: Prescribing and Transcribing 2010 were published in the April 15 issue in the American Journal of Health-System Pharmacy.
The findings demonstrate that the pharmacist’s role in patient care continues to grow, according to Douglas J. Scheckelhoff, a study author and ASHP vice president. “Throughout the survey, there is significant evidence that pharmacists’ unique expertise is sought after and valued by other health care providers,” said Scheckelhoff. “This includes the increase in hospitals providing 24-hour review of medication orders by pharmacists, and the growing ways that pharmacists provide leadership in the medication-use system.”
Key findings include:
- 60 percent of pharmacy directors view P&T committees as being highly effective at “increasing safety,” scoring it even higher then the committee’s role in decreasing cost, improving outcomes, or promoting evidence-based use of medicines.”
- The rate at which prescribers accept pharmacists’ recommendation has risen dramatically over the last decade, most significantly in the areas of antibiotic use (94 percent in 2010 as compared to 55.5 percent in 2001), pain management (98.9 percent in 2010 as compared to 65.9 percent in 2001), dosage adjustment (99.3 percent in 2010 as compared to 72.7 percent in 2001), and anticoagulation therapy (98 percent in 2010 as compared to 73.2 percent in 2001).
- Pharmacists are providing prescribing advice through consultations at a vast majority of hospitals, especially in the areas of dosage adjustment (98.1 percent in 2010 as compared to 88.1 percent in 2001), drug information (98.1 percent in 2010 as compared to 91.9 percent in 2001), pharmacokinetics (90.6 percent in 2010 as compared to 76.9 percent in 2001), antibiotics (83.8 percent in 2010 as compared to 78.8 percent in 2001), and anticoagulation (64.8 percent in 2010 as compared to 33.8 percent in 2001).
Pharmacy directors find that pharmacists’ intervention is the most effective strategy to improve the appropriateness of drug use (69.4 percent), rating it significantly more effective than the formulary (52 percent), P&T policy (52.4 percent) and clinical guidelines (58.2 percent).
- Pharmacists are routinely engaged in a variety of high-risk therapies, managing both dosing and monitoring, including warfarin (37.1 percent), low molecular weight heparin (35.7 percent), and heparin (32.3 percent).
- The percent of hospitals without a system to provide 24-hour review of prescriptions by pharmacists, either on site or remotely, has significantly decreased over the past five years (43.4 percent in 2010 as compared to 59.6 percent in 2001).
- Pharmacists lead antimicrobial stewardship programs in nearly half (48.5 percent) of all hospitals, with the highest percentage in hospitals with 400-599 beds (73.3 percent) and greater than 600 beds (77.3 percent).
ASHP surveyed a stratified random sample of pharmacy directors at 1968 general and children’s medical-surgical hospitals in the United States, via Internet and mail. ASHP conducts this national survey annually to examine trends in pharmacy practice over time, focusing on one of three themes on a rotating basis. This year, the survey focused on prescribing and transcription issues. Other years focus on dispensing and administration, as well as medication monitoring and patient education.
For more than 60 years, ASHP has helped pharmacists who practice in hospitals and health systems improve medication use and enhance patient safety. The Society's 35,000 members include pharmacists and pharmacy technicians who practice in inpatient, outpatient, home-care, and long-term-care settings, as well as pharmacy students. For more information about the wide array of ASHP activities and the many ways in which pharmacists help people make the best use of medicines, visit ASHP's website, www.ashp.org, or its consumer website, www.SafeMedication.com.