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Press Release

ASHP Survey Identifies Enabling Factors Critical for Expansion of Pharmacists' Services

Support from medical staff and senior management are just two of the factors that empower ambulatory care pharmacists to conduct direct patient care in health systems, according to a new ASHP study. The 1999 "Survey of Managed Care and Ambulatory Care Pharmacy Practice in Integrated Health Systems," which queried 400 pharmacy managers and administrators on issues such as the responsibilities of pharmacists within their systems, unveiled compelling evidence of new opportunities for enhanced patient care.

Conducted by the ASHP Center on Managed Care Pharmacy and supported by an unrestricted grant from Pfizer, the study found that since 1997, the role of health-system pharmacists in ambulatory care has expanded dramatically in breadth and scope. For example, more than half of the respondents indicated that, of the 24 functions typically performed in ambulatory care settings, 13 are now considered routine activities (up from nine in 1997). These include: 

  • Tracking patient's adverse drug reactions, 
  • Conducting medication management programs, and 
  • Using pharmacoeconomic data to make formulary decisions.
Eighty percent of surveyed sites already offer the above services, and others indicated they were planning to offer them within a year. Growth areas include conducting specialized pharmacy-managed clinics, determining patients' use of herbal products and dietary supplements, and providing Internet prescription services.

"We were surprised at the extent to which ambulatory pharmacy roles have grown since the last survey," said study co-author Katherine K. Knapp, Ph.D., professor and dean, School of Pharmacy and Health Sciences, University of the Pacific, Stockton, Calif. "Managed care and other market forces such as workforce shortages apparently have not curtailed the progress of pharmaceutical care into new areas." 

Critical to that expansion are enabling factors often found in settings that allow pharmacists more latitude in providing direct patient care. In addition to "very supportive" medical staff and senior management, pharmacy services were enhanced in ambulatory care settings that had: 

  • Integrated electronic medical records, 
  • Automated dispensing systems, and 
  • Pharmacists on interdisciplinary care teams.
In settings that were equipped with these factors, ambulatory care pharmacists are successful in providing integrated ambulatory care pharmacy services, including tracking adverse drug reactions and providing patient consultations via a call center.

"Members who want to expand services within their settings can use this survey as a tool to educate administrators," said Colleen O'Malley, director of ASHP's Center on Managed Care Pharmacy. "They can also use the data as a benchmark in assessing current services or as a source of ideas for 'next steps.' " 

The full text of the 1999 "Survey of Managed Care and Ambulatory Care Pharmacy Practice in Integrated Health Systems" is published in the December 1 issue of the American Journal of Health-System Pharmacy and is featured on-line at

The ASHP Center on Managed Care Pharmacy serves as an information source for ASHP members and other health care professionals on trends and developments related to the practice of managed care pharmacy, such as pharmacy benefits management, formularies, and other issues within managed care. The Center's goals include helping pharmacist understand managed care and develop important skills to practice in today's evolving health care environment, encouraging career development activities, networking opportunities, and supporting professional advocacy for managed care pharmacists. 

ASHP is the 30,000-member national professional association that represents pharmacists who practice in hospitals, health maintenance organizations, long-term care facilities, home care, and other components of health care systems. ASHP believes that the mission of pharmacists is to help people make the best use of medications. Assisting pharmacists in fulfilling this mission is ASHP's primary objective. The Society has extensive publishing and educational programs designed to help members improve their delivery of pharmaceutical care, and it is a national accrediting organization for pharmacy residency and pharmacy technician training programs.