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Survey Shows Gains and Losses in Ambulatory Care Pharmacists' Patient Care Roles

Kate Traynor

Ambulatory care pharmacists in health systems are taking on more leadership roles in patient care, including operating disease management clinics and participating in medication-error-reduction programs, according to the results of a recently released ASHP survey. At the same time, these practitioners are reporting a steady decline in the time spent on other clinical activities.

The 2001 Survey of Managed Care and Ambulatory Care Pharmacy Practice in Integrated Health Systems shows a dramatic increase in pharmacists’ participation in specialized clinics; most often pharmacists participated in anticoagulation, oncology, and diabetes clinics. This growth is tempered by reductions in the routine performance of 20 of the 24 functions typically performed in ambulatory care settings since ASHP’s 1999 survey. The greatest reductions in activity were reported in negotiating pharmaceutical contracts (–28 percent), administering immunizations (–27 percent), and providing immunization screening (–24 percent).

Although the mean full-time pharmacy staffing level rose 33 percent between 1999 and 2001, a continuing national shortage of pharmacists is making it increasingly difficult for a majority of organizations to fill vacant slots. The lack of candidates may be forcing some health systems to reconfigure pharmacists’ activities and functions.

"What we see is a decision by integrated health systems to assign pharmacists to increasingly take on the more basic, essential functions," said ASHP Executive Vice President Henri R. Manasse Jr., Ph.D., Sc.D. "This hinders opportunities for pharmacists to make broader contributions to the improvement of the medication-use system in their practice sites."

The complete survey report appears in the Nov. 15, 2001, issue of the American Journal of Health-System Pharmacy. The survey was conducted by the ASHP Center on Managed Care Pharmacy and supported by an unrestricted grant from Pfizer Inc.