Hospital Pharmacists Significantly Enhance Medication Prescribing Safety
The survey findings, published in the December 1, 2001, issue of the American Journal of Health-System Pharmacy, found that pharmacists in hospitals exert a great deal of influence on the prescribing activities within their institutions. Pharmacy and therapeutics (P&T) committees that are present in most hospitals (90 percent) develop and manage formulary systems, establish drug-use policy, review adverse drug events, and evaluate medication use. Pharmacists are also actively involved in providing prescribers with objective drug information (98 percent) and developing clinical practice guidelines (92 percent). Pharmacists also:
- Screen a majority of medication orders for allergies and drug interactions (89 percent),
- Implement clinical practice guidelines (80 percent), and
- Consult with physicians on drug therapy regimens for patients who have renal impairments, and system-wide antibiotic use and pharmacokinetics (75 percent).
The survey also found that pharmacists in 52 percent of hospitals have authority under protocol to initiate medication orders.
"Pharmacist involvement in the prescribing stage of the medication-use process is critical," said ASHP President Steven L. Sheaffer, Pharm.D., FASHP, noting that the 1999 Institute of Medicine report, cited prescribing errors as the most common cause of adverse drug events. "We are very pleased to see that hospitals are counting on the expertise of pharmacists to prevent these types of errors."
The survey, however, also finds that in some areas, pharmacists face an uphill battle in their efforts to positively affect the medication-use process. Some activities such as including pharmacists on hospital rounds are not widely used (30 percent), despite research findings showing that they improve patient safety. Other under-utilized activities include:
- Integration of pharmacy computer systems with the institutions computerized prescriber order-entry (26 percent)
- Tracking and trending treatment failures (28 percent)
- Verification of oral orders using the "hear back" method (31 percent)
"There is solid evidence to show that these practices positively affect patient outcomes and prevent adverse drug events," said Shaeffer. "We find it surprising that more hospitals arent making use of them."
The survey, which is supported by Eli Lilly and Company, is the first in a repeating series of three studies that focus on the role pharmacists play in managing and improving the medication-use process. Future studies will look at medication dispensing and administration and patient monitoring and wellness activities. A summary report of the survey findings can be obtained by calling 1-800-874-2778.
ASHP is the 31,000-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, which has a long history of medication error prevention efforts, believes that the mission of pharmacists is to help people make the best use of medicines. 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 the national accrediting organization for pharmacy residency and pharmacy technician training programs. For more information, visit ASHPs Web site, www.ashp.org.