The researchers find that the The survey also explores the expanding role of hospital and health-system pharmacists in drug therapy monitoring and providing care in outpatient clinics. Hospital and health-system pharmacists play a major role as patient care providers on the inter professional team in managing medication therapy, educating patients and other providers, and helping to solve public health issues like the opioid crisis and drug shortages.
Pharmacists in drug therapy
Pharmacists possess unique knowledge, skills; and abilities that make them critical team members to help ensure that medication use is optimal, safe, and effective. That is why hospitals ;and health systems rely on them to take a leading role in addressing the opioid crisis and many other medication-related areas.”
Michael Ganio, Pharm.D., M.S., ASHP’s Director of Pharmacy Practice and Quality Ganio is also an author of the study The National Survey of Pharmacy Practice in Hospital Settings 2018 analyzes pharmacy’s role in drug therapy monitoring and patient education. In addition to opioid stewardship programs; the survey covers several contemporary pharmacy practice issues; including management of medication therapy activities; and pharmacist participation in outpatient clinics.
Contemporary pharmacy practice
The study includes responses from pharmacy directors in 811 general and children’s hospitals in the U.S. The most common strategies that health systems employ for preventing opioid misuse include providing clinician education and guidelines (71.4 %), followed by using prescription drug monitoring database searches to track prescribing practices and patient behaviors that can lead to abuse (65.3 percent); and opioid diversion detection programs (55.6%).
In opioid stewardship, pharmacists most commonly play a role in diversion detection (70.8%). Pharmacists are also likely to be involved in clinical utilization review (57.2%), leadership and accountability (54.8%), and prescribing support (34.5%). Other health-system strategies to prevent opioid misuse include limiting supplies of opioid prescriptions on home discharge, naloxone dispensing or education, opioid medication reconciliation during transitions of care, prescription opioid takeback programs, and medication-assisted opioid addiction management.
Opioid medication reconciliation
Strategies employed to encourage appropriate prescribing include monitoring opioid prescribing practices to identify outliers among clinicians, using clinical decision-support; imposing restrictions on specific opioids or doses, and providing daily feedback to prescribers. The survey also shows that pharmacists are integral to drug therapy management, a comprehensive and proactive approach to medication monitoring that involves selecting appropriate drug therapies; educating and monitoring patients, and assessing patient outcomes.
More than 60% of hospitals routinely assign pharmacists to provide drug therapy management services to a majority of patients. Pharmacists are managing medication therapy activities that include; but are not limited to, monitoring therapeutic drug levels, patient outcomes and laboratory results, adverse drug event monitoring; adjusting medication regimens, and monitoring medication errors – for a growing portion of their patients.