ASHP’s 2015 initiative: a collective effort to improve pharmacy practice in hospitals and health-systems in the United States

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The association between pharmacy closures and prescription drug use: a retrospective analysis of Medicaid prescription claims in Iowa.

OBJECTIVES: The objectives of this study were 2-fold: (1) to examine the association of pharmacy closures with prescription drug use by Medicaid recipients in Iowa; and (2) to evaluate how drug utilization patterns differ between patients whose pharmacies closed and patients whose pharmacies remained open. DESIGN: A 2-group pretest-posttest study of Medicaid enrollees who may have been affected by pharmacy closures. Prescription medication use during the periods preceding and after pharmacy closures was compared. A comparison group was used to account for extraneous factors. PATIENTS AND METHODS: Sixteen community pharmacies were selected from a pool of pharmacies that closed during 1994; 1092 patients were identified as the main users of these pharmacies, and a comparison group of 3491 patients whose main pharmacies had not closed also was identified. The average number of each patient's prescription claims for the 6 months preceding closing and the 6 months after closing was computed. Multiple regression analysis was conducted to determine whether any association existed between pharmacy closures and the use of prescription drugs. RESULTS: Patients whose pharmacies closed during 1994 had fewer prescription claims after the closings than before the closings. In contrast, patients whose pharmacies remained open had more prescription claims. This difference remains statistically significant after controlling for other factors, such as patient demographics and health status. CONCLUSIONS: A decrease in prescription drug use was associated with pharmacy closures. Attention should be directed to patient access to prescription medications in rural areas, as relatively more pharmacies close in rural areas.

Pharmaceutical services in rural hospitals in Illinois--1991.

The results of a 1991 survey of pharmaceutical services in rural hospitals in Illinois are reported and compared with the results of previously published national and regional surveys. A questionnaire was developed and mailed to the director of pharmacy at each hospital in the study population (n = 95 rural hospitals in Illinois) to obtain information about inpatient drug distribution services, ambulatory-care services, clinical services, and human resources. The response rate was 81% (77 usable responses). Respondents reported a mean hospital size of 115.5 licensed beds. The mean average daily census was 51.2. Drug distribution systems appear similar to those reported in the 1990 ASHP survey, with complete unit dose drug distribution systems existing in 90.1% of respondent rural Illinois hospitals and complete and comprehensive i.v. admixture services in 71.2%. The percentage of pharmacy departments that are decentralized is lower among rural Illinois hospitals than among previous survey populations. Respondents indicated that they provided the following clinical pharmacy services: drug therapy monitoring (73%), patient rounds (12.2%), nutritional support (37.8%), pharmacokinetic consultations (32.4%), and patient education and counseling (24.3%). These results are comparable to those reported in previous surveys. Respondents reported an average of 5.9 full-time equivalents per hospital pharmacy department. The pharmacist vacancy rate and the total vacancy rate per department were reported as 10% and 5.3%, respectively, with vacant positions taking an average of 15 months to fill. The pharmacist vacancy rate is markedly higher than that reported in the 1990 ASHP survey. Rural Illinois hospitals are comparable to other U.S. hospitals in the provision of most pharmaceutical services.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacy agenda for change: the time is now.

In the midst of society's debate and focus on patient care and outcome, healthcare providers must articulate their strategic positioning to be part of the collective societal drive. Pharmacy as an integral component of healthcare provided, must also take the opportunity to create its own agenda for change. This agenda revolves around pharmacists agreeing on aspects of pharmaceutical care for which they are legally and ethically responsible. Pharmacists must also strive to gain social and cultural authority for those aspects for which the profession has accepted responsibility. Pharmacist action is needed to ensure appropriate drug therapy to the public.

Models for the supply of pharmacists.

The BHPr (formerly Bureau of Health Professions) Supply Model for pharmacists is presented and analyzed. Recommendations are made for improvement of the supply model. Included are considerations of additional variables and improvement of tables of separation rates to more accurately reflect working patterns of male and female pharmacists. The supply model shares many features of supply models for other health professions such as nursing and medicine. The variables suggested for improvement of supply determinations parallel supply measures of other health professions also. The adoption of suggestions for improvement of the pharmacy supply model to other health professions' supply models is suggested.