The results of a survey of academic medical centers assessing the presence and description of opioid stewardship activities. Methods: Academic medical centers within the Vizient University Health System Consortium Pharmacy Network were asked to complete a survey related to opioid stewardship activities. The survey consisted of 30 questions aimed at identifying current opioid stewardship practices among hospitals and health systems. Results: There were 27 respondents to the survey. Only 42.3% of respondents have opioid stewardship activities in place. Opioid stewardship practices are primarily linked to either formal consult services or the role of a clinical pharmacy specialist. Very few institutions have opioid stewardship embedded into the daily practice of clinical pharmacists. Just over half of respondents have pharmacists as part of a pain consult team. Principle roles of pharmacists on consult teams include provider education, patient education, and optimization of therapy outside of a collaborative practice or prescribing role. Over half of the respondents participating in stewardship maintain a pharmacist's role in monitoring surgery and postoperative opioid prescribing. The majority of respondents have opioid medication policies in place to address range orders, smart pump programming of opioids, limits on meperidine use, and cumulative limits on acetaminophen dosing. Conclusion: There are limited examples of pharmacy services related to opioid stewardship. The authors believe this is a pharmacy practice model that will evolve with the national attention to the opioid epidemic and new Joint Commission Standards.
The American College of Clinical Pharmacy (ACCP) Board of Regents charged the 2020 to 2021 Publications Committee to review and revise the 2004 ACCP guideline statement on therapeutic interchange. The committee reviewed previous guidelines and relevant published literature. After development of new guidelines, the committee and Board of Regents voted in support of the updated guideline. The ACCP reaffirms its support of therapeutic interchange. Additional recommendations for appropriate implementation and practice of therapeutic interchange are provided. Therapeutic interchange is an important tool in optimizing patient care, improving access to care, and reducing the cost of medications.
Most states have adopted conscience clauses since the Roe v. Wade paradigm in the 1970s; however, not all clauses are respective to pharmacists. The purpose of this report is to quantify the presence of conscientious objection among US states with respect to pharmacist’s right to refuse to dispense. Fifty Boards of Pharmacy administrative codes were consulted for review. If Web sites were ambiguous or undeterminable, E-mail requests were sent on active legislation per National Association of Boards of Pharmacy contact information. Eleven states have conscience clauses present in their pharmacy administrative code—nearly double than last published in 2006. Requirements vary throughout the states including drug-specific limitations, requirement in writing, or notification in advance. Some states alternatively require duty to dispense. Less than one-fourth of United States boards of pharmacy provide a conscience clause or similar intended language in laws or policies. Within those states, pharmacists have a right to refuse to perform certain services based on religious, ethical, or moral objections. Imprecise language throughout the nation allows the rights to vary widely.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.