The American Society of Health-System Pharmacists released its annual survey of pharmacy directors from nearly 5,000 hospitals across the country.
Trends include:
- Prescribing
- Opioid Stewardship
- Staffing
- Mobile Technology
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Results of ASHP’s annual survey of pharmacy directors at nearly 5,000 hospitals in the United States provide key insights into the current state of pharmacy practice in hospitals and health systems, particularly in the areas of prescribing, opioid stewardship, staffing, and use of mobile technology.
Published June 23 in AJHP, the 2019 ASHP National Survey evaluated practices and technologies related to prescribing and transcribing. At the most recent Midyear Clinical Meeting & Exhibition, lead author Craig A. Pederson of Virginia Mason Medical Center, spoke about trends in prescribing and drug formulary strategies used by hospital pharmacy and therapeutics (P&T) committees. The most common tools implemented by P&T committees were therapeutic interchange, evidence-based clinical practice guidelines, and comparing the effectiveness of products when making formulary decisions.
“These are not surprising, as these have traditionally been effective strategies,” Pederson said, adding, however, that the use of therapeutic interchange has increased since 2016.
Also of note in the area of formulary management strategies:
- the rise in hospitals that reported rationing of medications on the basis of expected patient outcomes and cost of therapy (31%, up from 25% in 2016)
- the rise in the number of hospitals with a limited strict formulary and tight restrictions on non-formulary medication use (73%, up from 63% in 2016)
Eighty-nine percent of hospitals indicated pharmacists have authority to write medication orders; among this group, 94% can modify or initiate therapy by policy or protocol and 6% are authorized to prescribe.
Medication use evaluation also has increased as hospitals critically examine product use, Pederson said.
“Seventy-two percent of hospitals use protocols that transfer authority for product selection and dosing from prescribers to pharmacy as a strategy by P&T, suggesting that pharmacists are increasingly recognized as effective stewards of the formulary system, and at implementing formulary standards,” Pedersen said. “This is significantly less than 77% of hospitals in 2016.”
The survey also showed that half of hospitals are including pharmacoeconomics in formulary decision-making, up from about one-third in 2013...
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*Editor’s note: This survey was conducted prior to the COVID-19 pandemic.
