Author Affiliations: Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Center for Education and Research on Therapeutics, University of Pennsylvania School of Medicine, Philadelphia.
In recent years, pharmacists have received increasingly sophisticated
clinical training. Given the well known and well publicized recognition of
widespread problems induced by use of medications,1 pharmacists'
skills represent an enormous potential resource to improve drug therapy. To
that end, interest and expectation that pharmacists provide "pharmaceutical
care" services has increased.2 Such models
vary dramatically and include collaborative prescribing agreements,3 participation in interdisciplinary inpatient care
teams,4,5 disease-state management
programs,6 anticoagulation clinics,7 and routine functions like monitoring symptoms, providing
medication counseling, helping resolve drug-related problems, and facilitating
communication with physicians. Federally mandated drug utilization review
in ambulatory settings and drug regimen review in skilled nursing facilities
indicate at least partial acceptance of such functions by legislators.8 Pharmacists' scope of practice has even been the subject
of formal policy statements by the American College of Physicians-American
Society of Internal Medicine.9 Yet to date,
there have been remarkably few rigorous studies of the effectiveness of various
models of pharmaceutical care, particularly in outpatient settings.
Strom BL, Hennessy S. Pharmacist Care and Clinical Outcomes for Patients With Reactive Airways Disease. JAMA. 2002;288(13):1642-1643. doi:10.1001/jama.288.13.1642