APhA wrestles again with medication error policy

APhA debates medication error policy at convention again




APhA wrestles again with medication error policy at its convention in San Francisco

Last year, a late retreat by its house of delegates stopped the American Pharmaceutical Association from registering official opposition to mandatory reporting of serious medication errors. Last month, the delegates at APhA's 148th annual meeting in San Francisco took a different tack. They didn't oppose mandatory reporting, but, after rejecting a motion to further study the issue, instead adopted a policy that "strongly encourages pharmacists' voluntary, nonpunitive, and anonymous participation" in medication error reporting programs. The delegates also said state pharmacy boards and other regulatory bodies should "consider pharmacists' participation in reporting of errors as a mitigating factor in determining any legal or disciplinary action related to the incident."

Various facets of the medication error equation also were a featured part of the educational programming sessions for this year's convention of America's oldest pharmacy association. The APhA Foundation collaborated with the Institute for Safe Medication Practices to design a safety self-assessment test for community pharmacies unveiled at the convention. The National Association of Chain Drug Stores also worked closely with ISMP to develop the tool to help pharmacies look critically at their dispensing systems with an eye on making mistakes less likely and improving patient safety. The assessment will be Internet-based, guarantee anonymity, and allow pharmacies to compare themselves with others with similar demographics, said IMSP chief Michael Cohen.


NACDS, along with the Pharmaceutical Care Management Association and the Academy of Managed Care Pharmacy, also has been working closely with APhA on reducing a major time-waster for dispensing pharmacists—the high volume of drug utilization review messages that are of little value. The groups formed a task force, which reported at an open hearing at the APhA convention that it was making progress on identifying and eliminating irrelevant alerts and establishing criteria for appropriate ones. The task force also is studying unit-of-use packaging and communications between prescribers and pharmacists.

Another collaborative venture, kicked off at the convention, joins APhA and the National Association of Boards of Pharmacy in a Web site that will include pharmacy news, continuing education, job posting, drug information, practice tests for NABP-produced competency exams, and on-line license renewal. "We see it as a resource not only for APhA members but also for the broader pharmacy community," said new president Thomas E. Menighan. "It's a source for professional development tools that can be accessed by any pharmacist, pharmacy student, or pharmacy technician."

APhA's house of delegates wrestled with a policy supporting "the concept of a generalist practitioner as that which best serves the needs of the patient and also serves as the basis for reimbursement of patient care services." The policy would also express continued support for voluntary specialization, but specialization would not be necessary as a requirement for payment of services. Delegates could not come to an agreement, and the policy committee eventually withdrew it for further study. In other actions, the delegates:

• Decided against stating that R.Ph.s shouldn't accept handwritten prescriptions after 2005 and, instead, encouraged prescribers to use technology to transmit prescriptions or to legibly handprint them.

• Declined to support elimination of Latin phrases, abbreviations, and "as directed" on Rx orders and, instead, said they should be avoided.

• Rejected a suggestion that APhA petition the Food & Drug Administration to authorize nonprescription use of fexofenadine (Allegra, Aventis) and loratadine (Claritin, Schering-Plough), even though their manufacturers do not want to make the switch.

• Updated past policy opposing prescription quotas to now read, "APhA opposes workload requirements that stifle professional motivation and prerogatives."

• Rescinded anti-mail-order policy ("by its very nature constitutes a threat to public health and welfare") dating back more than 30 years.

Michael F. Conlan


Mike Conlan. APhA wrestles again with medication error policy. Drug Topics 2001;7:16.