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Pharmacy Times
Volume 0

Patients Find IV Self-Dosing for Pain a Challenge

Recently released research on patients'experiences with controlling their painthemselves with self-dosing intravenous(IV) analgesia reveals that these therapiesare 4 times more likely to cause patientharm than other medications.

The findings, published in the December2008 issue of The Joint CommissionJournal on Quality and Patient Safety,show that most mistakes involving IVpatient-controlled analgesia (PCA) werea result of human error, equipment problems,or communication breakdownsleading to the patient receiving the wrongdosage or medication.

The study ofmore than 9500PCA errors overa 5-year periodin the UnitedStates showedthat patientharm occurredin 6.5% of incidents, comparedwith 1.5%for general medicationerrors. The PCAerrors also were more severe—harmingpatients and requiring clinical interventionsin response to the error—thanother types of medication errors. Onecase involved a patient who receivedseveral 10-mg doses instead of 1-mgmedication doses after surgery becauseof an incorrectly programmed dispensingpump.

"The entire PCA process is highlycomplex," said the study's lead author,Rodney Hicks, PhD, MSN, MPA, and hecalled on health care organizations toplan now to make the process safer.Among the strategies he and his coauthorsrecommend to reduce PCA errorsare simplifying the equipment, using barcodes and electronic medication administrationrecords, and involving pharmacistsin the design of more easily understoodand standardized forms for PCA.For more information on the study, go

Patients with AD Benefit from Pharmacist Involvement

New research underscores the needfor pharmacist involvement in treatingpatients with Alzheimer's disease (AD).The November/December 2008 issue ofthe Journal of the American PharmacistsAssociation featured the article entitled"White Paper on Expanding the Roleof Pharmacists in Caring for Individualswith Alzheimer's Disease." The paperpresents a summary discussion froma March 2008 meeting convened bythe American Pharmacists Association(APhA) Foundation.

Leading national experts met as a coordinatingcouncil to discuss the currentlevels of care and services provided bypharmacies to patients with AD. Thecouncil outlined several items that couldinvolve pharmacists in improving care forpatients with the disease. Those itemsinclude:

  • Identifying and publicizing best practicesin collaborative care models
  • Increasing continuing education programsthat provide not only clinicalinsights but information on caregiverissues
  • Evaluating residencies, fellowships,and other certification processes thatenhance pharmacist skills
  • Providing overall medication managementfor patients
  • Provision of medication packagingoptions that promote patient independenceand ease of use for caregivers

"The coordinating council meetingand subsequent white paper highlightedthe tremendous need and numerousopportunities for pharmacist involvementin helping patients and families dealwith Alzheimer's disease," said WilliamEllis, executive director of the APhAFoundation. "It is also important to recognizethat many patients with Alzheimer'sdisease also suffer from other chronicconditions where a pharmacist's expertiseand skills in medication therapy managementcan be valuable."

Web Site Offers Resources for Immunizing Pharmacists

The National Community PharmacistsAssociation (NCPA) is offering a newImmunization Information ResourceCenter through Pharmacist e-Link. Thegoal is to provide pharmacists with thetools and information needed to developand build immunization niche services.

The online center offers practice tools,resources, and education for immunizingpharmacists. Immunization by pharmacistsis allowed by law in 49 states. Nearlyhalf of all community pharmacies offerimmunizations, according to the 2008NCPA Digest.

NCPA President Holly Henry, PharmD,said, "From the everyday concerns of aresurgence of mumps, pneumonia, theneed for vaccinations for travel abroadto the more global issues of pandemicor greater public health concerns, theindependent pharmacy is the ideal centerfor adult vaccinations and immunizationsyear round."

Visit for more information.

New Reference Book on Patient Symptoms

Pharmacists looking for a handy reference guide to help patients understand their symptoms maywant to check out Merck's first-ever reference book on the subject, The Merck Manual of PatientSymptoms. The paperback is designed to assist pharmacists, nurses, medical students, residents,nurse practitioners, and physician assistants in their growing role on the front line of patient care.

Organized alphabetically, 88 common symptoms—from abdominal pain to wheezing—areaddressed in detail. Entries for each symptom begin with a list of possible causes, calling out wheneverpossible the ones that are more common, more dangerous, or both, followed by suggestivefindings. "Red flags" highlight indications of serious health conditions, and treatment guidelinescover common therapies, drugs, and dosages for symptom relief. "The book will make it easier tosort through patients' varied sensations and physical findings and create an effective diagnosticplan," noted Editor Robert Porter, MD.

The Merck Manual of Patient Symptoms complements The Merck Manual of Diagnosis andTherapy, first published in 1899 and now translated into 17 languages. For more information,

IRS Delays Debit Card Restrictions in Pharmacies

New health care debit card guidelines from the InternalRevenue Service (IRS) that would have taken effect thismonth have been delayed until June 1, 2009.

The 6-month delay is to allow more time for compliancewith the new rules that add retail pharmacies tothe list of merchants required to have an IRS-approvedpoint-of-sale system in place in order to accept ahealth care debit card. Those rules exclude an exceptionenabling pharmacies that primarily sell health careitems to accept the card as long as they met certain IRSrequirements.

TV Star Goes "Behind-the-Counter" to Promote Pharmacy

Comedian Brad Sherwood is the face of the Behind-the-CounterEncounters educational campaign. The campaign, launched by theAmerican Pharmacists Association (APhA) and supported by McNeilConsumer Healthcare, combines educational content and wit to shedlight on the vital role that pharmacists play in health care.

As part of the program, Sherwood stars with pharmacists in anentertaining series of online vignettes that portray a "day in the life" of apharmacist, based on real-life pharmacists' experience. An APhA surveyof 1719 individuals found that 68% of individuals do not even know theirpharmacist's name, but when they asked their pharmacist a question,99% received the help they needed.

For more information on the campaign, visit

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