Pharmacists are among the final safeguards (in many cases, the final safeguard) to protect patients from medication errors, drug-drug interactions, and other untoward medication-related events. Pharmacists and staff do so by conducting concurrent drug utilization review (DUR) for patients prior to completing a prescription, implementing various quality checks to minimize the likelihood of a dispensing or drug labeling error, and provide oral and written communication to help ensure that patients understand their medication regimen and facilitate their adherence with it. Adherence includes more than just taking the medication on time; it also includes the correct dosage and avoidance of potential interactions with other drugs and even with non-pharmacological aspects of their therapy.
The FDA has a guidance for pharmacies to provide consumer medication information (CMI). Panich et al undertook an evaluation of CMI leaflets provided by community pharmacies for accuracy and completeness with respect to drug-drug interactions (DDIs).1 They obtained CMI leaflets for azithromycin, ciprofloxacin, and simvastatin from 14 community pharmacies that are part of 6 chain operations. Three to four salient interacting medications for each leaflet medication were identified using 2 well-recognized drug compendia. The content of the DDI information in the leaflets was evaluated for completeness. The font size and reading level of each leaflet was also assessed. The leaflets came from two vendors, Wolter’s Kluwer and First Databank. The CMI from First Databank mentioned 5 of 11 previously identified interactions with the target medications, although one chain in this group chose not to print the DDI section at all. The CMI developed by Wolter’s Kluwer mentioned only 2 of the 11 identified DDIs. The average reading grade level for First Databank leaflets was 10.6, while it was 5.0 from Wolter’s Kluwer. The font size varied from 8 to 12-point font, while the FDA recommends the information be printed in font size 12 or larger. The study concluded that community pharmacies appear to be distributing CMI leaflets with limited warnings about serious and well-known DDIs.
Pharmacy managers are in a position to select, or at least help inform the selection of vendors as well as give feedback to those vendors. This includes vendors not only for large equipment, but items such as medication information vendors as well as software vendors to help screen for potentially inappropriate medications. Pharmacy managers in knowing that some products from external vendors might lack quality, must ensure that the quality of other aspects of practice in their control such as oral counseling will help make up the difference, at least to the extent possible.
Additional information about Managing Medication Use Process Supporting Technologies and Automation and Ensuring Quality in Pharmacy Operations and Preventing and Managing Medication Errors: The Pharmacist’s Role in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.
1Panich J, Gooden A, Shirazi FM, et a. Warnings for drug-drug interactions of consumer medication information provided by community pharmacies. J Am Pharm Assoc. 2019;59(1):35-42.