Pharmascript October 2016: Legislative Update A Summary of Policy Positions Passed at the 2016 ASHP

Brian Heilbronner
PharmD Candidate, 2017
Ohio Northern University

The House of Delegates (HOD) of the American Society of Health-Systems Pharmacists (ASHP) presides as the ultimate authority over the passing of ASHP professional policy positions. Meeting annually at the ASHP Summer Meetings and virtually in March and November, the HOD approves policies that address various issues pertaining to pharmacy practice. Policies typically originate from proposals by ASHP councils throughout the year, highlighting issues from a variety of areas in pharmacy practice, including therapeutics, pharmacy management, education and workforce development, and public policy.1

During the 2016 ASHP Summer Meeting, the HOD approved twenty-four policy positions, many of which are amendments to previously approved policies.2 Summarized below are four of the twenty-four policies approved at the 2016 ASHP Summer Meeting on June 12 and 14, including potential implications for hospital practice

Ban on Direct-to-Consumer Advertising for Prescription Drugs and Medication-Containing Devices (Policy 1624)

The HOD approved a policy advocating that Congress ban direct-to-consumer advertising (DTCA) for prescription drugs and medication-containing devices, repealing its former, more lenient stance on the issue. There is a growing body of evidence that DTCA may lead to rising healthcare costs, the overuse of prescription drugs, less appropriate prescribing, and an intrusion of the patient-physician relationship. 3-6 ASHP contends that the risks of DTCA outweigh its potential benefits. ASHP expresses its commitment to providing additional evidence of the potential negative impacts of DTCA on the healthcare system.

With regards to hospital practice, pharmacists play a vital role in fully understanding and evaluating the evidenced-based risks and benefits of medical therapies frequently advertised by DTCA as well as educating prescribers on these benefits and risks. Prescribers who are completely educated on the benefits and risks of medical therapies advertised via DTCA may feel less pressured to fulfill inappropriate DTCA-prompted patient requests for prescriptions, ultimately avoiding inappropriate prescribing and the continued overuse of prescription drugs.

Timely Board of Pharmacy Licensing (Policy 1621)

The HOD also approved a policy advocating that the National Association of Boards of Pharmacy (NABP) collaborate with state boards of pharmacy to streamline the licensure process and timeliness of application approval for pharmacists. Emphasizing that pharmacists often face many logistical barriers to securing licensure in new jurisdictions efficiently, ASHP promotes that pharmacists in good standing be granted up to six months of temporary licensure while permanent licensure is processed.

Slow delays in the issuance of pharmacy licensure pose potential problems for pharmacists relocating to new jurisdictions, especially new pharmacy graduates transitioning to out-of-state residency programs. Because workforce productivity is lost during delays in licensure transfer and reciprocity, ASHP urges NABP to assemble a task force to identify areas in improving timeliness and access of licensure. Increased awareness, advocacy, and assessment of areas for improvement at the state level will help contribute to the larger conversation of approaches to streamlining the process of pharmacy licensing.

Pharmacy Technician Training and Certification (Policy 1609)

The HOD approved a policy advocating that Pharmacy Technician Certification Board (PTCB) certification be required for and maintained by all pharmacy technicians, effectively reinstating a policy from 2014 that had been previously amended to remove the requirement of maintenance of PTCB certification. Presently, ASHP has partnered with the Accreditation Council for Pharmacy Education (ACPE) to develop an accreditation standard for pharmacy technicians programs, aiming to institute a requirement that all pharmacy technicians be graduates of an ASHP-ACPE accredited program in order to test for PTCB licensure, by the year 2020. ASHP emphasizes that the shift in requiring ASHP-ACPE accredited education prior to licensure for pharmacy technicians mirrors that of the pharmacy profession.

As the anticipated demand for enrollment in ASHP-ACPE accredited programs is expected to increase by the year 2020, ASHP cites concern for having the necessary resources to expand the number of ASHP-ACPE accredited programs. Hospitals, especially large academic medical centers, have an opportunity to use their educational resources to establish such programs and meet the growing demand for ASHP-ACPE accredited pharmacy technician programs.

Patient Experience (Policy 1616)

The HOD approved a policy advocating that pharmacists and other pharmacy personnel be educated about the relationship between patient satisfaction and positive health outcomes with medication therapy. Furthermore, ASHP encourages that pharmacists continually develop and adopt tools that will help engage patients and improve their overall satisfaction. Highlighting that current research suggest a clear correlation between positive patient satisfaction and improved patient outcomes, ASHP stresses the importance of pharmacists identifying ways to promote patient satisfaction through the coordination of team-based care.

The hospital setting presents a unique environment for patients to receive care for an extended length of time, depending upon their duration of admission. As a result, there exists numerous opportunities for pharmacists to intervene and facilitate positive patient experiences along the continuum of inpatient care. For example, pharmacists can play an active role in providing quality patient education about newly initiated high-risk medications in the hospital, such as insulin, anticoagulants, and inhalation devices. Additionally, pharmacists can coordinate with other multidisciplinary healthcare professionals to identify new methods of facilitating positive patient experiences.

While the HOD approved numerous additional policy positions at the 2016 ASHP Summer Meeting, these four policies highlight particular challenges facing the future of hospital practice, specifically regarding public policy, pharmacy management, and education and workforce development. State-level chapters of pharmacy organizations, such as the Maryland Society of Health-System Pharmacy, are well suited to engage with nationally driven efforts by ASHP to develop solutions to the many issues facing hospital practice. A complete list of all twenty-four policies is available on the ASHP website.2

References:
1. Introduction: ASHP Policy Positions. xix-xxi. Available from: http://www.ashp.org/DocLibrary/BestPractices/BPIntro.aspx accessed 2016 Aug 24)
2. House of Delegates. Policies Approved by the 2016 ASHP House of Delegates (with Rationale). ASHP. 18 Jul 2016. Available from: http://www.ashp.org/menu/PracticePolicy/HOD.aspx
3. Frosch DL, Grande D, Tarn DM, et al. A decade of controversy: Balancing policy with evidence in the regulation of prescription drug advertising. Am J Publ Health 2010; 100: 24-32.
4. The Impact of Direct-to-Consumer Advertising. Information for Consumers (drugs). U.S. Food and Drug Administration. Available from: http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm143562.htm (accessed 24 Aug 2016)
5. Mintzes B. Advertising of prescription-only medicines to the public: Does evidence of benefit counterbalance harm? Annu Rev Publ Health 2012; 33: 259-77.
6. Donohue JM, Cevasco M, Rosenthal MB. N Engl J Med. 2007; 357:673-81.