APhA OPPOSES DRUG PATIENT COMPLIANCE PROGRAMS THAT "COMPROMISE" ABILITY

APhA OPPOSES DRUG PATIENT COMPLIANCE PROGRAMS THAT "COMPROMISE" ABILITY of pharmacists to "provide pharmaceutical care to the patient," the American Pharmaceutical Association's House of Delegates agreed during its March 20-24 annual meeting in Dallas. "Pharmaceutical care" is a term developed by organized pharmacy to define pharmacy as a clinical profession and denote the range of patient care services that may be provided in addition to dispensing, such as patient monitoring, counseling and drug use review. APhA members have been concerned about manufacturer-sponsored patient compliance programs that permit patients to enroll only upon a physician's recommendation. One APhA official cited Lederle's ProStep program as one such effort supported by the association. The nicotine patch was launched in early 1992 accompanied by a patient support program that allows pharmacist referrals and also reimburses pharmacists for counseling patients using ProStep. "APhA supports the development of patient compliance programs that adhere to the principles of pharmaceutical care and are intended to improve the patient's health," the resolution states. "APhA should exert a leadership position in a collaborative effort with industry, the medical profession and other organizations to develop guidelines for patient compliance programs." APhA delegates also endorsed a resolution backing the development of "pharmacy-based starter dose programs for prescription drug products to replace traditional sampling." While the starter dose approach offers pharmacists the advantage of dispensing to patients who otherwise would have received drug samples from their physicians, APhA cites the proposal's potential to reduce costs and product waste. Patient response and tolerance of a drug could be monitored during the short-term starter dose and, if needed, the patient could then be switched to a different product without wasting the rest of an unused normally prescribed amount, for example, 100 tablets. The resolution directs APhA to encourage "formation of a task force" on the starter dose approach, to be composed of representatives from pharmacy, industry and medicine. Ways to implement the resolution will be considered at a May meeting of APhA leadership, including representatives of the Academy of Pharmacy Practice and Management.