Survey of pharmacist collaborative drug therapy management in hospitals

Abstract

The extent and scope of collaborative drug therapy management (CDTM) in U.S. hospitals and pharmacy directors' perceptions regarding CDTM were studied. A survey was developed after reviewing the literature on CDTM. The sample for the study was obtained from the 2001 American Hospital Association Guide. The mail survey was pretested in January 2002 with 30 hospital pharmacy directors in Illinois, Indiana, and Michigan. A national random sample of 1000 hospital pharmacy directors stratified by state were mailed surveys in March 2003. Two follow-up surveys were mailed at approximately four-week intervals. Responses were received from 327 hospitals, a 32.7% response rate. A total of 158 respondents (49.7%) indicated that some pharmacists in their hospital were engaged in CDTM. Most hospitals with CDTM authorized pharmacists to adjust a drug's strength (86.7%), order laboratory or related tests (84.2%), and change a drug's frequency of administration (81.6%). The CDTM-related activities pharmacists performed varied with disease and treatment area. Payment or reimbursement for some CDTM was received by 12.7% of hospitals with CDTM. Respondents from hospitals with CDTM perceived significantly greater support for CDTM and greater strategic impact of CDTM than those from hospitals without CDTM. Respondents perceived positive support for CDTM but believed that CDTM had little or no financial impact on pharmacy departments. Approximately 50% of respondent hospitals had some pharmacists engaged in CDTM. Although CDTM was perceived as not having a positive financial impact on pharmacy departments, it was perceived as having a positive strategic impact by improving the views of upper administration regarding the value of pharmacists and facilitating implementation of other pharmacy services.