The Pharmacist’s News Source
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Volume 40 • Number 9 • September 2013
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in this issue UP FRONT
3
CDC: Opioid overdose deaths surging in women.
CLINICAL
14
Practice Pearl: Improving health literacy can boost drug adherence.
POLICY
25
NuVision compounding pharmacy takes another hit from FDA.
OPERATIONS & MGMT
30 31
Lessons on preparing for Joint Commission surveys. CMS gets kudos for untangling the billing unit web.
EDUCATIONAL REVIEW
Assessing Interactions With CholesterolLowering Drugs See page 6.
Compatibility of Commonly Used IV Drugs See insert after p. 14
Outsourced Hospital Sterile Compounding: A New and Safer Era To Come See insert after page 22.
Teflaro for the Treatment Of Community Acquired Pneumonia See insert after page 6.
Tips for Surviving ‘The Unthinkable’ In Patient Safety
Are You Confident About Your Sterile Compounding QI Plan? One hospital’s strategy for ensuring safety
Minneapolis—What keeps you up at night when it comes to medication safety? A misplaced decimal point leading to a 10-fold dosing error? A contaminated batch of compounded IV drugs? A medication given to the wrong patient? Serious clinical adverse events, some tragic, occur every day in health care; many involve drug therapy, which is the most common intervention in medicine. Whatever the source, no health system is invulnerable. Is your hospital prepared for the unthinkable? “Many health care systems think they have a crisis plan, but they don’t,” said Frank Federico, RPh, executive director at the Institute for Healthcare Improvement (IHI) in Cambridge, Mass. “Often it’s only in someone’s head. It’s not written, not practiced, not tested,” he noted during a crisis management session at the 2013 Summer Meeting of the American Society of Health-System Pharmacists.
Minneapolis—With public confidence in compounding pharma-cies badly shaken by last fall’s deadly fungal meningitis outbreak, some hospital pharmacies have reexamined the oversight of theirr sterile preparation facilities to ensure greater compliance with U.S. S. Pharmacopeia (USP) Chapter <797> standards. Unfortunately, the number of hospitals that have done so is meager, said Eric Kastango, K RPh, MBA, FASHP, a compounding quality expert who is the president and CEO of Clinical IQ. In the harsh light of the fungal meningitis crisis, he said, he would have anticipated that hospital pharmacies “would be more concerned about their state of compliance relative
see THE UNTHINKABLE, page 40
see QI PLAN, page 26
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Data Fraud May Take the Bloom Off β-Blocker Rx London—The debate about using β-blockers perioperatively for noncardiac surgery patients continues with a new meta-analysis from British researchers indicating that starting the drugs specifically for surgery can increase the risk for death by 27%. Reporting in Heart (doi:10.1136/ heart-jnl-2013-304262 [Epub ahead of print]), investigators from Imperial College, in London, reviewed nine
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see DATA FRAUD, page 22
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Rapid Response Teams, Tech Tools Help Limit Drug Shortage Damage Minneapolis—With many critically needed medications in short supply over the past few years, pharmacists are looking at ways to improve how they handle drug shortages. Strategies for managing these scarcities by using informatics and collecting, analyzing and communicating information on medication shortfalls were presented at the American Society of Health-System Pharmacists (ASHP) 2013 Summer Meeting. “Shortages take a tremendous amount of time and labor to manage,” said Erin Fox, PharmD, the director of the Drug Informa-
tion Service at the University of Utah Hospitals and Clinics in Salt Lake City, and a noted expert on drug shortages. “It’s helpful to see published results like this on how to more efficiently manage shortages in the real world. It gives organizations ideas they can copy at their own institutions.”
Proactive Help via Informatics Dealing with drug shortages can be a huge drain on staff resources, noted Charles Burometto Jr., RPh, an information systems
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see SHORTAGES, page 32
New Products Amneal launches five new oral solids.
TEVA introduces generic temozolomide.
See page 29.
See page 29.