Pharmacy Physician Relations and Appropriate Prescribing for Long-Term Care Patients

Resolution and Position Statements
Medication Management, Attending Physician, Pharmacist
Allied Health Professional, NP/PA, Physician
March 1, 2003

Position Statement F03
Becomes Policy March 2003

Physicians, consultant pharmacists, and provider pharmacies play an important role in ensuring optimal outcomes of drug therapy, including provision of appropriate, effective and safe medications. Drug Regimen Review is most effective when done prospectively at the point of prescribing. To accomplish this, pharmacists (consulting and dispensing) and physicians (attendings and medical directors) must have effective communication and cooperation among themselves as well as other members of the interdisciplinary team. "Ideally, the pharmacist should be involved as early as possible in the prescribing process to provide the necessary information and a prospective, rather than retrospective drug regimen review." (Dimant, JAMDA 2001;2:81-93.)

Pharmacists' recommendations to physicians to change prescribing orders must be:

  1. evidence-based
  2. made in the context of the patient's entire medical and psychosocial condition, prognosis, quality of life and patient's or surrogate's wishes.
  3. made in the context that overuse, under use and inappropriate use of medications are equally important quality of care concerns.
  4. made without improper use or disclosure of confidential, individual protected medical information that is not necessary for direct patient care.

AMDA deems unethical any recommendation for medication use that is based solely on enhancing profitability without considering these four factors.

All members of organizations need to recognize all potential conflicts of interest and should keep the patients' interests as the highest priority. Strict ethical standards must be adhered to.

AMDA objects to any practice that suggests inappropriate prescribing recommendations to physicians.