Joseph L. Fink

Pharmacists on Facebook: Online social networking and the profession

OBJECTIVE To provide a brief history of Facebook and online social networking and discuss how it has contributed and can contribute in the future to a paradigm change in social communications. SUMMARY When student pharmacists complete school and enter practice, they encounter enhanced expectations to act appropriately and professionally. Facebook expands the dilemma of separating private and public life--a challenge for individuals in all professions. From the standpoint of a professional association, Facebook provides a tremendous opportunity to reach out to members in an unprecedented way. Pharmacy organizations are beginning to use these new tools to increase communication and dissemination of information. CONCLUSION The popularity of Facebook has brought the issue of online social networking to the forefront of professional and organizational discussions. The issues of privacy, identity protection, and e-professionalism are likely to reappear as pharmacists and student pharmacists continue to communicate via online networks. The potential exists for organizations to harness this organizational and communication power for their own interests. Further study is needed regarding the interaction between online social networking applications and the profession of pharmacy.

A multistate trial of pharmacy syringe purchase

Pharmacies are a potential site for access to sterile syringes as a means for preventing human immunodeficiency virus (HIV), but the type and extent of their utility is uncertain. To examine pharmacy syringe purchase, we conducted a standardized, multistate study in urban and rural areas of four states in which attempts to purchase syringes were documented. Of 1,600 overall purchase attempts, 35% were refused. Colorado (25%) and Connecticut (28%) had significantly lower rates of refusal than Kentucky (41%) and Missouri (47%). Furthermore, urban settings had higher rates of refusal (40%) than rural settings (31%, P<.01). Race and gender did not have a consistent impact on rates of refusal. Despite potential advantages of pharmacies as sites for access to sterile syringes, pharmacy purchase of syringes faces significant obstacles in terms of the practices in different jurisdictions.

Liability Claims Based on Drug Use

The incidence of drug-related liability claims is discussed, and data from a number of studies in this area are reviewed. Drug categories that appear to cause the greatest problems are hormones, anticoagulants, adrenal steroids, and antibiotics. Focusing attention on these categories may enable the pharmacist to function as a liability-reducing factor in the institutional setting.

Child-Resistant Packaging for Medication

The Poison Prevention Packaging Act of 1970 became effective on December 30, 1970, and its provisions and the enforcement efforts of the regulatory agencies charged with administering the Act have caused great consternation among both laymen and health professionals. An understanding of the social policy reflected by this legislation as well as the standards which have been promulgated for child-resistant packaging may go far to ameliorate the frustrations of those who have to deal with the requirements of the Act on a daily basis. A discussion of the historical evolution of the 1970 Act and the controversy surrounding it is followed by a review of the standards for child-resistant packaging and exemptions from the requirements of the Act. A discussion of physician and patient waivers focuses on the desirability of documentation. The role of the Act in a professional liability suit is anticipated. A list of the drugs which are currently under consideration for exemption is provided. A better understanding of this legislation should enable health professionals to better deal with their patients.

Some Legal Issues Presented in Clinical Pharmacy Practice

As the pharmacists clinical role expands he is confronted with legal questions concerning actual or proposed activities. A number of papers have appeared in the literature of pharmacy which address the potential legal liability of the pharmacist who engages in clinical activity but most are written in terms of general principles of law with few specific circumstances addressed. In this article, legal questions raised by clinical pharmacists in the course of their everyday practices are evaluated and discussed. Among the issues presented are use of an FDA-approved drug for an unapproved use, informed consent in administration of unapproved drugs, the role of the pharmacist in managing hypertensive patients visiting a hospital-based clinic, the legality of a pharmacist administering injectible drugs, the legality of permitting Pharm.D. students to draw blood, and the application of the Federal Food, Drug and Cosmetic Act to the preparation of aluminum hydroxide cookies for dialysis patients. The specific questions are answered and the legal standard of care expected of pharmacists performing clinical functions is discussed. While no cases have been decided yet concerning newer clinical activities, some precedent can be found in past cases. Approaches to handling these questions should be of value in addressing future legal issues presented as pharmacists further seek to better utilize their knowledge.

Educational innovations: categories of bulletin board postings designed to increase awareness of contemporary pharmaceutical policy issues

Objective The goal of this project was to categorize and classify bulletin board postings pertaining to pharmaceutical policy from both the professional and lay press. Methods Bulletin board postings were used to supplement in-class discussion to keep students, faculty and staff up-to-date on emerging trends. A bulletin board located in the main classroom area of the College of Pharmacy Building where students would pass by on the way to class and congregate during break periods was used to display articles from various sources concerning topics related to pharmaceutical policy. Information is presented about the primary subject matters addressed in the articles, the types of publications from which they were drawn, and the top ten sources of articles displayed. Results This project showed that coverage of issues related to pharmacists is predominantly seen in newspapers and most pertinent issues are business related. Conclusions It can be seen from this analysis that the issues facing pharmacists are varied. The pharmaceutical policy field is transforming and many of these changes are very relevant to the general population. This is seen from the coverage of all of these issues in the lay press.

Legal issues surrounding the number of dosage units dispensed.

Pharmacists often are called upon to adjust the number of dosage units dispensed pursuant to a prescription. Common examples are requests to dispense half or double the amount requested by the prescriber. In some cases, reductions in quantity may be dictated by the provisions of a prescription drug insurance program, either private or governmental. A review of the literature reveals very little information on the legality of such actions by pharmacists. Focusing on both the federal Food, Drug and Cosmetic Act and the federal Controlled Substances Act, a review of the law in this area is presented. Some states also have provisions, either in statutes or regulations, that address the issue. Specific examples are presented and discussed, with the goal being to clarify the law in this area with which the pharmacist must deal on a daily basis.

Direct-to-Consumer Advertising Implications for the Pharmacist and Other Health Professionals

Direct-to-consumer advertising of prescription-only medications is big business for pharmaceutical manufacturers and has altered the relationship between patients and health professionals. Seeing promotional messages from the manufacturer of a pharmaceutical can have both positive and negative impacts. These are discussed along with current efforts to control activities in this area as well as possible future developments.

Policy-Related Degree Options for Pharmacists Interested in Careers in the Health Care Field

Policies exist at many levels and impact the practice of pharmacy in a wide variety of ways. Some pharmacists may seek advanced education related to policy development and assessment. In this article, policy is defined and the various ways the term is used with regard to the profession are reviewed with selected examples provided. Sources of information about policy-related degree programs offered both by educational units primarily focusing on pharmacy and units outside the specialty area are emphasized along with points to consider in making a decision. Examples of career opportunities are provided and questions to consider are presented.

Pharmacy and Public Policy: Evolution of the Legal and Regulatory Framework for Generic Interchange

The past 40 years have seen a movement in the profession of pharmacy to modify the strictures on professional judgment and professional service to patients emanating from antisubstitution laws, both statutes and regulations, at the state level of government. The shift of responsibility for preparing final dosage forms more and more from the community pharmacist to the pharmaceutical industry led the brand name pharmaceutical manufacturers to form an organization to seek enactment of restrictions on the ability of pharmacists to select the brand of medication to be dispensed. Beginning in 1970, the American Pharmaceutical Association sought to change these laws, and through that decade, coalitions were formed with a variety of groups to effect the modifications. A variety of public policy issues were presented for consideration as part of this movement, with the states adopting a variety of approaches, with all jurisdictions eventually restoring to pharmacists the ability to make professional judgments in the area of drug product selection. This initiative within the profession was a highlight of the past century and may have built the confidence of pharmacists to seek other modifications in public policy related to the legal and regulatory framework within which they practice. This article was adapted from a presentation before the American Society for Pharmacy Law 31st/American Pharmaceutical Association 153rd Annual Meeting, San Francisco, CA, March 18, 2006.