'Best practices for health-system pharmacy, 1999-2000', edited by Joseph H. Deffenbaugh. Pp xvii+518. Price $48.50. Bethesda, Maryland: American Society of Health-System Pharmacists, 1999. ISBN 1 879907 99 2.
The monographs in this book are intended to foster improvements in pharmacy practice and patient care. Practice standards have evolved as a result of advances in technology, research and lessons gained from experience. The book is structured by topics to help readers to locate quickly, related position statements and practice guidelines. Under each topic is listed the relevant American Society of Health-System Pharmacists (ASHP) positions, statements, guidelines and technical assistance bulletins.
In the chapter on automation and information technology, a series of ASHP position papers is presented. This includes use of machine-readable code technology, electronic information systems, telepharmacy, electronic entry of medication orders (prescriptions) and patient information systems.
A statement from the ASHP, which is a declaration and explanation of basic philosophy or principle, on the pharmacist's role with respect to drug delivery systems and administration devices, then follows and the chapter ends with guidelines on the safe use of automated medication storage and distribution devices. This style is repeated for the monographs on drug distribution and control, education and training, ethics, formulary management, government (law and regulation), medication misadventures, medication therapy and patient care, the pharmaceutical industry, pharmacy management, practice settings and research.
In addition to the practice standards, the book also describes a series of therapeutic position statements such as the use of aspirin for prophylaxis of myocardial infarction. The position statement suggests that many eligible patients remain untreated with aspirin and the ASHP encourages pharmacists to help to alleviate this problem.
Other therapeutic position statements include antithrombotic therapy in chronic atrial fibrillation, safe use of oral non-prescription analgesics, strategies for preventing and treating multidrug-resistant tuberculosis and smoking cessation.
In order to make best use of this book, a careful reading of the introduction is essential so that difficulties in understanding the terminology can be overcome. What is a "position"? How does it differ from a "statement" or a "guideline" or an "endorsement"? The ASHP has attempted, with some success, to include all its policy documents in one reference source. While many of the documents relate to the practice of pharmacy in the United States, much can be transferred nearer home.
Reviewer - Laurence A. Goldberg
Laurence Goldberg is a pharmaceutical consultant based in Bury, Lancashire