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• Cover Letter
• Table of Contents
• Registry Partner Organizations
• Organization Summaries
• Quick Reference of Listed Projects
• Project Summaries

National Registry
Partnerships to Advance Therapeutics (PATHs) March 2004

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CERTs Coordinating Center, Duke University Medical Center, P. O. Box 17969, Durham, NC 27715 (919) 668 -8543 Fax (919) 668-7166 http://www.certs.hhs.gov
March 2004

Letter from the CERTs

Welcome to the 4th annual Partnerships to Advance Therapeutics (PATHs) meeting. At the first annual meeting in 2001, the CERTs Coordinating Center responded to the
PATHs partners' request to develop, survey, and distribute a registry of projects describing therapeutic initiatives among PATHs partners. The first PATHs Registry was
distributed in March 2002 at the second annual meeting.

The Registry contains information on research and educational projects from various organizations committed to improving the use of therapeutics. It includes summaries of
the goals and objectives of many of the organizations participating in the program as well as descriptions of projects. We hope that the Registry continues to serve as a valuable
national resource for information about collaborative opportunities that address important therapeutics issues.

We welcome your organization to submit information to the registry using the forms located on the CERTs Web site: http://www.certs.hhs.gov/partners/paths/regis/index.html
If you have questions regarding the PATHs program or the Registry, please feel free to contact Ms. Rene Hamilton, CERTS Coordinating Center, at rene.hamilton@duke.edu.
Thank you for your commitment to PATHs and participation in the PATHs Registry.

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PATHs National Registry 2004

Table of Contents

PATHs Partners............................................................... page 4
Organizational Summaries.................................................... pages 5-27
Quick Reference to Projects.................................................. pages 28-33
Project Summaries............................................................. pages 34-79

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PATHs National Registry Partner Organizations

For questions or comments, please contact René Hamilton at (919) 668 -8543 or e-mail rene.hamilton@duke.edu CERTs Coordinating Center, Duke University Medical Center, P. O. Box 17969, Durham, NC 27715
Fax (919) 668-7166 http://www.certs.hhs.gov

Academy of Managed Care Pharmacy -AMCP
AcademyHealth -AH
AdvancePCS -APCS
Agency for Healthcare Research and Quality -AHRQ
American College of Cardiology -ACC
American College of Clinical Pharmacology -ACCP/ Pharmacology
American College of Clinical Pharmacy -ACCP/ Pharmacy
American Heart Association -AHA
American Medical Association -AMA
American Nurses Association -ANA
American Pharmacists Association -APA
American Society of Health-System Pharmacists -ASHP
American Society of Health-System Pharmacists Research and Education Foundation -ASHPF
Arthritis Foundation -AF
Centers for Disease Control and Prevention -CDC
Centers for Education and Research on Therapeutics -CERTs
Centers for Medicare & Medicaid Services -CMS
Council for Affordable Quality Healthcare -CAQH
Food and Drug Administration -FDA
International Society for Pharmacoepidemiology -ISP
International Society for Pharmacoepidemiology -ISPE
Marshfield Medical Research Foundation -MMRF
National Council on Patient Information and Education -NCPIE
National Pharmaceutical Council -NPC
National Quality Forum -NQF
Pharmaceutical Research and Manufacturers of America - PhRMA

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Organizational Summaries

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Academy of Managed Care Pharmacy
Mission
To empower our members to serve society by using sound medication principles and
strategies to achieve positive patient outcomes.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. Ensuring positive health care outcomes through quality, accessible and affordable pharmaceutical care.
2. Encourage patient-focused medication management, including an emphasis on improved quality of life, positive outcomes, the affordability and accessibility of prescription medications.
3. Promote, document and/ or demonstrate the value of managed care pharmacy.

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AcademyHealth
Mission
In collaboration with its members and other key stake holders, AcademyHealth supports
the best health services research through
1) Expanding and improving the scientific basis of the field;
2) Increasing the capabilities and skills of researchers; and
3) Promoting the development of the necessary financial, human, infrastructure, and data resources.

AcademyHealth facilitates the use of the best available health services research and
health policy information by;

1) Translating research findings and the lessons of experience into useful information for clinical, management, and policy decisions;
2) Enhancing communication and interaction between health services researchers and health policy-makers; and
3) Identifying areas in which additional research is needed to better inform decisions

Top objectives/ goals relative to optimizing the use of therapeutics: Although we don't have a specific project to include in the registry, we support development of the resources needed and the dissemination of research to inform practice.

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AdvancePCS
Mission
To provide the most cost-effective use of therapeutic interventions for consumers.

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Reduce the rate of adverse drug events.
2. Develop and implement improved adverse event surveillance techniques.
3. Develop and implement point of prescribing information systems.

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Agency for Healthcare Research and Quality
Mission
To improve the quality, safety, efficiency, and effectiveness of health care for all
Americans.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. Support the study of the relative effectiveness, appropriateness, and cost-effectiveness of alternative strategies for the prevention, diagnosis, treatment, and management of clinical conditions.
2. Development and administration of research programs related to patient outcomes associated with pharmaceutical therapy.

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American College of Cardiology
Mission
The mission of the American College of Cardiology is to foster optimal
cardiovascular care and disease prevention through professional education, promotion
of research, leadership in the development of standards and guidelines and the
formulation of health care policy.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. Deliver professional education through in-person and online services to give members up-to-date research, guidelines, education and information relevant to clinical practice;
2. Increase efforts and opportunities for the continued improvement of cardiovascular quality of care
3. Strengthen advocacy for the improved health of members' patients;
4. Enhance the benefits of membership in the American College of Cardiology.

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American College of Clinical Pharmacology
Mission
The American College of Clinical Pharmacology strives to be the premier
professional society with the size, influence and diversity of membership consistent
with the breadth of the discipline of clinical pharmacology that will
1) Provide innovative, unbiased, quality educational programs and forums for our
membership, fellow health professionals, students and the public,
2) Lead in the development and dissemination of basic and clinical
knowledge to improve rational drug use and patient outcomes,
3) Support and encourage discovery and development efforts designed to provide
improved therapeutic modalities,
4) Serve as a forum for active public debate
to influence scientific, regulatory, and public health policy issues, and
5) Serve the membership through ongoing, open communication, recognition of excellence and service, and by providing opportunities to influence future directions of the College

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Publish the Journal of Clinical Pharmacology.
2. Provide the highest quality educational programs in clinical pharmacology.
3. Endorse the efforts of organizations or agencies to influence scientific, regulatory, and public health policy issues

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American College of Clinical Pharmacy
Mission
ACCP/ Pharmacy is a professional and scientific society that provides leadership,
education, advocacy, and other resources that enable clinical pharmacists to achieve
excellence in practice and research.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. Advocate for amendment of the Social Security Act to add pharmacists to the group of recognized providers of health services.
2. Double funding support provided for research awards and fellowships by the ACCP/ Pharmacy Research Institute.
3. Double the number of ACCP/ Pharmacy members who are board certified

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American Heart Association
Mission
Reduce disability and death from cardiovascular diseases and stroke.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. Support professional education in the area of cardiovascular disease and stroke by providing healthcare professionals up-to-date research guidelines, education and information relevant to clinical practice, funding research, and publishing scientific journals (e. g., Circulation, Circulation Research, Stroke, Hypertension, and Arteriosclerosis, Thrombosis, and Vascular Biology).
2. Increase efforts and opportunities for the continued improvement of cardiovascular disease quality improvement through the development and dissemination of: scientific guidelines and statements; tools to implement scientific guidelines and statements; and educational materials for the general public and patients around primary and secondary prevention, risk factors and warning signs.
3. Advocate for cardiovascular disease and stroke patients, which might include prescription drug coverage, risk factor screening, and quality improvement initiatives

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American Medical Association
Mission
To Promote the art and science of medicine and the betterment of the public health.

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Improving patient safety by reducing risks and errors.
2. Clinical Quality Improvement.
3. Clinical Performance Improvement

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American Nurses Association
Mission
Nurses advancing our profession to improve health for all.

Top objectives/goals relative to optimizing the use of therapeutics:
1. Work for the improvement of health standards and availability of health care services for all people
2. Foster high standards of nursing
3. Stimulate and promote the professional development of nurse

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American Pharmacists Association
Mission
Provides information, education and advocacy to help all pharmacists improve
medication use and advance patient care.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. Expand access to and promote the value of pharmacist's care-giving services in obtaining positive health outcomes through optimal use of medications.

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American Society of Health-System Pharmacists
Mission
ASHP believes that the mission of pharmacists is to help people make the best
use of medications. The mission of ASHP is to advance and support the professional
practice of pharmacists in hospitals and health systems and serve as their collective
voice on issues related to medication use and public health.

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Publish and maintain continuously a comprehensive, unbiased, comparative, and evaluative drug information resource for physicians, pharmacists, and other health professionals (AHFS Drug Information-print and various electronic formats).
2. Facilitate the development and dissemination of evidence-based
professional consensus on important therapeutic controversies.
3. Promote fail-safe medication use in hospitals and health systems.
4. Encourage pharmacy departments in hospitals and health-systems to become formally engaged in implementing national quality indicators in drug therapy.

The ASHP Leadership Agenda focuses on:
1. Promoting fail-safe medication use in health systems,
2. Fostering evidence-based medication use in health systems,
3. Expanding access to the patient care services of health-system pharmacists,
4. Helping health-system pharmacists deal with the affordability and accessibility of pharmaceuticals,
5. Fostering an adequate supply of practitioners and practice leaders in health-system pharmacy

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American Society of Health-System Pharmacists Research and Education Foundation
Mission
The mission of the ASHP Foundation is to improve the health and well being of
patients in hospitals and health systems through appropriate, safe and effective
medication use. The Foundation provides leadership and conducts education and
research activities that foster the coordination of interdisciplinary medication
management leading to optimal patient outcomes. Emphasis is given to programs
that will have a major impact on advancing pharmacy practice in hospitals and health
systems, thereby improving public health.

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Conduct or provide grants to conduct research in therapeutic issues.
2. Provide educational sessions that advance optimal patient medication outcomes.
3. Provide awards and recognition for therapeutic research contributions to the pharmacy literature

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Arthritis Foundation
Mission
The mission of the Arthritis Foundation is to improve lives through leadership in the
prevention, control and cure of arthritis and related diseases.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. To support a unique and effective mix of research through the Arthritis Foundation Research Program (including national and chapter grants to support clinical and health services and outcomes research. See Project summary for example.)
2. To obtain Medicare coverage for outpatient prescription
drugs and biologic therapies, as a national leader working with other stake holders in this debate, by 2003, and for arthritis education activities, by 2004, to facilitate the control of arthritis.
3. To validate and implement, by 2006, the Arthritis Foundation Quality Indicator Set (AFQuIP) into performance measurement systems designed to improve arthritis quality of care in provider, health care organization, and consumer settings. (See Project Summary)
4. To provide high-quality, unbiased consumer education materials on therapeutics (e. g. brochures on specific medications, annual Drug Guide, press releases on new medications etc.)

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Center for Disease Control and Prevention
Mission
1. Reduce targeted catheter-associated adverse events by 50% in 5 years.
2. Reduce targeted surgery-associated adverse events by 50% in 5 years.
3. Reduce targeted antimicrobial-resistant infections by 50% in 5 years.
4. Reduce mortality and hospitalizations attributable to respiratory tract infections
among long-term care patients by 50% in 5 years.
5. Eliminate microbiology laboratory errors that cause adverse patient events in 5
years.
6. Eliminate occupational needle injuries
among healthcare personnel in 5 years.
7. Achieve 100% adherence to CDC
guidelines for immunization of healthcare personnel in 5 years

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Educate clinicians about the most appropriate use of antimicrobials in the healthcare setting (12 steps program).
2. Conduct intervention studies to improve prophylactic use of antimicrobials in surgical patients.
3. Conduct intervention studies to reduce the transmission of antimicrobial-resistant pathogens in healthcare settings.

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Centers for Education & Research on Therapeutics
Mission
To conduct research and provide education that will advance the optimal use of drugs,
medical devices, and biological products.
Top objectives/ goals relative to optimizing the use of therapeutics:
1. Increase awareness of both the uses and risks of new drugs and drug combinations, biological products, and devices as well as of mechanisms to improve their safe and effective use
2. To provide clinical information to patients and consumers; health care providers; pharmacists, pharmacy benefit managers, and purchasers; health maintenance organizations (HMOs) and health care delivery systems; insurers; and government agencies
3. To improve quality while reducing cost of care by
increasing the appropriate use of drugs, biological products, and devices and by preventing their adverse effects and consequences of these effects (such as unnecessary hospitalizations)

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Centers for Medicare and Medicaid Services
Mission
Assure health care security for beneficiaries. In serving beneficiaries, we
will open our programs to full partnership with the entire health community to
improve quality and efficiency in an evolving health care system. Among our
goals is to protect and improve beneficiary health and satisfaction and provide
leadership in the broader health care marketplace to improve health.

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Improve quality of care and health outcomes for the beneficiaries of CMS programs.
2. Protect beneficiaries from substandard or unnecessary care.
3. Continually improve CMS programs and operations by actively seeking and responding to the input of beneficiaries and the health care community

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Council for Affordable Quality Healthcare
Mission
CAQH is a not-for-profit alliance of health plans and networks that promotes
collaborative initiatives to help make healthcare more affordable, share
knowledge to improve the quality of care, and make administration easier for
physicians and their patients.

Top objectives/ goals relative to optimizing the use of therapeutics:
To increase appropriate use of antibiotics and reduce antibiotic resistance. To improve long term adherence to beta blockers post-myocardial infarction.

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HHS/ Food and Drug Administration
Mission
The FDA is responsible for protecting the public health by assuring the safety,
efficacy, and security of human and veterinary drugs, biological products,
medical devices, our nation's food supply, cosmetics, and products that emit
radiation. The FDA is also responsible for advancing the public health by helping to
speed innovations that make medicines and foods more effective, safer, and more
affordable; and helping the public get the accurate, science-based information they
need to use medicines and foods to improve their health.

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Use science-based efficient risk management in all Agency regulatory activities, so that the Agency's limited resources can provide the most health promotion and protection at the least cost for the public.
2. Enable consumers to make smarter decisions by getting them better information to weigh the benefits and risks of FDA-regulated products.
3. Seek continuous improvements in patient and consumer
safety by reducing risks associated with FDA-regulated products.
4. Strengthen FDA's capability to identify, prepare for, and respond to terrorist threats and incidents.

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International Society for Pharmacoepidemiology
Mission
ISPE is an international forum for the open exchange of scientific information among
academia, government, and industry and for the development of policy; a provider of
education; and an advocate for the fields of pharmacoepidemiology and therapeutic risk
management.

Top objectives/ goals relative to optimizing the use of therapeutics:

1. Establish scientific forums
   °Convenes annual scientific forum and mid-year meeting.
2. Disseminates scholarly and practical information
   °Newsletter, Scribe
   °Journal, Pharmacoepidemiology & Drug Safety
3. Facilitates communication and capacity building
   °Directories of pharmacoepidemiology resources
   °Courses in pharmacoepidemiology and therapeutic risk management

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National Council on Patient Information and Education
Mission
Formed in 1982 as one of the original patient safety coalitions, NCPIE's mission
is to improve communication between health care professionals and
patients/ consumers about the safe, appropriate use of medicines. Its over 100
coalition members include health professional associations, consumer and
patient advocacy groups, pharmaceutical manufacturers, academic institutions, and
state and federal government agencies (e. g., FDA, AHRQ, Administration on Aging).
NCPIE maintains two Web sites: http://www.talkaboutrx.org and
http://www.bemedwise.org

Top objectives/ goals relative to optimizing the use of therapeutics:
1. Pursuant to "Healthy People 2010" (objective #17-4) and Public Law 104-180, promote the development and awareness of enhanced written consumer medicine information (leaflets that accompany prescriptions obtained at pharmacies), in accordance with guidelines for "usefulness".
2. Promote public and professional awareness of the importance of oral counseling (at the point of prescribing and dispensing) as a supplement to distribution of written consumer medicine information (see "Healthy People 2010" Objective #17-5).
3. Six of the top 10 most frequently used medicines are available without a prescription. Promote the safe, appropriate use of non-prescription medicines by
encouraging consumers to: (1) ask questions of health professionals prior to using OTC products, and (2) read carefully the "Drug Facts" label

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National Pharmaceutical Council
Mission
NPC conducts, supports and disseminates research for health care decision makers
and public and private payers on behalf of the research-based pharmaceutical industry.
NPC has three major strategies:
A) Development of intellectual assets.
B) Partnering with member companies and outside organizations to achieve maximum
impact.
C) Direct dissemination of programs and products

Top objectives/ goals relative to optimizing the use of therapeutics:
Replace component management with a systems approach to pharmaceutical therapy based on:
1. Integrating total patient care,
2. Recognizing the total cost/ benefit over time,
3. Aligning incentives,
4. Developing more accurate measures for integrated care.

Foster appropriate use of pharmaceuticals through:
1. Timely and accurate diagnosis,
2. Initiation of treatment for diagnosed conditions,
3. Rapid adoption of "state-of-the-art" therapies,
4. Patient compliance with treatment regimens

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Quick Reference Of Listed Projects

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Project Summaries

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Academy of Managed Care Pharmacy
ID: AMCP-DDI
Status: Currently ongoing
Title: On-line Drug-Drug Interaction Initiative
Description: Drug-drug interaction system improvement
Key Words: drug-drug interactions, online drug utilization review
Partners: American Pharmacists Association, National Association of Chain Drug Stores, National Community Pharmacy Association, American Society for Automation in Pharmacy, US Pharmacopeia, Pharmaceutical Care Management Association
Desire Additional Partners: yes
Comments on Partners:
Partners Description: drug database vendors
Contact: Marissa Schlaifer
(703) 683-8416 x303
mschlaifer@amcp.org
Year Added: 2004
Last Update: 2004

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American College of Cardiology
ID: ACC-001
Status: Currently ongoing
Title: CERTs - Duke University Medical Center
Description: The goal of this project is to enhance the state of knowledge about the quality of using therapeutics in cardiovascular disease, within a conceptual framework that will stimulate a more efficient approach to knowledge development and dissemination.
Key Words: clinical trials, research, guidelines, quality indicators, performance, outcome, quality cycle
Partners: Duke University Medical Center
Desire Additional Partners: no
Comments on Partners:
Contact: Paula Thompson, MPH
(301) 493-2389
pthompso@acc.org
Year Added: 2003
Last Update: 2004

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American College of Clinical Pharmacy
ID: ACCP/ Pharmacy-001
Status: Currently ongoing
Title: Pharmacotherapy Self-Assessment Program (4th edition)
Description: Comprehensive, modular-based home-study program that updates and assesses pharmacotherapy knowledge in 19 therapeutic areas.
Key Words: pharmacotherapy, self-assessment, home study
Partners: American Society of Health-System Pharmacists
Desire Additional Partners: yes
Comments on Partners: Promote PSAP use by their members.
Contact: Kristin Povilonis
(816) 531-2177
kpovilonis@accp.com
Year Added: 2002
Last Update: 2003

ID: ACCP/ Pharmacy-002
Status: Currently ongoing
Title: Updates in Therapeutics
Description: Web-based updates on more than 60 therapeutic topics in pharmacotherapy, psychiatry, oncology, and nutrition support. www.accp.com
Key Words: on-line, drug therapy, education
Partners: None
Desire Additional Partners: yes
Comments on Partners: Promote use by their members.
Contact: Peggy Kuehl
(816) 531-2177
pkuehl@accp.com
Year Added: 2002
Last Update: 2002

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ID: ACCP/ Pharmacy-003
Status: Currently ongoing
Title: Pediatric Medication Education Text
Description: More than 200 monographs written at 6th grade level in English and Spanish for use in patient education.
Key Words: pediatrics, drug information, patient education
Partners: None
Desire Additional Partners: yes
Comments on Partners:
Contact: Wendi Kishi
(816) 531-2177
wkishi@accp.com
Year Added: 2002
Last Update: 2002

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American Heart Association/ American Stroke Association
ID: AHACLD001
Status: Currently ongoing
Title: The Cholesterol Low Down
Description: The Cholesterol Low Down teaches families what they can do to manage their cholesterol, including diet, exercise and therapeutics.
Key Words: cholesterol, prevention, diet, exercise, AHA, risk factors, education, treatment
Partners: Pfizer
Desire Additional Partners: yes
Comments on Partners: The American Heart Association would be interested in collaborative activities to increase awareness and compliance with guidelines.
Contact: Pamela Garmon
(214) 706-1650
pamela.garmon@heart.org
Year Added: 2004
Last Update: 2004

ID: AHAGWTG001
Status: Currently ongoing
Title: Get With The Guidelines
Description: The Get With The Guidelines program is a rapid cycle quality improvement hospital-based program that helps improve patient outcomes. This program makes it possible forthe healthcare provider team to consistently treat every patient in the hospital setting with the most updated guideline information.
Key Words: guidelines, secondary prevention, quality indicators, performance, outcome, quality improvement, hospital implementation
Partners: Hospitals, Health Systems, QIOs, Health Plans, Health Departments
Desire Additional Partners: yes
Comments on Partners: The American Heart Association would be interested in collaborative activities to increase awareness and compliance with guidelines.
Contact: Diane Porter
(214) 706-1829
diane.porter@ heart.org
Year Added: 2004
Last Update: 2004

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ID: AHAHOD001
Status: Currently ongoing
Title: Heart of Diabetes
Description: The Heart of Diabetes works by first giving people the knowledge they need in managing their Diabetes, including diet, exercise and therapeutics.
Key Words: diabetes, prevention, diet, exercise, AHA, risk factor, education, treatment
Partners: Eli Lilly & Company, Takeda Pharmaceuticals North America, Inc.
Desire Additional Partners: yes
Comments on Partners: The American Heart Association would be interested in collaborative activities to increase awareness and compliance with guidelines.
Contact: Pamela Garmon
(214) 706-1650
pamela.garmon@ heart.org
Year Added: 2004
Last Update: 2004

ID: AHAHP001
Status: Currently ongoing
Title: Heart Profilers
Description: Through a series of online questions, Heart Profilers provides patients treatment options for a variety of cardiovascular disease risk factors, including condition specific therapeutics.
Key Words: secondary prevention, diet, exercise, AHA, risk factors, education, treatment
Partners: Nexcura, Guidant Corporation, KOS Pharmaceuticals
Desire Additional Partners: yes
Comments on Partners: The American Heart Association would be interested in collaborative activities to increase awareness and compliance with guidelines.
Contact: Martha Harry
(214) 706-1927
martha. harry@heart.org
Year Added: 2004
Last Update: 2004

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American Pharmacists Association
ID: APA-001
Status: Planned and wills start within year
Title: Maximizing the pharmacist's role in risk management.
Description: Exploring use of a performance-based group of pharmacists and pharmacies to improve risk management initiatives.
Key Words: pharmacist, pharmacy
Partners: None
Desire Additional Partners: yes
Comments on Partners: Academia, industry, other health professional organizations
Contact: Susan Winckler
(202) 429-7533
swinckler@APhAnet.org
Year Added: 2003
Last Update: 2003

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American Society of Health-System Pharmacists
ID: ASHP-001
Status: Currently ongoing
Title: Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Adult Critically Ill Patient
Description: These Clinical Practice Guidelines focus on maintaining an optimal level of comfort and safety for critically ill patients. This document includes an evaluation of the literature published since 1994 comparing the use of these agents. This document is limited to a discussion of prolonged sedation and analgesia and excludes use for short-term (minutes to hours) procedures. The focus is on patients > 12 years of age.
Key Words: guidelines, sedation, analgesia, critical care, drug therapy, monitoring
Partners: This guideline is a joint effort. The developed is with the Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), in collaboration with the American Society of Health-Systems Pharmacists (ASHP); in alliance with the American College of Chest Physicians
Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities to increase awareness and compliance with the guidelines. Published in: Am J Health-Syst Pharm: 59: 150-178. January 2002
Contact: Cynthia LaCivita, Pharm. D.
301-657-3000 X1210
clacivita@ashp.org
Year Added: 2002/ 03
Last Update: 2004

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ID: ASHP-002
Status: Currently ongoing
Title: Clinical Practice Guidelines for the Sustained Use of Neuromuscular Blocking Agents in the Adult Critically Ill Patient
Description: These Clinical Practice Guidelines focus on maintaining an optimal level of comfort and safety for critically ill patients with regard to using neuromuscular blocking agents. This document includes an evaluation of the literature published since 1994 comparing the use of these agents.
Key Words: guidelines, neuromuscular blocking agents, intensive care, critical care, drug therapy, monitoring
Partners: This guideline is a joint effort. The developed is with the Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), in collaboration with the American Society of Health-Systems Pharmacists (ASHP); in alliance with the American College of Chest Physicians.

Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities to increase awareness and compliance with the guidelines. Published in AM J Health-Syst Pharm: 59: 179-195. January 2002.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashporg
Year Added: 2002/ 03
Last Update: 2004

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ID: ASHP-003
Status: Currently ongoing
Title: ASHP Therapeutic Position Statement on the Use of HMG-CoA Reductase Inhibitors in the Prevention of Atherosclerotic Vascular Disease
Description: The position statement encourages pharmacists to become involved and support the use and encourages of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors or " statins" to lower blood cholesterol and reduce morbidity and mortality in eligible patients at risk for atherosclerotic events. Statin therapy has been shown to reduce the risk of fatal and non-fatal myocardial infarction, unstable angina, and the need for revascularization procedures in hypercholesterolemic patients without known ASVD (primary prevention). In addition, statins have reduced all-cause mortality and stroke for patients with ASVD (secondary prevention).
Key Words: drug therapy, monitoring, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, statins, cholesterol, atherosclerotic events, primary prevention, secondary prevention
Partners: None
Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities o increase awareness and compliance with guidelines. The Therapeutic Position Statement will be published in early spring of 2003.
Contact: Cynthia LaCivita, Pharm. D.
301-657-3000 X1210
clacivita@ashp.org
Year Added: 2002/ 03
Last Update: 2004

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ID: ASHP-004
Status: Currently ongoing
Title: ASHP Therapeutic Position Statement on Low Molecular Weight Heparin for Adult Outpatient Treatment of Deep Vein Thrombosis
Description: The outpatient use of low-molecular-weight heparin (LMWH) is a safe and effective means of treating acute deep vein thrombosis (DVT). The American Society of Health-System Pharmacists supports the use of outpatient LMWH therapy in appropriate patients, on the basis of clinical evidence indicating that (1) outpatient treatment of acute DVT with LMWH has been shown to be as safe and effective as traditional inpatient therapy utilizing unfractionated heparin, (2) outpatient treatment of acute DVT with LMWH has been associated with increased patient satisfaction compared to traditional inpatient therapy, and (3) outpatient treatment of acute DVT with LMWH is often more cost-effective than traditional inpatient therapy. Pharmacists should actively participate in developing, implementing and monitoring the success of outpatient DVT treatment programs using LMWH within their health-care systems.
Key Words: outpatient, low-molecular-weight heparin, safe, effective, deep vein thrombosis, evidence, unfractionated heparin
Partners: None
Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities to increase awareness for treatment and prevention and compliance with evidence based medicine.
Contact: Cynthia LaCivita, Pharm. D.
301-657-3000 X1210
clacivita@ashporg
Year Added: 2002/ 03
Last Update: 2004

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ID: ASHP-005
Status: Currently ongoing
Title: ASHP Therapeutic Position Statement on the Use of B-Blockers for the secondary prevention after acute myocardial infarction
Description: ASHP supports the use of B-blockers for secondary prevention in patients surviving an acute myocardial infarction. Strong and consistent evidence derived from randomized controlled trials demonstrates that the administration of B-blockers to patients post-myocardial infarction reduces morbidity and mortality. Despite these findings, B-blockers are underused in clinical practice leading to increased mortality and rehospitalization rates of infarct survivors. ASHP recognizes that mortality among infarct survivors can be reduced through improved use of B-blocker therapy.
Key Words: B-blockers, secondary prevention, acute myocardial infarction, post-myocardial infarction bradycardia, AV nodal conduction delays, pulmonary disease, contra-indications
Partners: None
Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities to increase awareness and compliance with guidelines.
Contact: Cynthia LaCivita, Pharm. D.
301-657-3000 X1210
clacivita@ashp.org
Year Added: 2002/ 03
Last Update: 2004

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45 Page 46 47

ID: ASHP-006
Status: Currently ongoing
Title: ASHP Therapeutic Position Statement on Strict Glycemic Control in Patient with Diabetes
Description: The maintenance of strict glycemic control in patients with type 1 and type 2 diabetes mellitus has been shown to reduce the appearance and the progression of the chronic complications: nephropathy, retinopathy, and neuropathy. A strong trend towards a risk reduction in macrovascular disease in patients managed with strict glycemic control has also been demonstrated. Additionally, several compelling biochemical mechanisms by which hyperglycemia causes tissue damage have been proposed. The medication utilized for glycemic control in patients with type 1 disease is insulin. Type 2 patients may be managed with oral agents monotherapy, combination oral agents therapy, combination oral agent/ insulin therapy or insulin monotherapy. ASHP supports the maintenance of reasonable glycemic control in all patients with diabetes mellitus. The glycemic goal for patients will vary depending of a number of factors including; 1) age of the patient, 2) predisposition to hypoglycemia, 3) ability to follow various treatment regimens. However in the vast majority of cases patients should be managed to achieve a hemoglobin A1C value of < 7% as is recommended by the American Diabetes Association.
Key Words: hyperglycemia, type 1 diabetes mellitus, type 2 diabetes mellitus, nephropathy, retinopathy, neuropathy, risk reduction, macrovascular oral agents, monotherapy, insulin, hemoglobin A1C
Partners: None
Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities to increase awareness and compliance with the guidelines.
Contact: Cynthia LaCivita, Pharm. D.
301-657-3000 X1210
clacivita@ashp.org
Year Added: 2002/ 03
Last Update: 2004

46 Page 47 48

ID: ASHP-007
Status: Planned and will start within year
Title: ASHP Therapeutic Position Statement on Strategies for Identifying and Preventing Pneumococcal Resistance
Description: Supports collaborative efforts with pharmacists and other health care providers in identifying and preventing Pneumococcal Resistance
Key Words: vaccination, drug therapy, pneumococcal, resistance, prevention
Partners: None
Desire Additional Partners: yes
Comments on Partners: Experts to collaborate in document development, review or dissemination of information.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.org
Year Added: 2002/ 03
Last Update: 2004

ID: ASHP-008
Status: Planned and will start within year
Title: ASHP Therapeutic Position Statement on Strategies for Preventing and Treating Multidrug-Resistance Tuberculosis
Description: Supports collaborative efforts with pharmacists and other health care providers in preventing and treating multidrug-resistance tuberculosis
Key Words: treatment, drug therapy, resistance, prevention, multidrug-resistance, tuberculosis
Partners: None
Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities to increase awareness on strategies for identifying and preventing multidrug-resistance tuberculosis.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2002/ 03
Last Update: 2004

47 Page 48 49

ID: ASHP-009
Status: Planned and will start within year
Title: ASHP Therapeutic Position Statement on the Treatment of Attention Deficit Hyperactivity Disorder
Description: To increase the awareness with pharmacists on the treatment of Attention Deficit Hyperactivity Disorder, including the appropriate use of medications and monitoring.
Key Words: treatment, attention deficit hyperactivity disorder, pediatric, children, adolescents, monitoring, drug therapy
Partners: None
Desire Additional Partners: yes
Comments on Partners: Identification of knowledgeable outside reviewers, possible commentaries or editorials to accompany the final document.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2002/ 03
Last Update: 2004

ID: ASHP-010
Status: Currently ongoing
Title: ASHP - AHA Medication Safety Issue Briefs
Description: The American Society of Health-System Pharmacists, Center on Patient Safety, and the American Hospital Association Collaborated on a series of six Medication Safety Issue Briefs. This series was published in the AHA publication Hospitals and Health Networks. The intended audiences are hospital administrators. The topics were as follows: Creating a Culture of Safety; Using Automation to Reduce Errors; Asking Consumers for Help; Using a System-wide Approach; Crucial Role of Therapeutic Guidelines; and Finding and Using Resources.
Key Words:
Partners: American Hospital Association, American Society of Health-System Pharmacists. Funding provided by McKesson HBOC
Desire Additional Partners: no
Comments on Partners:
Contact: Kasey K. Thompson
301-657-3000 X 1270
kthompson@ashp.org
Year Added: 2002
Last Update: 2004

48 Page 49 50

ID: ASHP-011
Status: Currently ongoing
Title: Medication Safety Officer
Description: The goal of this project is to develop a job description for a health system Medication Safety Officer. It is envisioned that the health system Medication Safety Officer would coordinate, and oversee all aspects of safety and quality in the medication-use process. The project includes three distinct phases. In Phase I ASHP educational design experts conducted a task analysis of individuals currently working as hospital / health system Medication Safety Officers. Experts from medicine, pharmacy, human factors, and epidemiology will analyze data from the task analysis to design an idealized job description. In phase II research will be done to test the effectiveness of someone performing the proposed tasks in a hospital / health system setting to determine if safety is, in fact, improved. In Phase III education will be developed to train individuals to become health system Medication Safety Officers.
Key Words: medication, safety, pharmacy, medicine, human factors, research, education, interdisciplinary, hospitals, health systems
Partners: ASHP Research and Education Foundation
Desire Additional Partners: yes
Comments on Partners: Primarily in the research, and educational development phases. Interdisciplinary collaboration on this project is key to its success
Contact: Kasey K. Thompson
301-657-3000 X 1270
kthompson@ashp.org
Year Added: 2002
Last Update: 2004

49 Page 50 51

ID: ASHP-012
Status: Currently ongoing
Title: General Principles for the Purchase and Safe Use of Computerized Prescriber-Order Entry Systems
Description: The American Society of Health-System Pharmacists Center on Patient Safety developed a list of suggestions and questions to consider before purchasing a computerized prescriber-order entry (CPOE) system. This list, while not exhaustive, is intended as a tool to support the immediate need to act on this issue.
Key Words: CPOE, physician order entry, computerized, prescriber, safety, medication, pharmacists, hospitals, health systems
Partners: None
Desire Additional Partners: yes
Comments on Partners: We are currently seeking feedback on this document in the interest of strengthening its value for hospitals and health systems to use as tool when considering the purchase of a prescriber order entry system.
Contact: Kasey K. Thompson
301-657-3000 X 1270
kthompson@ashp.org
Year Added: 2002
Last Update: 2004

ID: ASHP-013
Status: Currently ongoing
Title: ASHP Therapeutic Position Statement on Strategies for Preventing and Treating Osteoporosis.
Description: This document supports the use of appropriate pharmacotherapy for the prevention and treatment of osteoporosis. Osteoporosis is a serious health disorder characterized by low bone mineral density and microarchitectural deterioration of bone tissue, leading to bone fragility. The document will focus on medications that have been shown to increase bone mineral density ands prevent fractures. Appropriate drug selection depends on several patient specific factors. Many patients at risk for osteoporosis or who have sustained an osteoporotic fracture remain undiagnosed or untreated.
Key Words: osteoporosis, low bone mineral density, microarchitectural deterioration of bone tissue, calcium, vitamin D, bisphosphonates, SERMS, calcitonin, and estrogen
Partners: None
Desire Additional Partners: yes
Comments on Partners: ASHP would be interested in collaborative activities to increase awareness and compliance with regard to treatment and prevention of osteoporosis.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2003
Last Update: 2004

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50 Page 51 52

ID: ASHP-014
Status: Planned and will start within year
Title: ASHP Therapeutic Position Statement on the Safe Use of Niacin in the Management of Dyslipidemias
Description: ASHP Therapeutic Position Statement are concise statements that respond to therapeutic issues of concern to health care providers and health care consumers. The revision of this document will be developed through the guidance of the ASHP Commission on Therapeutics and must be approved by the ASHP Board of Directors. The focus of this document is to revise and update the current document that supports the use of niacin products under the supervision of a qualified health care provider for the treatment of dyslipidemias in adults. Niacin is proven safe and effective in the management of most lipid disorders but requires ongoing monitoring by a health care provider to detect potential toxicities. Health care providers should teach patients how to minimize niacin' s bothersome adverse effects and encourage long-term adherence. Because a variety of nonprescription niacin products with various potentials for toxicity are available, pharmacists should actively monitor patient selection of niacin products and discourage patient self-treatment with niacin. In addition, pharmacists should work in conjunction with patients and their primary care providers to ensure adequate monitoring for toxicity and effectiveness of therapy.
Key Words: niacin, potential toxicities actively monitor, niacin products, discourages self-treatment with niacin
Partners: None
Desire Additional Partners: yes
Comments on Partners: Experts to collaborate in document development, review or dissemination of information.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2003
Last Update: 2004

51 Page 52 53

ID: ASHP-015
Status: Currently ongoing
Title: ASHP Therapeutic Statement on Preferential Use of Metronidazole for the Treatment of Clostridium difficile-Associated Disease.
Description: ASHP supports the use of oral metronidazole as the preferred antimicrobial agent for the treating Clostridium difficile-associated disease (CDAD). Oral metronidazole and oral vancomycin appear to be equally efficacious for the treatment of CDAD in most situations. Oral vancomycin should be reserved for the most severe cases. Asymptomatic carriers of C. difficile should not be treated for CDAD.
Key Words: oral metronidazole, treating clostridium difficile-associated disease (CDAD), oral vancomycin, equally efficacious
Partners: None
Desire Additional Partners: yes
Comments on Partners: Experts to collaborate in document development, review or dissemination of information.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2003
Last Update: 2004

52 Page 53 54

ID: ASHP-016
Status: Currently ongoing
Title: ASHP Therapeutic Position Statement on the Use of Aspirin for Prophylaxis of Myocardial Infarction.
Description: The effectiveness of aspirin as an antiplatelet agent in preventing myocardial infarction (MI) has been demonstrated in clinical trials in various patient groups. 1 However, despite adequate evidence of benefit, many eligible patients remain untreated with aspirin. 2,3 ASHP supports the long-term use of aspirin as an adjunct to modifying controllable risk factors for coronary artery disease for the following indications: (1) primary prophylaxis of MI in asymptomatic men older than 50 years of age with risk factors for coronary artery disease (i. e., hypercholesterolemia, smoking, diabetes mellitus, hypertension, family history of early onset coronary artery disease), 4 (2) stable5 or unstable6 angina, and (3) secondary prophylaxis of MI. ASHP supports the role of pharmacists in communicating to appropriate patients that modification of controllable risk factors for coronary artery disease (smoking, hypercholesterolemia, and hypertension) together with aspirin prophylaxis is the primary method of reducing the likelihood of MI.
Key Words: myocardial infarction, aspirin, risk factors, coronary artery disease, primary prophylaxis, MI, smoking, diabetes mellitus, hypertension.
Partners: None
Desire Additional Partners: yes
Comments on Partners: Experts to collaborate in document development, review or dissemination of information.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2003
Last Update: 2004

53 Page 54 55

ID: ASHP-017
Status: Currently ongoing
Title: ASHP Therapeutic Position Statement on the Recognition and Treatment of Depression in Older Adults.
Description: Depression in older adults is an under recognized, under diagnosed, and under treated health problem. ASHP supports collaborative efforts to ensure appropriate diagnosis and treatment of depression in older adults. ASHP encourages pharmacists to work with other health care providers to optimize the management of depression in older adults by increasing the public's awareness of depression as a public health problem and what it all entails.
Key Words: depression, older adults, under recognized, under diagnosed and untreated, risk factors, drug therapy, public awareness, educating, antidepressant pharmacotherapy
Partners: None
Desire Additional Partners: yes
Comments on Partners: Experts to collaborate in document development, review or dissemination of information.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2003
Last Update: 2004

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54 Page 55 56

ID: ASHP-018
Status: Currently ongoing
Title: ASHP Therapeutic Statement on the Use of Second Generation Antipsychotics Medication in the Treatment of Psychotic Disorders.
Description: ASHP supports the use of second-generation (" atypical" or "novel") antipsychotics for the treatment of individuals with psychotic disorders. ASHP believes the second-generation antipsychotics offer patients equal efficacy, better tolerability, and improved outcomes than older antipsychotics. ASHP encourages health professionals to consider these agents as first-line treatment for psychotic disorders. ASHP recognizes that schizophrenia, schizoaffective disorder, and other psychotic disorders are serious mental illnesses that can significantly affect the perceptual, affective, cognitive, and behavioral functioning of individuals with these conditions. The successful treatment of these disorders typically requires long-term treatment with antipsychotic medications, the use of adjunctive pharmacologic treatments and ongoing psychosocial and supportive interventions.
Key Words: second-generation antipsychotic, treatment, psychotic disorders, tolerability, improved outcomes, mental illnesses, functioning, continual treatment, psychosocial and supportive interventions
Partners: None|
Desire Additional Partners: yes
Comments on Partners: Experts to collaborate in document development, review or dissemination of information.
Contact: Cynthia LaCivita, PharmD
301-657-3000 X1210
clacivita@ashp.rg
Year Added: 2003
Last Update: 2004

55 Page 56 57

ID: ASHP-019
Status: Planned and will start within year
Title: ASHP Therapeutic Position Statement on Optimal Use of Insulin in Hospitalized Patients
Description: This document will focus on the optimal use of insulin in hospitalized patients and address the importance of glycemic control for patients with diabetes, as well as patients in whom diabetes has not previously been diagnosed. Hospitalized patients with poor glucose control are more likely to develop infections and have longer inpatient stays.
Key Words: hyperglycemia, diabetes, hospital,