A group known as the Pharmacy Practice Research Roundtable has issued a

list of 10 top-priority areas for investigation as guidance to the

government, private foundations, universities and others interested in

conducting or funding research on improving patient safety associated with

the use of medicines. The list, which was created from the perspective of

pharmacy practice, is based on consensus ideas for re-engineering the

medication-use system that emerged from a recent national

multidisciplinary conference on the subject.

The Pharmacy Practice Research Roundtable is a 15-member body of experts

convened and coordinated by the Center for Pharmacy Practice Research and

Development at Western University of Health Sciences (WesternU). It is

chaired by Max Ray, PharmD, dean of WesternU’s College of Pharmacy, and

funded by Cardinal Health, Inc. The 10 top-priority areas the group

identified at their meeting March 22-24 are as follows:

1. Initiate and support use of interdisciplinary health care teams to

manage the medication-use process for high-risk patients (those who are on

complex therapy).

2. Establish a clinical information system that allows health

professionals to exchange data (either an online system or a “”smart card””

system).

3. Support the establishment and use of a comprehensive health-related

electronic information database that includes a complete medical record,

owned by the patient; drug information (e.g., properties, dosing, adverse

effects); and treatment guidelines, practice guidelines and pertinent

literature and that is confidential.

4. Educate and empower patients to be active participants in decisions

regarding goals of treatment.

5. Develop and maintain a mechanism for “”hand-offs”” between health care

professionals and between practice settings.

6. Support the development and use of expert systems to guide medication

decision-making by health care providers.

7. Establish an epidemiologic method for detecting and reporting

medication errors and other medication-related problems.

8. Explore methods of communications in other complex systems and evaluate

their utility as models in health care.

9. Develop tools to monitor medication distribution systems for accuracy

and safety.

10. Develop educational strategies to help patients understand their

responsibilities in the medication-use process.

The 10 research priorities in medication safety were derived from the

results of the Conference on Re-engineering the Medication-Use System

conducted by the Joint Commission of Pharmacy Practitioners, October 1-3,

1999, in Baltimore, Maryland. (See the March 15, 2000, issue of American

Journal of Health-System Pharmacy for conference proceedings.) The

roundtable assessed all 42 strategies identified by the 108 pharmacists,

physicians, nurses and others at the conference and rated those that are

most amenable to scientific assessment. The roundtable believes that its

list will be especially helpful to research funding agencies that are

responding to the current national imperative to reduce the incidence of

medical error.

The Pharmacy Practice Research Roundtable was established at WesternU in

1998 to propose a specific research agenda related to pharmacy practice

based on an analysis of the key issues that affect the pharmacist’s

ability to help people make responsible use of medicines. For more

information about the list of research priorities or the Pharmacy Practice

Research Roundtable, contact Dr. Ray at WesternU’s College of Pharmacy,

309 E. Second Street, Pomona, CA 91766, or via e-mail to

mdray@westernu.edu).