The American Medical Directors Association (AMDA) has addressed an emerging ethical concern about the role of pharmacists in recommending prescription medications for long-term care residents "based solely on enhancing profitability," without regard to the individual needs of patients.
The AMDA board of directors issued a position statement in September after investigating a problem raised by one of its 7,200 members. Tom von Sternberg, a Minnesota physician, informed the association that he had received a faxed recommendation from a pharmacy for prescribing a certain brand-name medication. The fax included the patient's health information and a preprinted prescription that Sternberg only needed to sign to approve the change. Not only did von Sternberg find the recommendation inappropriate for the particular patient, but also he took issue with the format of the fax, which, he said, "made it far too possible that a busy physician would sign the prescription without fully realizing the intent He called such a practice "unethical."
AMDA developed the position statement, which is posted on the group's website at www amda.com, after seeking input from organizations representing professionals in long-term care settings, including pharmacy providers, consultant pharmacists and pharmaceutical manufacturers.
In the statement, AMDA, based in Columbia, Md., stipulates that prescribing recommendations from pharmacists "must be evidence-based and made in the context of a patient's entire medical and psychosocial condition, prognosis, quality of life and the patient's or surrogate's wishes. …