Guidelines for Therapeutic Interchange—2004: American College of Clinical Pharmacy

Abstract

This publication is an update of the American College of Clinical Pharmacy (ACCP) Position Statement on "Guidelines for Therapeutic Interchange," 1 originally published in 1993.The ACCP supports the practice of therapeutic interchange, in which pharmacists collaborate with physicians and other health care professionals to develop policies and implement programs that improve drug use to provide the best possible patient care at the most affordable cost.The ACCP has established the following guidelines for implementing therapeutic interchange policies and procedures within health care organizations and other appropriate patient care settings:• Guideline I: Therapeutic interchange is appropriate in institutional and ambulatory settings that have a functioning formulary system and pharmacy and therapeutics committee or equivalent drug use policysetting bodies.• Guideline II: Organizations implementing therapeutic interchange programs must accept the obligation to measure their impact on the clinical, economic, and humanistic outcomes of care.• Guideline III: Therapeutic interchange, as defined herein, may be executed by pharmacists when prescribers have been advised of the policy set forth by the pharmacy and therapeutics committee or its equivalent.Notification to each individual prescriber need not occur for each interchange when institutional or organizational policies do not require such.In other cases, prescribers should be notified within a reasonable time frame through written, oral, or electronic communication.Use of technology to aid in managing the therapeutic interchange policy is highly desirable.• Guideline IV: The pharmacy and therapeutics committee or an equivalent body should ensure that professional staff is educated regarding the policies, procedures, objectives, and rationale for therapeutic interchange.The policies should include provisions for disclosure of therapeutic interchange practices to patients as appropriate to the setting in which therapeutic interchange will occur.• Guideline V: Therapeutic interchange policies should define a mechanism that permits exceptions to the policy and procedures when necessary and/or appropriate.

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