To Err Is Human, the institute of medicine (IOM) pioneering report of 1999, mobilized efforts to correct medication errors. IOM`s estimate of 7,000 deaths per year due to preventable medication errors has fuelled federal and federal spending, accreditation agency requirements and BOP regulations that draw practitioners` attention to error prevention.13 BOPs recommends that practitioners check work procedures to address the causes of medication errors. While technology has been highlighted as the key to reducing waste expenditure estimated at $21 billion, due to avoidable medication errors, BOPs play a role in providing pharmacists with assurances about drug safety. Iowa, Maryland, New Mexico, New York, Oregon, Pennsylvania and the District of Columbia contain collection errors or safety requirements in their annual CE hours.1 More than 20 states have regulatory language requiring pharmacies to maintain a form of Quality Improvement Program (QIP) that in some cases is also known as Continuous Quality Improvement (CQI) to monitor and prevent errors. In 1999, Texas became the first state to pass legislation to create a peer review committee for QIPs in pharmacies.15 The Texas program remains voluntary, but the BOP has required pharmacies to implement a QIP to resolve drug error hearings. Naloxone contains another regulatory response to the opioid epidemic. On July 3, 2014, U.S. Attorney General Eric Holder issued a memorandum calling on federal law enforcement to identify, train and equip their employees with the tools they need to combat the opioid epidemic. Naloxone has been identified as an important instrument.11 These national efforts are reinforced by government legislation that allows individuals access to naloxone. According to the Public Health Network, 32 states and the District of Columbia have amended their laws to allow health care professionals to prescribe and distribute naloxone for opioid overdose emergencies; People can use naloxone for this purpose, without fear of legal effects. In addition, 24 states have extended the laws of the merciful Samaritan to people seeking help for an overdose victim.12 The National Association of Boards of Pharmacy (NABP) supports state efforts with their interconnected software that allows some participating states to exchange data. Interconnect ensures that government data access rules are imposed by its program.
The data is not stored by the NABP. NABP has a Memorandum of Understanding with 33 countries to use Interconnect. In 2014, NABP`s interconnect recorded 7 million requests for data.10 State PDMPs and Interconnect allow pharmacists to access data to ensure the validity of a pharmacy prescription. This article will focus on monitoring opioid use, preventing medication errors and advice/alerting issues to illustrate the new or emerging legal risks arising from the expansion of professional practice in the pharmaceutical sector. Historically, the courts have consistently held that the responsibility to warn patients of possible adverse side effects remains with the physician. Courts have often used the teaching of justice to exclude pharmacists from the duty to alert. In Happel/WalMart, the proceedings against a pharmacist who distributed toradol (ketorolac) to a patient allergic to aspirin were dismissed.19 On appeal, the Illinois Supreme Court found that the pharmacist had a specific knowledge of the potential danger and was therefore required to warn the physician or the patient of the potential danger.