12 key trends in hospital pharmacy from the annual ASHP survey

The American Society of Health-System Pharmacists has released its annual survey of pharmacy directors at nearly 5,000 hospitals across the country.

The investigation – which was conducted before the COVID-19 pandemic and released on June 23 – asked administrators questions about prescribing, opioid management, staffing and the use of mobile technology.

Twelve key trends in hospital pharmacy, according to the survey:

Forms management strategies:

  1. Thirty-one percent of hospitals reported drug rationing due to expected patient outcomes and cost of treatment, up from 25 percent in 2016.
  2. Seventy-three percent of hospitals have a limited strict formulary and strict restrictions on the use of off-formulary drugs, up from 63 percent in 2016.
  3. Eighty-nine percent of hospitals reported that pharmacists have the authority to write prescriptions for drugs. Of this group, 94 percent can modify or initiate therapy by policy or protocol and 6 percent are allowed to prescribe.


  1. Half of hospitals include pharmacogenomics in decision making on forms, up from a third in 2013.
  2. Of the hospitals surveyed, 5.4 percent reported recommending or planning pharmacogenomic testing to aid in the drug and dosage selection process, while 90 percent said pharmacist involvement was limited to product distribution. related to the management of drug pharmacotherapy.

Opioid management:

  1. Eighty-five percent of hospitals have opioid education programs or guidelines, up from 71.4 percent in 2018.
  2. Eighty-five percent of hospitals have a Prescription Drug Monitoring Program database, up from 65.3 percent in 2018.
  3. Sixty-one percent of hospitals are limiting the supply of home discharge opioid prescriptions, up from 46.3 percent in 2018.
  4. Sixty-five percent of hospitals indicated that pharmacists have leadership and accountability roles in their opioid management programs.

Hospital pharmacy staff:

  1. The number of full-time pharmacist positions continued to grow overall, with an average of 19.2 positions per 100 beds occupied.
  2. Pharmacists had a low vacancy rate, less than 3%, while the vacancy rate for pharmacy technicians was 6.5%.
  3. The majority of pharmacists use smartphones, tablets, or laptops in the delivery of patient care services, an increase that the survey authors say can be attributed in part to quasi-electronic health records. universal.

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