Practice guidelines and drug-usage evaluation.

Currently, there is a great deal of interest in the development of practice guidelines for medical care that will be more rigorous and clinically sound than what is available today. With the impetus of federal legislation mandating such an approach, it may continue to develop into a significant movement in the medical arena. Pharmacy managers should be aware of developments in this area, particularly as they relate to appropriateness of drug therapy and drug-utilization review. The result may eventually be an evolution from drug-utilization review programs to diagnosis-based, outcome-focused interdisciplinary systems for QA. Even with the development of practice guidelines as described, there will continue to be a need for competent pharmacy practitioners to ensure appropriate pharmaceutical care. With the increasing acuity of patients in the health care system and the rapid development of new drugs and technologies, the role of the institutional pharmacist in ensuring optimal patient care will be more important than ever.